The risk of spreading multi-resistant bacteria is greatest in hospital sinks, a study said Thursday.
The findings are based on an outbreak of superbugs carbapenemase-producing Enterobacterales (CPE) that occurred in 2017 at a pediatric ward at Toho University Omori Medical Center in Tokyo.
In the paper, published in the American Journal of Infection Control (AJIC), the team describes that the first case of CPE was discovered in a one-year-old boy who was hospitalized with heart disease in June 2016.
Nine months later, in March 2017, a 15-year-old boy became the second to be infected with the deadly superbug.
The outbreak subsequently spread to 19 pediatric patients.
Upon investigation, nine wells were found to be contaminated with CPE.
Of these, six came from hospital rooms with CPE-positive patients, and three from a nursing center, waste room, and ice machine.
Genomic analysis identified bacterial strains such as “Klebsiella variicola, Klebsiella quasipneumoniae and Escherichia coli.”
Importantly, CPE contamination persisted even after the team replaced all sinks in the pediatric ward with new ones that had been thoroughly disinfected with hydrogen peroxide.
Furthermore, DNA sequences showed that the resistance mechanism could have been transferred from one bacterial species to another within the hospital, the team said.
“The discovery of the same bacterial species in sinks in adjacent rooms indicates that the transmission of pathogens is possible from one sink to another through the drains and connected pipes,” the team said.
Preventive measures include recommending hand disinfection after using sinks, introducing disposable utensils for cleaning sinks, banning mouthwashes with sink water, introducing disinfection and drying procedures for all objects exposed to sink water, and more.
The outbreak was finally brought under control in October 2017.
“After months of intensive infection control protocols, we were finally able to put an end to this outbreak,” said Sadako Yoshizawa, associate professor in the Department of Microbiology and Infectious Diseases at Toho University.
“Our experience underlines the importance of focusing on wells and other water-related areas in hospital wards, as these are critical to the transmission of CPE and are therefore important fronts in the fight against antibiotic resistance,” Yoshizawa added.
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