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A prospective multicentre surveillance study to investigate the risk associated with contaminated sinks in the
Anne-Sophie Valentin1, Sandra Dos Santos1, Florent Goube1
1Mission Nationale SPIADI, Centre d'Appui pour la Prévention des Infections Associées aux Soins en Région Centre Val de Loire, Centre Hospitalier Universitaire, Tours, France.
Objectives:
The aim was to assess the incidence of sink contamination by multidrug-resistant (MDR) Pseudomonas aeruginosa and Enterobacteriaceae, risk factors for sink contamination and splashing, and their association with clinical infections in the intensive care setting.
Methods:
A prospective French multicentre study (1 January to 30 May 2020) including in each intensive care unit (ICU) a point-prevalence study of sink contamination, a questionnaire of risk factors for sink contamination (sink use, disinfection procedure) and splashing (visible plashes, distance and barrier between sink and bed), and a 3-month prospective infection survey.
Results:
Seventy-three ICUs participated in the study. In total, 50.9% (606/1191) of the sinks were contaminated by MDR bacteria: 41.0% (110/268) of the sinks used only for handwashing, 55.3% (510/923) of those used for waste disposal, 23.0% (62/269) of sinks daily bleached, 59.1% (126/213) of those daily exposed to quaternary ammonium compounds (QACs) and 62.0% (285/460) of those untreated; 459 sinks (38.5%) showed visible splashes and 30.5% (363/1191) were close to the bed (<2 m) with no barrier around the sink. MDR-associated bloodstream infection incidence rates ≥0.70/1000 patient days were associated with ICUs meeting three or four of these conditions, i.e. a sink contamination rate ≥51%, prevalence of sinks with visible splashes ≥14%, prevalence of sinks close to the patient's bed ≥21% and no daily bleach disinfection (6/30 (20.0%) of the ICUs with none, one or two factors vs. 14/28 (50.0%) of the ICUs with three or four factors; p 0.016).
Discussion:
Our data showed frequent and multifactorial infectious risks associated with contaminated sinks in ICUs.
Insights
Contaminated sinks in intensive care units (ICUs) frequently harbor multidrug-resistant (MDR) bacteria, increasing infection risks. Factors like waste disposal use and proximity to beds elevate contamination and splashing, contributing to MDR infections in ICUs.
Area of Science:
- Infection Control
- Microbiology
- Public Health
Background:
- Intensive care units (ICUs) are critical settings for managing severe infections.
- Multidrug-resistant (MDR) bacteria pose a significant threat in healthcare environments.
- Sink contamination is a potential, yet often overlooked, source of healthcare-associated infections.
Purpose of the Study:
- To determine the incidence of sink contamination by MDR bacteria in French ICUs.
- To identify risk factors associated with sink contamination and splashing.
- To investigate the link between contaminated sinks and clinical infections in the ICU setting.
Main Methods:
- A prospective, multicenter study conducted in French ICUs.
- Point-prevalence study of sink contamination and a questionnaire on risk factors.
- Three-month prospective survey of clinical infections.
Main Results:
- Over 50% of ICU sinks were contaminated with MDR bacteria.
- Sinks used for waste disposal and those not regularly disinfected showed higher contamination rates.
- Sink contamination, splashing, and proximity to patient beds were associated with increased MDR bloodstream infection rates.
Conclusions:
- ICU sinks are a frequent reservoir for MDR bacteria.
- Multiple factors contribute to sink contamination and splashing, posing significant infectious risks.
- Addressing sink hygiene is crucial for reducing healthcare-associated infections in ICUs.
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