Korean J healthc assoc Infect Control Prev 2024; 29(2): 103-109
Published online December 31, 2024 https://doi.org/10.14192/kjicp.2024.29.2.103
Copyright © Korean Society for Healthcare-associated infection Control and Prevention
Office for Infection Control, Asan Medical Center1, Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine2, Seoul, Korea
Correspondence to: Jiwon Jung
E-mail: jiwonjung@amc.seoul.kr
ORCID: https://orcid.org/0000-0003-4333-3270
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0).
The hospital water environment serves as a reservoir for Gram-negative multidrug-resistant organisms. Drains, sinks, drink dispensers, toilets, and shower equipment were identified as sources of the outbreak. Plumbing systems with variable nutrient and microbial loads promote bacterial colonization and biofilm formation. Plumbing traps (P-traps) in sinks are the primary source of sink-related outbreaks. Pathogens are introduced into P-traps through handwashing and disposal of waste or nutrients. Some pathogens can survive and develop biofilms in P-traps. When nutrients are introduced, the biofilm can extend upwards, reaching the sink strainer. During faucet operation, aerosols and drain contents are dispersed into the surrounding environment. Guidelines for handwash basin design generally recommend that large basins contain splashes and taps that are not aligned directly over the drains to minimize aerosol generation. Ensuring that basins are not used for the disposal of patient-related waste or nutrients and prohibiting the storage of clean patient material near the sink is important. Daily cleaning and disinfection of sink surfaces with bleach (sodium hypochlorite) are essential. Additionally, self-disinfecting traps that use heat, vibration, or ultraviolet radiation have been reported to reduce microbial burden and prevent further biofilm formation. Eradicating sink and drain contamination is often difficult and outbreaks can recur. Even after the replacement of the sink, the sink component had only temporary effects, suggesting a persistent reservoir in the retained sink fit. Further research is needed to develop continuous and effective disinfection methods for sinks and drains.
Keywords: Infection control, Sink, Biofilm, Transmission, Outbreak
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