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Withey Z, Gweon HS. Longitudinal bacterial community dynamics and sodium hypochlorite intervention in a newly built university building. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 950:175349. [PMID: 39122041 DOI: 10.1016/j.scitotenv.2024.175349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 07/05/2024] [Accepted: 08/05/2024] [Indexed: 08/12/2024]
Abstract
Urbanisation and building advancements have increased microbial growth in indoor environments, altering human interactions with these microorganisms. Restrooms and their sinks harbour diverse bacterial communities, that differ from those found in natural environments, that could have negative implications for human health. Over two and a half years, this study examined the diversity, temporal dynamics, and resilience of bacterial communities in restroom sink P-traps in a newly built university building. Structured into two phases, the first phase consisted of continuous monitoring of bacterial community dynamics for two years (n = 352), while the second phase involved an intervention with sodium hypochlorite (bleach) and subsequent sampling (n = 132). In the first phase, we show that sink communities converge, becoming more compositionally similar to other sinks within the building. Bacterial families such as Rhodocyclaceae and Flavobacteriaceae dominated across the sinks, and others such as Comamonadaceae, Moraxellaceae and Enterbacteriaceae were highly prevalent. When comparing bacterial structure and composition to other sinks located on the university campus, the mean bacterial dissimilarity decreased over time, indicating compositional similarity, particularly with the newer buildings on campus. The second phase demonstrated resilience by the bacterial sink communities. Following bleach treatments, a distinct increase in Acinetobacter was observed. However, by the fourth week after bleach invention, bacterial communities had re-established to levels observed prior to treatment. This study had the unique opportunity to sample a newly built building before occupancy and for the subsequent two and a half years. The findings provide crucial insights into the development and resilience of sink P-trap bacterial communities in restrooms, laying the groundwork for more targeted approaches to disinfection strategies.
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Affiliation(s)
- Zoe Withey
- School of Biological Sciences, University of Reading, Reading, UK
| | - Hyun S Gweon
- School of Biological Sciences, University of Reading, Reading, UK; UK Centre for Ecology & Hydrology, Wallingford, Oxfordshire OX10 8BB, UK.
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Bourdin T, Benoit MÈ, Prévost M, Charron D, Quach C, Déziel E, Constant P, Bédard E. Disinfection of sink drains to reduce a source of three opportunistic pathogens, during Serratia marcescens clusters in a neonatal intensive care unit. PLoS One 2024; 19:e0304378. [PMID: 38865328 PMCID: PMC11168660 DOI: 10.1371/journal.pone.0304378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/10/2024] [Indexed: 06/14/2024] Open
Abstract
OBJECTIVE Evaluate the effects of five disinfection methods on bacterial concentrations in hospital sink drains, focusing on three opportunistic pathogens (OPs): Serratia marcescens, Pseudomonas aeruginosa and Stenotrophomonas maltophilia. DESIGN Over two years, three sampling campaigns were conducted in a neonatal intensive care unit (NICU). Samples from 19 sink drains were taken at three time points: before, during, and after disinfection. Bacterial concentration was measured using culture-based and flow cytometry methods. High-throughput short sequence typing was performed to identify the three OPs and assess S. marcescens persistence after disinfection at the genotypic level. SETTING This study was conducted in a pediatric hospitals NICU in Montréal, Canada, which is divided in an intensive and intermediate care side, with individual rooms equipped with a sink. INTERVENTIONS Five treatments were compared: self-disinfecting drains, chlorine disinfection, boiling water disinfection, hot tap water flushing, and steam disinfection. RESULTS This study highlights significant differences in the effectiveness of disinfection methods. Chlorine treatment proved ineffective in reducing bacterial concentration, including the three OPs. In contrast, all other drain interventions resulted in an immediate reduction in culturable bacteria (4-8 log) and intact cells (2-3 log). Thermal methods, particularly boiling water and steam treatments, exhibited superior effectiveness in reducing bacterial loads, including OPs. However, in drains with well-established bacterial biofilms, clonal strains of S. marcescens recolonized the drains after heat treatments. CONCLUSIONS Our study supports thermal disinfection (>80°C) for pathogen reduction in drains but highlights the need for additional trials and the implementation of specific measures to limit biofilm formation.
