Antibiotic resistant bacteria risk from hospital sinks

The Department of Health has issued an alert warning that hospital wash basins have been identified as a source of gram negative bacteria.

The DH has written to directors of nursing and other senior trust managers saying it is aware of reports “emanating from English NHS trusts” and from Wales concerning infection outbreaks stemming from hospital handwash basins.

Abertawe Bro Morgannwg University Health Board confirmed on Monday that three taps in Morriston Hospital, Swansea had tested positive for the bug. In a statement a spokeswoman said only a small number of patients could have been affected and it was contacting them and their families. The hospital had also checked all taps of the same model and tests had come back negative.

The pathogen concerned is an antibiotic resistant organism known as a pseudomonas, which have been found in high dependency wards such as neonatal critical care centres, renal and burns units.

A letter published by the DH on Friday, signed by the department’s director of health protection Clara Swinson and the director of estates and facilities Rob Smith stated that in the cases known to the DH: “Hand washing facilities have been identified as the source.”

The letter continued: “It is important for all NHS trusts and their infection control teams to assess the risk to their patients and where appropriate establish if the water used in hand washing has an unacceptable bacterial count.”

The letter also suggested the sink taps could have been colonised after sinks were used for purposes other than hand washing, such as disposing of bodily fluids.

The DH is investigating the issue and has advised hospital trusts to immediately ensure hand wash sinks are only used for that purposes and never for the disposal of body fluids.

It adds that sinks should be cleaned in a manner that “minimises the contamination of the faucet from organisms in the sink trap (via plug hole or overflow)”.

The DH advises hospitals may need to introduce extra precautions onto high dependency wards, including using filters on sink taps to protect vulnerable patients.

Infection Prevention Society vice president Tracey Cooper told Nursing Times the bacteria in question was not common in hospitals.

She said: “I’m not familiar with the background to this alert but in the past there have been issues with the humidity traps in [hospital] ventilation systems. These can become contaminated with respiratory agents and colonise a sink if emptied down it. Then there’s the risk of splash-back.

“Every clinical area would have a sluice and procedures in place for the disposal of bodily fluids,” she said.

According to the Health Protection Agency the organisms are “relatively insusceptible to antiseptics, disinfectants and antibiotics”.

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