A prospective multicentre surveillance study to investigate the risk associated with contaminated sinks in the intensive care unit. (September 2021)

• Record Type: Journal Article
• Authors: Valentin, Anne-Sophie; Santos, Sandra Dos; Goube, Florent; Gimenes, Rémi; Decalonne, Marie; Mereghetti, Laurent; Daniau, Côme; van der Mee-Marquet, Nathalie; Abdoush, H.; Alfandari, S.; Allaire, A.; Aloe, L.; Andreo, A.; Antoine, E.; Aurel, C.; Azaouzi, A.; Barry-Perdereau, V.; Berrouane, Y.; Blaise, S.; Blanie, M.; Bonjean, S.; Borderan, G.C.; Bounoua, M.; Bourigault, C.; Brean, V.; Cecille, A.; Chakaroun, H.; Chanay, O.; Chauvin, C.; Curnier, V.; Dalmas, H.; Degallaix, D.; Del Guidice, F.; Delhomme, J.; Demasure, M.; Denis, C.; Diaw, F.; Dorel, S.; Fourneret-Vivier, A.; Fradin, B.; Fribourg, A.; Fumery, B.; Gallais, S.; Gazagne, L.; Genillon, J.P.; Gerbier, C.; Glanard, A.; Gouin, C.; Gourmelen, F.; Haond, C.; Huart, C.; Idri, N.; Ionescu, P.; Joron, S.; Joseph, E.; Labonne, V.; Laurent, B.; Le Coq, M.; Lecuru, M.; Legrand, A.; Lehiani, O.; Lepainteur, M.; Lesteven, C.; Llorens, M.; Lugagne, N.; Magneney, M.; Mahamat, A.; Marie, V.; Mattioli, K.; Mesnil, M.; Mien, S.; Morange, V.; Negrin, N.; Neulier, C.; Ory, J.; Ouzani, S.; Perez, A.; Pospisil, F.; Sevin, T.; Thomas-Hervieu, A.; Valdes, A.; Victoire, C.; Vidal-Hollaender, B.; Veyres, P.; Zamfir, O.; Anguel, N.; Aussant, P.; Badetti, C.; Bavozet, F.; Bayekula, J.; Bedon-Carte, S.; Bedos, J.P.; Berthon, M.; Bertrand, P.M.; Brunel, E.; Burel, C.; Cerf, C.; Chelha, R.; Combaux, D.; Da Silva, D.; Damoisel, C.; De Rudnicki, S.; Debost, J.; Desfrere, L.; Della-Guardia, M.; Dieye, E.; Eisenmann, N.; Ethuin, F.; Favier, L.; Fedun, S.; Feller, M.; Ferreira, L.; Fillatre, P.; Galin, X.; Garot, D.; Duclos, J. Gaubert; Gette, S.; Georges, H.; Godde, F.; Hamet, M.; Hira, M.; Hoff, J.; Hyvernat, H.; Illinger, J.; Jacques, L.; Joubert, J.; Kaidomar, M.; Kalfon, P.; Kallel, H.; Lafforgue, P.; Lambiotte, F.; Landivier, A.; Lazard, T.; Le Gall, F.; M'fam, W.; Mariot, J.; Martin, A.; Martinet, O.; Michaux, P.; Michel, O.; Mofredj, A.; Montini, F.; Muller, L.; Pommier, C.; Pottie, J.C.; Prevost, F.; Roger, C.; Samat, C.; Serpin, L.; Siami, S.; Alaoui, S. Sidki; Simaillaud, A.; Simonoviez, P.Y.; Slimani, H.; Thouret, J.M.; Toledano, D.; Travert, B.; Trouiller, P.; Trouillet, G.; Vescovali, C.; Adochitei, A.; Amara, M.; Arsene, S.; Bachelier, M.N.; Barrans, A.; Belmonte, O.; Ben Hadj Yahia, S.; Bensaid, T.; Beretta-Salaun, G.; Bertei, D.; Bizet, J.; Bleunven, S.; Bonfils, F.; Bonnet, R.; Brisou, P.; Cantet, P.; Cattoen, C.; Chaplain, C.; Cordoleani, B.; Dao, A.; Dorangeon, E.; Dupin, C.; Farfour, E.; Farrugia, C.; Fines, M.; Fougnot, S.; Garnier, P.; Guerin, M.; Guillet-Caruba, C.; Guinard, J.; Gourmelen, F.; Goux, A.; Hammami, S.; Heusse, E.; Heym, B.; Alet, C. Hombrouck; Jacquemin, P.; Jensen, C.; Labonne, V.; Lacomme, M.P.; Lafay, E.; Lance, F.; Lanselle, C.; Lavigne, J.P.; Le Gallou, F.; Lechat, S.; Lemenand, O.; Leotard, S.; Lepainteur, M.; Levast, M.; Louis, G.; Lourtet, J.; Luizy, N.; Mereghetti, L.; Mignot, L.; Moquet, O.; Navarrot, J.C.; Ouzani, S.; Lory, M. Pancher; Parmeland, L.; Patoz, P.; Poussing, S.; Ragot, C.; Roudiere, L.; Ruimy, R.; Rose, V. Sainte; Sanchez, R.; Seraphin, H.; Vanson, M.l.;
• Is Part Of: Clinical microbiology and infection. Volume 27:Number 9(2021)
• Page Start: 1347.e9
• Page End: 1347.e14
• Publication Date: 2021-09
• Subjects: Bloodstream infection -- Enterobacteriaceae -- Intensive care -- Pseudomonas aeruginosa -- Sink -- Ventilator-associated pneumonia; Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1016/j.cmi.2021.02.018
• Languages: English
• ISSNs: 1198-743X

Abstract

Abstract: Objectives: The aim was to assess the incidence of sink contamination by multidrug-resistant (MDR) Pseudomonas aeruginosa and Enterobacteriaceae, risk factors for sink contamination and splashing, and their association with clinical infections in the intensive care setting. Methods: A prospective French multicentre study (1 January to 30 May 2020) including in each intensive care unit (ICU) a point-prevalence study of sink contamination, a questionnaire of risk factors for sink contamination (sink use, disinfection procedure) and splashing (visible plashes, distance and barrier between sink and bed), and a 3-month prospective infection survey. Results: Seventy-three ICUs participated in the study. In total, 50.9% (606/1191) of the sinks were contaminated by MDR bacteria: 41.0% (110/268) of the sinks used only for handwashing, 55.3% (510/923) of those used for waste disposal, 23.0% (62/269) of sinks daily bleached, 59.1% (126/213) of those daily exposed to quaternary ammonium compounds (QACs) and 62.0% (285/460) of those untreated; 459 sinks (38.5%) showed visible splashes and 30.5% (363/1191) were close to the bed (<2 m) with no barrier around the sink. MDR-associated bloodstream infection incidence rates ≥0.70/1000 patient days were associated with ICUs meeting three or four of these conditions, i.e. a sink contamination rate ≥51%, prevalence of sinks with visible splashes ≥14%, prevalence of sinks close to the patient's bed ≥21% and no daily bleach disinfection (6/30 (20.0%) of the ICUs with none, one or two factors vs. 14/28 (50.0%) of the ICUs with three or four factors; p 0.016). Discussion: Our data showed frequent and multifactorial infectious risks associated with contaminated sinks in ICUs.