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Hospital taps often home to slime and biofilm, warn researchers

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Dirty hospital taps may be helping spread infections as an unintended consequence of clinical staff being encouraged to wash their hands more often, warn researchers.

They noted that hand hygiene was a critical component of hospital infection control, but highlighted that water splashing out of a sink could spread germs present on dirty taps – often called faucets in the US.

“The inside of faucets where you can’t clean were much dirtier than expected”

Kristen VanderElzen

Their study findings on the topic are being presented this week in Philadelphia at the annual conference of the Association for Professionals in Infection Control and Epidemiology.

Researchers at the University of Michigan Health System assessed eight different designs across four intensive care units to determine how dirty sinks and taps really were.

They found that a shallow depth of the sink bowl enabled potentially contaminated water to splash onto patient care items, healthcare worker hands, and into patient care spaces.

At times, they found this splashing could reach a distance of more than four feet from the sink itself.

“Infection preventionists play an increasingly important role in healthcare facility design as this study illustrates”

Karen Hoffmann

To identify the grime level of the sinks, the researchers used adenosine triphosphate (ATP) monitoring to measure the cleanliness.

Visible biofilm was associated with higher ATP readings, and cultures tested over the course of the study grew Pseudomonas aeruginosa, mold, and other environmental organisms.

The researchers also found aerators on sinks where they had previously been removed, pointing to an overall inconsistency of equipment protocols across the facility.

Included in the design improvement programme were sink guards, which were shown to limit splash significantly.

Study author Kristen VanderElzen, an infection prevention and epidemiology project manager at the University of Michigan, said: “The inside of faucets where you can’t clean were much dirtier than expected.

University of Michigan Health System

Kristen VanderElzen

Kristen VanderElzen

“Potentially hazardous germs in and around sinks present a quandary for infection preventionists, since having accessible sinks for hand washing is so integral to everything we promote,” she said.

She added: “Acting on the information we found, we have undertaken a comprehensive faucet replacement program across our hospital.”

Back in 2010, the UK Department of Health issued an alert warning that hospital wash basins had been identified as a source of gram negative bacteria.

The move came after Abertawe Bro Morgannwg University Health Board confirmed that three taps in Morriston Hospital, Swansea had tested positive for the bug.

Karen Hoffmann, nurse and current president of APIC, said: “As we learn more about the often stealthy ways in which germs can spread inside healthcare facilities, infection preventionists play an increasingly important role in healthcare facility design – including in the selection of sink and faucet fixtures – as this study illustrates.”

She added: “Because the healthcare environment can serve as a source of resistant organisms capable of causing dangerous infections, an organisation’s infection prevention and control programme must ensure that measures are in place to reduce the risk of transmission from environmental sources and monitor compliance with those measures.”

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