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Affiliation(s)
| | | | | | | | - Caroline Quach
- CHU Sainte-Justine, Université de Montréal, Montréal, QC, Canada
| | - Eric Déziel
- INRS-Armand-Frappier Santé Biotechnologie, Laval, QC, Canada
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Shikama Y, Yokoya C, Ohara A, Yamashita M, Shimizu Y, Imagawa T. Carbapenemase-producing Enterobacterales isolated from hospital sinks: molecular relationships with isolates from patients and the change in contamination status after daily disinfection with sodium hypochlorite. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2024; 4:e98. [PMID: 38836042 PMCID: PMC11149038 DOI: 10.1017/ash.2024.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 06/06/2024]
Abstract
Objective This study aimed to investigate the contamination status of hospital sinks with carbapenemase-producing Enterobacterales (CPE), the efficacy of daily cleaning with sodium hypochlorite, and the relationships between CPEs isolated from contaminated sinks and patients. Design Pre/postintervention surveys of the CPE-contaminated sinks. Setting Hospital wards including pediatric intensive care unit in a children's hospital. Participants Consenting CPE-colonized patients admitted between November 2018 and June 2021 in our hospital. Methods Environmental culture of 180 sinks from nine wards in our hospital was performed three times with an interval of 2 years (2019, 2021, 2023). Molecular typing of the isolated strains from the sinks and patients was performed. After the first surveillance culture, we initiated daily disinfection of the sinks using sodium hypochlorite. Results Before the intervention, we detected 30 CPE-positive sinks in 2019. After the intervention with sodium hypochlorite, we observed a substantial decline in the number of sinks contaminated with CPE; 13 in 2021 and 6 in 2023. However, the intervention did not significantly reduce the number of CPE-contaminated sinks used for the disposal of nutrition-rich substances. The CPE isolates from the patients and those from the sinks of the wards or floors where they were admitted tended to have similar pulse-field gel electrophoresis patterns. Conclusion Contaminated sinks could be reservoirs of disseminating CPE to the patients. Daily disinfection of sinks with sodium hypochlorite may be effective in eliminating CPE, although the effect could be weaker in sinks with a greater risk of contact with nutrition-rich substances.
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Affiliation(s)
- Yoshiaki Shikama
- Infection Control and Prevention Service, Kanagawa Children's Medical Center, Yokohama, Japan
- Department of Infectious Disease and Immunology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Chiemi Yokoya
- Infection Control and Prevention Service, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Akira Ohara
- Infection Control and Prevention Service, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Megumi Yamashita
- Infection Control and Prevention Service, Kanagawa Children's Medical Center, Yokohama, Japan
- Department of Clinical Laboratory, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yuichi Shimizu
- Infection Control and Prevention Service, Kanagawa Children's Medical Center, Yokohama, Japan
- Department of Pharmacy, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Tomoyuki Imagawa
- Infection Control and Prevention Service, Kanagawa Children's Medical Center, Yokohama, Japan
- Department of Infectious Disease and Immunology, Kanagawa Children's Medical Center, Yokohama, Japan
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Regev-Yochay G, Margalit I, Smollan G, Rapaport R, Tal I, Hanage WP, Pinas Zade N, Jaber H, Taylor BP, Che Y, Rahav G, Zimlichman E, Keller N. Sink-traps are a major source for carbapenemase-producing Enterobacteriaceae transmission. Infect Control Hosp Epidemiol 2024; 45:284-291. [PMID: 38149351 DOI: 10.1017/ice.2023.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
OBJECTIVE We studied the extent of carbapenemase-producing Enterobacteriaceae (CPE) sink contamination and transmission to patients in a nonoutbreak setting. METHODS During 2017-2019, 592 patient-room sinks were sampled in 34 departments. Patient weekly rectal swab CPE surveillance was universally performed. Repeated sink sampling was conducted in 9 departments. Isolates from patients and sinks were characterized using pulsed-field gel electrophoresis (PFGE), and pairs of high resemblance were sequenced by Oxford Nanopore and Illumina. Hybrid assembly was used to fully assemble plasmids, which are shared between paired isolates. RESULTS In total, 144 (24%) of 592 CPE-contaminated sinks were detected in 25 of 34 departments. Repeated sampling (n = 7,123) revealed that 52%-100% were contaminated at least once during the sampling period. Persistent contamination for >1 year by a dominant strain was common. During the study period, 318 patients acquired CPE. The most common species were Klebsiella pneumoniae, Escherichia coli, and Enterobacter spp. In 127 (40%) patients, a contaminated sink was the suspected source of CPE acquisition. For 20 cases with an identical sink-patient strain, temporal relation suggested sink-to-patient transmission. Hybrid assembly of specific sink-patient isolates revealed that shared plasmids were structurally identical, and SNP differences between shared pairs, along with signatures for potential recombination events, suggests recent sharing of the plasmids. CONCLUSIONS CPE-contaminated sinks are an important source of transmission to patients. Although traditionally person-to-person transmission has been considered the main route of CPE transmission, these data suggest a change in paradigm that may influence strategies of preventing CPE dissemination.
