E de Jonge1, M G J de Boer2, E H R van Essen3, H C M Dogterom-Ballering4, K E Veldkamp4. 1. Department of Intensive Care, Leiden University Medical Centre, Leiden, the Netherlands. Electronic address: e.dejonge@lumc.nl. 2. Department of Infectious Diseases, Leiden University Medical Centre, Leiden, the Netherlands. 3. Department of Intensive Care, Leiden University Medical Centre, Leiden, the Netherlands. 4. Department of Medical Microbiology, Leiden University Medical Centre, Leiden, the Netherlands.
Abstract
BACKGROUND: Sink drains in intensive care units (ICUs) are frequently colonized with bacteria such as Pseudomonas aeruginosa. AIM: To study the influence of installing disinfecting devices on sink drains on colonization of sinks and patients in an ICU during a prolonged outbreak of multidrug-resistant P. aeruginosa. METHODS: From 2010, there was a clonal outbreak of multidrug-resistant P. aeruginosa (MDR-PA). In April 2013, in ICU subunit A, the siphons draining these sinks were replaced by devices applying heat and electromechanical vibration to disinfect the draining fluid. In the other units, siphons were replaced by new polyvinyl chloride plastic siphons (control). In February 2016 the disinfecting devices were also placed at ICU subunit B. FINDINGS: Baseline colonization rate of sinks was 51% in ICU A and 46% in ICU B. In ICU A colonization decreased to 5% (P < 0.001) after the intervention whereas it was 62% in ICU B (control). After installing the disinfection devices in ICU B, colonization rate was 8.0 and 2.4% in ICU A and B, respectively (both P < 0.001 compared with baseline). Colonization in ICU patients decreased from 8.3 to 0 per 1000 admitted patients (P < 0.001) and from 2.7 to 0.5 per 1000 admitted patients (P = 0.1) in ICU A and B respectively. CONCLUSION: Colonization with MDR-PA in sink drains in an ICU was effectively managed by installing disinfection devices to the siphons of sinks. Colonization of patients was also significantly reduced, suggesting that sink drains can be a source of clinical outbreaks with P. aeruginosa and that disinfecting devices may help to interrupt these outbreaks.
BACKGROUND: Sink drains in intensive care units (ICUs) are frequently colonized with bacteria such as Pseudomonas aeruginosa. AIM: To study the influence of installing disinfecting devices on sink drains on colonization of sinks and patients in an ICU during a prolonged outbreak of multidrug-resistant P. aeruginosa. METHODS: From 2010, there was a clonal outbreak of multidrug-resistant P. aeruginosa (MDR-PA). In April 2013, in ICU subunit A, the siphons draining these sinks were replaced by devices applying heat and electromechanical vibration to disinfect the draining fluid. In the other units, siphons were replaced by new polyvinyl chloride plastic siphons (control). In February 2016 the disinfecting devices were also placed at ICU subunit B. FINDINGS: Baseline colonization rate of sinks was 51% in ICU A and 46% in ICU B. In ICU A colonization decreased to 5% (P < 0.001) after the intervention whereas it was 62% in ICU B (control). After installing the disinfection devices in ICU B, colonization rate was 8.0 and 2.4% in ICU A and B, respectively (both P < 0.001 compared with baseline). Colonization in ICU patients decreased from 8.3 to 0 per 1000 admitted patients (P < 0.001) and from 2.7 to 0.5 per 1000 admitted patients (P = 0.1) in ICU A and B respectively. CONCLUSION: Colonization with MDR-PA in sink drains in an ICU was effectively managed by installing disinfection devices to the siphons of sinks. Colonization of patients was also significantly reduced, suggesting that sink drains can be a source of clinical outbreaks with P. aeruginosa and that disinfecting devices may help to interrupt these outbreaks.
Authors: Cheryl Volling; Narges Ahangari; Jessica J Bartoszko; Brenda L Coleman; Felipe Garcia-Jeldes; Alainna J Jamal; Jennie Johnstone; Christopher Kandel; Philipp Kohler; Helena C Maltezou; Lorraine Maze Dit Mieusement; Nneka McKenzie; Dominik Mertz; Adam Monod; Salman Saeed; Barbara Shea; Rhonda L Stuart; Sera Thomas; Elizabeth Uleryk; Allison McGeer Journal: Open Forum Infect Dis Date: 2020-12-08 Impact factor: 3.835
Authors: W C van der Zwet; I E J Nijsen; C Jamin; L B van Alphen; C J H von Wintersdorff; A M P Demandt; P H M Savelkoul Journal: Infect Prev Pract Date: 2022-02-25