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What grows in the sink splash zone.

Mark I Garvey1, Robert A Moran2, Martyn A C Wilkinson3

  • 1Institute of Microbiology and Infection, College of Medicine and Health, University of Birmingham, Edgbaston, Birmingham, UK; University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK.

The Journal of Hospital Infection
|May 4, 2026
PubMed
Summary
This summary is machine-generated.

Hospital sink splash zones can harbor dangerous Gram-negative bacteria and carbapenemase-producing Enterobacterales (CPE). Environmental sampling confirmed these pathogens can spread via water splash, posing a risk in healthcare settings.

Keywords:
Critical careHealthcare-associated infectionsSplash zoneWaterWater outletsWater transmission

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Area of Science:

  • Microbiology
  • Environmental Health
  • Infectious Disease Control

Background:

  • Hospital sink drains are reservoirs for opportunistic pathogens and antimicrobial resistance genes.
  • Water outlets and sink drains pose a risk of patient exposure to waterborne pathogens.
  • Previous studies demonstrated water splashing up to two meters from clinical hand wash basins.

Purpose of the Study:

  • To identify microorganisms present in the environmental splash zone of a clinical hand wash basin.
  • To assess the potential for waterborne pathogen transmission from sink drains.

Main Methods:

  • Environmental sampling was conducted in the splash zone of a clinical hand wash basin at Queen Elizabeth Hospital Birmingham.
  • An air sampler was used to collect samples with and without the tap running.
  • Gram-negative organisms were cultured, and carbapenemase-producing Enterobacterales (CPE) were sequenced.

Main Results:

  • Sampling with the tap running yielded Gram-negative bacteria, including Citrobacter freundii, Enterobacter species, Pseudomonas aeruginosa, and Sphingobacterium multivorum.
  • One carbapenemase-producing Enterobacterales (CPE) isolate, Citrobacter freundii QE-SINK-CF1, carrying the blaKPC-2 gene, was identified.
  • No Gram-negative organisms were recovered during control sampling with the tap off.

Conclusions:

  • A variety of Gram-negative microorganisms, including CPE, can be cultured from the 2-meter sink splash zone.
  • Healthcare settings must consider sink splash zones and the risk of waterborne pathogen transmission.
  • Findings underscore the importance of infection control measures targeting water systems in hospitals.