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Multi-drug resistant bacteria ‘colonising’ hospital sinks

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Multi-drug resistant bacteria are living in hospital sink drainpipes, putting them in close proximity to vulnerable patients, warns a team of US researchers.

They have now investigated how the bacteria are colonising the sinks using a mock-up built in the lab, highlighting that the process was previously unclear.

“We wanted to better understand how transmission occurs”

Amy Mathers

The project grew out of the knowledge that patients were dying from infections with multi-drug resistant bacteria acquired while in hospital, said the study authors from the University of Virginia.

Along with researchers from Oxford University, they had initially carried out a review of studies to highlight the scale of the problem and that it was on the increase.

They reviewed more than 32 papers on the spread of bacteria resistant to the antibiotic carbapenem via sinks and other water reservoirs within hospitals, finding most were from after 2010.

For the new study, the US researchers built five identical sinks in their lab, modelling them on the most common intensive care unit sink in the university’s hospital in Charlottesville.

For their experiments with the sink, they used the bacteria Escherichia coli (E. coli), which though commonly harmless in the human intestinal tract, can acquire both pathological genes and antibiotic resistance genes, becoming superbugs.

Initially, the researchers found the bacteria colonised the elbows of the drain pipes. They showed that from there, the colonies grow slowly towards the sink strainers – at the rate of roughly one inch per day.

Given the distance in typical hospital sinks of elbows below the sink bowls, it frequently takes a week for the colonies to reach the sink strainers, said the study authors in the journal Applied and Environmental Microbiology.


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Source: Harry Moxley | UVA School of Medicine

The form of E. coli that causes many UTIs

From there, the suggested the bacteria quickly got splattered around the sink, and even onto the counters surrounding the sinks, where they could be picked up by the patients.

Study author Dr Amy Mathers, associate professor of medicine and pathology, said: “We wanted to better understand how transmission occurs, so that the numbers of these infections could be reduced.

“Our study demonstrates that bacterial spread from drainpipes to patients occurs via a staged mode of transmission,” she added.

The researchers said they would now use the sink lab – the only one in the US – to conduct a follow-up study to try and determine precisely how the pathogens reach the patients.

Dr Mathers said: “This type of foundational research is needed to understand how these bacteria are transmitted so that we can develop and test potential intervention strategies that can be used to prevent further spread.”

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Readers' comments (1)

  • Dear Steve Ford:
    I’m writing to express my concern over your news article concerning multi-drug resistant bacteria living in hospital sinks. As a student attending Idaho State University’s School of Nursing, I also feel that this topic needs to be addressed immediately. When attending clinical at a local hospital in Boise, I am always conscious of washing my hands thoroughly and preventing the spread of bacteria to my patients. When taking previous undergraduate microbiology courses, I was alerted about the possible dilemma of producing multi-drug resistant bacteria by the increase in use of antibacterial gel and hand soap. Reading your news story on how patients are now dying because of this monster bacteria, has reawakened the fear and the dire need to educate all.
    After feeling this immense thirst for more knowledge on this subject, I took it upon myself to research other studies that concerned this topic. Hocquet, Muller, and Bertrand (2016) conducted research in which they analyzed quantitative and qualitative data of multi-drug resistant bacteria in wastewaters in hospitals. They determined that antimicrobial resistance stands as one of the most serious health concerns in the twenty-first century, and that this topic needs to be viewed as an “environmental pollutant” (Hocquet et al., 2016). Another research piece by Wang et al. (2017) analyzed hospital surfaces found in patients’ rooms for this type of bacteria. Wang et al. (2017) concluded that the detection rate of bacteria was significantly high on hospital surfaces, and that this bacterium demonstrates variable resistance to antimicrobials. Another scientific source by Viana, Santos, and Oliveira (2016) conducted a cross sectional study in which samples were obtained from patient hospital mattresses to detect resistant bacteria. According to Viana et al., (2016) 26 out of the 51 mattresses analyzed had resistant bacteria on the surface. From this data, I can see this multi-drug resistant bacteria transmuting into a bigger and immeasurable devastating problem.
    In my opinion, a plausible strategy for improvement includes more community education on the use of antibiotics. This education can be implemented into city councils, but more essentially, to healthcare staff such as nurses. I have family members and friends who are nurses and practice in hospital settings. When I discussed your article with them, they were appalled. They knew that bacteria prevention protocols were necessary, but they did not realize the increase in number of multi-drug resistant bacteria. I feel through public health education, there can at least be more of an awareness to this issue. A study by Utt and Wells (2016) investigates health promotion in regards to the threat of antimicrobial resistance. One of the conclusions they eluded to also included that education can be a good defense mechanism against multi-drug resistant bacteria (Utt & Wells, 2016). Utt and Wells (2016) said education to providers concerning a decrease in antibiotics prescriptions can be beneficial. Education is one of the keys to this nursing major public health issue.
    Being a citizen of Idaho, I feel that awareness of this healthcare nursing issue is absolutely critical. In Boise, we have a very fast growing community. In response, our health care system is growing exponentially in our city and into rural Idahoan areas. I feel that this topic needs to be addressed immediately to all hospitals. I am passionate about preventing deaths related to multi-drug resistant bacteria in our state of Idaho. In addition, I believe that it is our responsibility as a nursing professional to take this issue not only to Idaho, but regionally. By incorporating numerous hospitals nation-wide, we can help find other ways to preventing patient deaths related to resistant bacteria. This is a team effort and we should all take a front seat in this cause.


    Ford, S. (2017). Multi-drug resistant bacteria 'colonising' hospital sinks. Nursing Times, Retrieved July 16, 2017, from
    Hocquet, D., Muller, A., & Bertrand, X. (2016). Review: What happens in hospitals does not stay in hospitals: antibiotic-resistant bacteria in hospital wastewater systems. Journal Of Hospital Infection, 93395-402. doi:10.1016/j.jhin.2016.01.010
    Utt, E., & Wells, C. (2016). The global response to the threat of antimicrobial resistance and the important role of vaccines. Pharmaceuticals Policy & Law, 18(1-4), 179-197. doi:10.3233/PPL-160442
    Viana, R. H., Santos, S. d., & Oliveira, A. C. (2016). Major article: Recovery of resistant bacteria from mattresses of patients under contact precautions. AJIC: American Journal Of Infection Control, 44465-469. doi:10.1016/j.ajic.2015.10.027
    Wang, H., Zhang, H., Liu, J., Dong, Q., Duan, S., Ge, J., & Zhang, Z. (2017). Major Article: Antimicrobial resistance of three types of gram-negative bacteria isolated from hospital surfaces and the hands of healthcare workers. AJIC: American Journal Of Infection Control, doi:10.1016/j.ajic.2017.06.002

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