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Affiliation(s)
- Gili Regev-Yochay
- Infection Prevention & Control Unit, Sheba Medical Center, Ramat Gan, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ili Margalit
- Infection Prevention & Control Unit, Sheba Medical Center, Ramat Gan, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Gillian Smollan
- Microbiology laboratory, Sheba Medical Center, Ramat-Gan, Israel
| | - Rotem Rapaport
- Infection Prevention & Control Unit, Sheba Medical Center, Ramat Gan, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ilana Tal
- Infection Prevention & Control Unit, Sheba Medical Center, Ramat Gan, Israel
| | - William P Hanage
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Nani Pinas Zade
- Infection Prevention & Control Unit, Sheba Medical Center, Ramat Gan, Israel
| | - Hanaa Jaber
- Infection Prevention & Control Unit, Sheba Medical Center, Ramat Gan, Israel
| | - Bradford P Taylor
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - You Che
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Galia Rahav
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Infectious Disease Unit, Sheba Medical Center, Ramat-Gan, Israel
| | | | - Nati Keller
- Microbiology laboratory, Sheba Medical Center, Ramat-Gan, Israel
- Ariel University, Ari'el, Samaria
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Fucini GB, Hackmann C, Gastmeier P. Sink interventions in the ICU to reduce risk of infection or colonization with Gram-negative pathogens: a systematic review of the literature. J Hosp Infect 2024; 143:82-90. [PMID: 38529781 DOI: 10.1016/j.jhin.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/04/2023] [Accepted: 10/15/2023] [Indexed: 03/27/2024]
Abstract
BACKGROUND Healthcare-associated infections (HAIs) are a major problem in intensive care units (ICUs). The hospital water environment is a potential reservoir for Gram-negative bacteria (GNB), and it has been shown that contaminated sinks contribute to the spread of GNB in outbreak and non-outbreak settings. This study aimed to investigate which sink interventions may reduce GNB infection and colonization rates in the ICU. METHODS A database search (MEDLINE via PubMed, EMBASE via Ovid and ClinicalTrials.gov) was undertaken without restrictions on language or date of publication. Studies of any design were included if they described an intervention on the water fixtures in patient rooms, and presented data about HAI or colonization rates in non-outbreak settings. Acquisition (infection and/or colonization) rates of GNB and Pseudomonas aeruginosa were analysed as outcomes. RESULTS In total, 4404 records were identified. Eleven articles were included in the final analysis. No randomized controlled trials were included in the analysis, and all studies were reported to have moderate to serious risk of bias. Removing sinks and applying filters on taps had a significant impact on GNB acquisition, but there was high heterogeneity among reported outcomes and sample size among the studies. CONCLUSION Few studies have investigated the association of sinks in patient rooms with healthcare-associated acquisition of GNB in non-outbreak settings. Heterogeneity in study design made it impossible to generalize the results. Prospective trials are needed to further investigate whether removing sinks from patient rooms can reduce the endemic rate of HAIs in the ICU.
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Affiliation(s)
- G-B Fucini
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany; National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany.
| | - C Hackmann
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany; National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany
| | - P Gastmeier
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany; National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany
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Donskey CJ. Update on potential interventions to reduce the risk for transmission of health care-associated pathogens from floors and sinks. Am J Infect Control 2023; 51:A120-A125. [PMID: 37890941 DOI: 10.1016/j.ajic.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 10/29/2023]
Abstract
Health care facility floors and sink drains and other wastewater drainage sites are universally contaminated with potential pathogens and there are plausible mechanisms by which organisms can be disseminated from these sites. However, floors and sink drains are not addressed as potential sources of pathogen transmission in most health care facilities. One factor that has hindered progress in addressing floors and sinks has been the lack of practical and effective measures to reduce the risk for dissemination of organisms from these sites. This article provides an update on some of the potential interventions being used to reduce the risk for transmission of health care-associated pathogens from floors and sinks. Practical approaches to address these sites of contamination are emphasized.
