Sinks situated next to patient toilets in hospital rooms may be reservoirs for Klebsiella pneumoniae carbapenemase (KPC), increasing the risk of dangerous germ transmission, according to researchers.
The new study, published in the American Journal of Infection Control, found a high prevalence of KPC positivity in sink drains located next to toilets.
“This study, if validated, could have major implications for infection control”
Of the samples tested, 87% of patient sinks next to toilets tested positive for KPC – in stark comparison to the 21.7% of sink drains located closer to the entry door of the room.
In four of five rooms in which the entry-door sink tested positive, the sink near the toilet was also positive, suggesting a potential source for cross-contamination within the same room.
Researchers noted that Klebsiella could cause a number of healthcare associated infections, such as pneumonia, bloodstream infections, wound infections or surgical site infections.
Increasingly, Klebsiella bacteria have also developed antimicrobial resistance, most recently to the class of antibiotics known as carbapenems, they warned.
They carried out the study in the medical intensive care unit of a 600-bed Wisconsin hospital. The unit did not have any documented interactions with KPC-producing organisms within the past year.
“Maintaining a strong understanding of environmental risks is critical to protecting patient safety”
It is the first study to directly examine the relevance of sink proximity to toilets in patient rooms, according to the researchers.
They highlighted that it was plausible that biofilms growing in pipes shared between toilets and sinks, or that flushing, generates contaminated drops that reach the sink drains.
The study authors, Dr Blake Buchan and Dr Silvia Munoz-Price, said: “This study, if validated, could have major implications for infection control.
“If sinks next to toilets are indeed a reservoir for KPC, additional interventions – such as modified hand hygiene practices and sink disinfection protocols – may be needed to stem the risk of transmission among healthcare providers and patients alike,” they said.
Karen Hoffmann, president of the US Association for Professionals in Infection Control and Epidemiology and a registered nurse, said: “The results of this study demonstrate the importance of remaining vigilant to potential areas of cross-contamination.
“Maintaining a strong understanding of environmental risks is critical to protecting patient safety, and this is yet another example of how germs can lurk in often the most unexpected of places,” she added.