Environmental hygiene intervention burden in hospital sinks: a prospective study

The effects of a prospective sink environmental hygiene intervention on Pseudomonas aeruginosa and Stenotrophomonas maltophilia burden in hospital sinks

Jennie Kwon, DO, MSCI, Associate Professor of Medicine at WashU Medicine’s Division of Infectious Diseases, co-published research in eBioMedicine about the burden of hygiene in hospital sinks. Co-principal investigators are; Gautam Dantas, PhD, Conan Professor of Laboratory and Genomic Medicine, and Carey-Ann Burnham, PhD, D(ABMM), FIDSA, F(AAM), Professor of Pathology and Immunology, WashU Medicine Department of Pathology and Immunology.

A healthcare associated infection (HAI) can be caused by opportunistic premise plumbing pathogens (OPPPs). There is currently no widely accepted protocol for sink drain cleaning to reduce OPPP burden.

Pathogens can establish reservoirs in hospital plumbing and cause healthcare associated infections (HAIs). This study tested a sink cleaning protocol to determine whether it reduced the burden of pathogens in sinks located in the intensive care unit at Barnes-Jewish Hospital. 

The two-step sink cleaning protocol included first wiping sink surfaces with 10% bleach wipes and then pumping a foamed preacid disinfectant into sink drains. They tested the intervention at two frequencies of implementation: once per week (low frequency) and five times per week (high frequency).

Swab specimens were collected from sink drains and sink surfaces before, during, and after the periods during which the sink cleaning protocol was implemented to assess its impact on the burden of pathogens, particularly antibiotic-resistant organisms. The intervention reduced the proportion of sink drains that yielded Gram-negative bacteria by up to 85% in the high frequency rooms. It also significantly reduced the burden of  Pseudomonas and Stenotrophomonas species in sink drains when applied at both frequencies. However, after the sink cleaning protocol was stopped, sinks became re-colonized with P. aeruginosa and S. maltophilia.

This environmental hygiene intervention may be effective in reducing the burden of OPPPs in hospital sinks.

Funding

Agency for Healthcare Research and Quality (R01HS027621), National Institute of Allergy and Infectious Diseases (U01AI123394, 1K23AI137321), Barnes-Jewish Hospital Foundation (5102), Washington University Institute of Clinical and Translational Sciences (4462) from the National Center for Advancing Translational Sciences (UL1TR002345).