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Affiliation(s)
- Curtis J Donskey
- Geriatric Research, Education and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH; Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH.
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Rutala WA, Boyce JM, Weber DJ. Disinfection, sterilization and antisepsis: An overview. Am J Infect Control 2023; 51:A3-A12. [PMID: 37890951 DOI: 10.1016/j.ajic.2023.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Each year in the United States there are approximately 100,000,000 outpatient/inpatient surgical procedures. Each of these procedures involves contact by a medical device or surgical instrument with a patient's sterile tissue and/or mucous membrane. A major risk of all such procedures is the introduction of infection. METHODS We searched published literature for articles on the use and effectiveness of disinfectants, sterilization methods and antiseptics. RESULTS The level of disinfection is dependent on the intended use of the object: critical (items that contact sterile tissue such as surgical instruments), semicritical (items that contact mucous membrane such as endoscopes), and noncritical (devices that contact only intact skin such as stethoscopes) items require sterilization, high-level disinfection and low-level disinfection, respectively. Cleaning must always precede high-level disinfection and sterilization. Antiseptics are essential to infection prevention as part of a hand hygiene program as well as other uses such as surgical hand antisepsis and pre-operative patient skin preparation. CONCLUSIONS When properly used, disinfection and sterilization can ensure the safe use of invasive and non-invasive medical devices. Cleaning should always precede high-level disinfection and sterilization. Strict adherence to current disinfection and sterilization guidelines is essential to prevent patient infections and exposures to infectious agents.
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Affiliation(s)
- William A Rutala
- Statewide Program for Infection Control and Epidemiology, UNC School of Medicine, Chapel Hill, NC; Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC.
| | - John M Boyce
- J.M. Boyce Consulting, Boyce Consulting, LLC, Middletown, CT
| | - David J Weber
- Statewide Program for Infection Control and Epidemiology, UNC School of Medicine, Chapel Hill, NC; Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC; Infection Prevention, University of North Carolina Medical Center, Chapel Hill, NC
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Maillard JY, Centeleghe I. How biofilm changes our understanding of cleaning and disinfection. Antimicrob Resist Infect Control 2023; 12:95. [PMID: 37679831 PMCID: PMC10483709 DOI: 10.1186/s13756-023-01290-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/15/2023] [Indexed: 09/09/2023] Open
Abstract
Biofilms are ubiquitous in healthcare settings. By nature, biofilms are less susceptible to antimicrobials and are associated with healthcare-associated infections (HAI). Resistance of biofilm to antimicrobials is multifactorial with the presence of a matrix composed of extracellular polymeric substances and eDNA, being a major contributing factor. The usual multispecies composition of environmental biofilms can also impact on antimicrobial efficacy. In healthcare settings, two main types of biofilms are present: hydrated biofilms, for example, in drains and parts of some medical devices and equipment, and environmental dry biofilms (DSB) on surfaces and possibly in medical devices. Biofilms act as a reservoir for pathogens including multi-drug resistant organisms and their elimination requires different approaches. The control of hydrated (drain) biofilms should be informed by a reduction or elimination of microbial bioburden together with measuring biofilm regrowth time. The control of DSB should be measured by a combination of a reduction or elimination in microbial bioburden on surfaces together with a decrease in bacterial transfer post-intervention. Failure to control biofilms increases the risk for HAI, but biofilms are not solely responsible for disinfection failure or shortcoming. The limited number of standardised biofilm efficacy tests is a hindrance for end users and manufacturers, whilst in Europe there are no approved standard protocols. Education of stakeholders about biofilms and ad hoc efficacy tests, often academic in nature, is thus paramount, to achieve a better control of biofilms in healthcare settings.
