Assessing the impact of handwashing soaps on the population dynamics of carbapenemase-producing and non-carbapenemase-producing Enterobacterales

Nutritional drinks and enteral feeds promote the growth of carbapenemase-producing Enterobacterales in conditions that simulate disposal in hospital sinks

BACKGROUND

Studies have shown that nutritional products are discarded via handwash sinks by healthcare workers, and this practice may promote bacterial growth, including growth of pathogens such as carbapenemase-producing Enterobacterales (CPE). Outbreaks and acquisition of CPE in nosocomial settings are associated with negative outcomes for patients and hospitals.

OBJECTIVES

To investigate the potential growth-promoting effect of nutritional support drinks (NSDs) and enteral tube-feed products (ETFPs) on CPE.

METHODS

Six different CPE strains were grown in five different diluted NSDs, five different diluted ETFPs, Mueller-Hinton broth (MHB) and M9 minimal salts media to simulate discarding a small volume of nutritional product in a u-bend, already containing liquid. CPE were enumerated at 0 h, 6 h and 24 h, and compared using two-way analysis of variance and Dunett test, with confidence levels at 95%. Spearman's r was used to measure the strength of correlation between component concentrations in nutritional products and CPE growth.

RESULTS

All NSDs and ETFPs promoted CPE growth that exceeded both M9 (negative growth control) and MHB (positive growth control). In several cases, growth in NSDs/ETFPs was significantly greater compared with growth in MHB.

CONCLUSION

Nutritional products support CPE growth under in-vitro conditions. The propensity of CPE to survive in drain pipework suggests that inappropriate product disposal may further nourish established CPE in these environmental reservoirs. The growth observed in diluted NSDs and ETFPs shows that modifiable practices should be optimized to mitigate the potential risk of CPE transmission from these reservoirs.

Anthropogenic chemicals and their impacts on microbes living in buildings

Humans spend the vast majority of their time indoors where complex interactions occur among indoor anthropogenic chemicals, indoor microbiomes and human occupants. This paper summarizes previous work addressing interactions between anthropogenic chemicals associated with indoor household products and building materials, and microorganisms found within the built environment. Water availability seems to determine the extent to which microbes are impacted by anthropogenic chemicals, since desiccation remains one of the primary stressors regulating microbial viability indoors. Several lines of evidence suggest that both fungi and bacteria are capable of transforming biodegradable ingredients originating from various products used indoors when water is present. Previous research also establishes positive and significant correlations between anthropogenic chemicals that are antimicrobial and antibiotic resistance gene abundance. As researchers move towards understanding complex indoor environments as well as the role of anthropogenic chemicals in shaping microbiomes, in situ activities associated with the viable indoor microbial population merit more attention.