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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”.

The NHS has previous experience of the infection.  The paediatric intensive care unit at Glasgow’s Royal Hospital for Sick Children was closed for 48 hours after Pseudomonas bacteria were found in five children in September 2007.

An outbreak at Guy’s Hospital in London infected 19 patients in the urological surgery department in 2005, resulting in one death.


Readers' comments (4)

  • I may be old fashioned with only 5 years to retirement but I remember when wards were cleaned thoroughly and every member of staff 'dirtied' an area at risk of the wrath of the domestic staff... that was before contract cleaners and the cheapening/dumbing down of the role of cleaning.. I'm afraid it's not just the overuse of antibiotics that has got us in this mess.
    Any wound infection was barrier nursed and we managed with much more basic facilities than the modern wards have. But every nurse knew that hygiene was a huge part of caring for patients and we all worked together to maintain standards... otherwise the nursing officers would have let us know that we were lacking in our care! I don't want to turn the clocks back, not everything was perfect in the seventies when I trained, but I do think that basic skills (and hygiene being one of them) have somehow taken a back seat to the high tech nursing of a modern hospital ward!

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  • I have always avoided the use of sink as basin and taught others the same for infection control purposes.This made sense as I rationalised one has no control over bugs around the sink environment.I think it always pays to take such sensible initiative.I think every use of the above researh is worth considering

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  • isn't this pretty obvious? why is it only being brought up now? Where has the DH been all these years? I think as nurses we know the difference between clean and contaminated. at least as a student we went right round the hospital ward taking swabs of anything and everything we thought interesting and sending them to be cultivated in the path lab. cleanest was the inside of hospital sheets, which in the good days were properly laundered and changed every day. objects with the highest colonies of bacteria were the ear pieces of ward stethscopes, mouth and ear pieces of telephone receivers and face flannels and soap which had a very high density of pseudomonas.
    Where do the DH have the priorities? The Health and Safety Inspectors seem to make ridiculous rules about many trivial things which get up everybodies nose yet things which are really dangerous seem to escape their attention all together!

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  • Pussy

    'Twas ever thus.

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