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Affiliation(s)
- Jean-Yves Maillard
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Redwood Building, King Edward VII Avenue, Cardiff, CF10 3NB, Wales, UK.
| | - Isabella Centeleghe
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Redwood Building, King Edward VII Avenue, Cardiff, CF10 3NB, Wales, UK
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Ledwoch K, Robertson A, Lauran J, Norville P, Maillard JY. It's a trap! The development of a versatile drain biofilm model and its susceptibility to disinfection. J Hosp Infect 2020; 106:757-764. [PMID: 32828863 DOI: 10.1016/j.jhin.2020.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/10/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Pathogens in drain biofilms pose a significant risk for hospital-acquired infection. However, the evidence of product effectiveness in controlling drain biofilm and pathogen dissemination are scarce. A novel in-vitro biofilm model was developed to address the need for a robust, reproduceable and simple testing methodology for disinfection efficacy against a complex drain biofilm. METHODS Identical complex drain biofilms were established simultaneously over 8 days, mimicking a sink trap. Reproducibility of their composition was confirmed by next-generation sequencing. The efficacy of sodium hypochlorite 1000 ppm (NaOCl), sodium dichloroisocyanurate 1000 ppm (NaDCC), non-ionic surfactant (NIS) and peracetic acid 4000 ppm (PAA) was explored, simulating normal sink usage conditions. Bacterial viability and recovery following a series of 15-min treatments were measured in three distinct parts of the drain. RESULTS The drain biofilm consisted of 119 mixed species of Gram-positive and -negative bacteria. NaOCl produced a >4 log10 reduction in viability in the drain front section alone, while PAA achieved a >4 log10 reduction in viability in all of the drain sections following three 15-min doses and prevented biofilm regrowth for >4 days. NIS and NaDCC failed to control the biofilm in any drain sections. CONCLUSIONS Drains are one source of microbial pathogens in healthcare settings. Microbial biofilms are notoriously difficult to eradicate with conventional chemical biocidal products. The development of this reproducible in-vitro drain biofilm model enabled understanding of the impact of biocidal products on biofilm spatial composition and viability in different parts of the drain.
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Affiliation(s)
- K Ledwoch
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - A Robertson
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - J Lauran
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | | | - J-Y Maillard
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK.
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Abstract
Previously, we showed that disinfection of sink drains is effective at decreasing bacterial loads. Here, we report our evaluation of the ideal frequency of sink-drain disinfection and our comparison of 2 different hydrogen peroxide disinfectants.
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Effectiveness of foam disinfectants in reducing sink-drain gram-negative bacterial colonization. Infect Control Hosp Epidemiol 2019; 41:280-285. [PMID: 31801646 DOI: 10.1017/ice.2019.325] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Sink drainage systems are not amenable to standard methods of cleaning and disinfection. Disinfectants applied as a foam might enhance efficacy of drain decontamination due to greater persistence and increased penetration into sites harboring microorganisms. OBJECTIVE To examine the efficacy and persistence of foam-based products in reducing sink drain colonization with gram-negative bacilli. METHODS During a 5-month period, different methods for sink drain disinfection in patient rooms were evaluated in a hospital and its affiliated long-term care facility. We compared the efficacy of a single treatment with 4 different foam products in reducing the burden of gram-negative bacilli in the sink drain to a depth of 2.4 cm (1 inch) below the strainer. For the most effective product, the effectiveness of foam versus liquid-pouring applications, and the effectiveness of repeated foam treatments were evaluated. RESULTS A foam product containing 3.13% hydrogen peroxide and 0.05% peracetic acid was significantly more effective than the other 3 foam products. In comparison to pouring the hydrogen peroxide and peracetic acid disinfectant, the foam application resulted in significantly reduced recovery of gram-negative bacilli on days 1, 2, and 3 after treatment with a return to baseline by day 7. With repeated treatments every 3 days, a progressive decrease in the bacterial load recovered from sink drains was achieved. CONCLUSIONS An easy-to-use foaming application of a hydrogen peroxide- and peracetic acid-based disinfectant suppressed sink-drain colonization for at least 3 days. Intermittent application of the foaming disinfectant could potentially reduce the risk for dissemination of pathogens from sink drains.
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Jones LD, Mana TS, Cadnum JL, Jencson AL, Alhmidi H, Silva SY, Wilson BM, Donskey CJ. Instillation of disinfectant behind a temporary obstruction created by an inflated urinary catheter balloon improves sink drain disinfection. Am J Infect Control 2019; 47:1522-1524. [PMID: 31402067 DOI: 10.1016/j.ajic.2019.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 07/12/2019] [Indexed: 10/26/2022]
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