A prospective multicenter surveillance study to investigate the risk associated with contaminated sinks in the intensive care unit

Clin Microbiol Infect. 2021 Feb 25:S1198-743X(21)00100-2. doi: 10.1016/j.cmi.2021.02.018. Online ahead of print.


OBJECTIVES: 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 multicenter study (1 January-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: 73 ICUs participated in the study; 50.9% (606/1,191) 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% (363/1,191) were close to the bed (<2m) with no barrier around the sink. MDR-associated bloodstream infection incidence rates >0.70/1,000 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).

CONCLUSIONS: Our data showed frequent and multifactorial infectious risks associated with contaminated sinks in ICUs.

PMID:33640576 | DOI:10.1016/j.cmi.2021.02.018