Register      Login
Healthcare Infection Healthcare Infection Society
Official Journal of the Australasian College for Infection Prevention and Control
RESEARCH ARTICLE

Pseudomonas aeruginosa outbreak linked to sink drainage design

Moi Lin Ling A B and Kue Bien How A
+ Author Affiliations
- Author Affiliations

A Infection Control, Singapore General Hospital, Outram Road, Singapore 169608.

B Corresponding author. Email: ling.moi.lin@sgh.com.sg

Healthcare Infection 18(4) 143-146 https://doi.org/10.1071/HI13015
Submitted: 4 April 2013  Accepted: 17 June 2013   Published: 9 July 2013

Abstract

Background: This paper describes an outbreak of Pseudomonas aeruginosa (PAE) that occurred in a haematology ward between 8 January and 24 March 2009. Four patients had healthcare-associated infections due to PAE which was recovered in the groin, blood and perianal tissue.

Aim: This report highlights the risks associated with the use of sinks and outlines the approach used to manage the outbreak.

Methods: Subsequent investigations showed that a contaminated sink drainage system represented the possible source of spread. Of a total of 21 environmental samples taken, two samples from the sink drainage system showed a similar susceptibility pattern as the patients involved in the outbreak. Four cycles of disinfection of the sink drainage systems were attempted with various modalities.

Findings: PAE contamination of the sink drains at the multiple grooves in the drains proved difficult to disinfect adequately, despite using several cleaning protocols. The outbreak was finally terminated following a change in the sink drainage system to one without grooves, hence preventing any further PAE colonisation.

Conclusion: Our experience demonstrated that the design of the sink drainage system may be a potential source of PAE contamination for an immunocompromised patient.


References

[1]  Mansour W, Bouallegue O, Said H, Dahmen S, Boujaafar N. Outbreak of Pseudomonas aeruginosa infections associated with contaminated water in a University Hospital in Tunisia. Infect Control Hosp Epidemiol 2008; 29 378–80.
Outbreak of Pseudomonas aeruginosa infections associated with contaminated water in a University Hospital in Tunisia.Crossref | GoogleScholarGoogle Scholar | 18462154PubMed |

[2]  Aumeran C, Paillard C, Robin F, Kanold J, Baud O, Bonnet R, Souweine B, Traore O. Pseudomonas aeruginosa and Pseudomonas putida outbreak associated with contaminated water outlets in an oncohaematology paediatric unit. J Hosp Infect 2007; 65 47–53.
Pseudomonas aeruginosa and Pseudomonas putida outbreak associated with contaminated water outlets in an oncohaematology paediatric unit.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD28jltVagsQ%3D%3D&md5=c4c5d527f954a9a39af258bc99eb8346CAS | 17141370PubMed |

[3]  Blanc DS, Nahimana I, Petignat C, Wenger A, Bille J, Francioli P. Faucets as a reservoir of endemic Pseudomonas aeruginosa colonization/infections in intensive care units. Intensive Care Med 2004; 30 1964–8.
Faucets as a reservoir of endemic Pseudomonas aeruginosa colonization/infections in intensive care units.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2crhtVersA%3D%3D&md5=39e0ac8059a0715e19f1951ac480d70aCAS | 15257431PubMed |

[4]  Tenover FC, Arbeit RD, Goering RV, Mickelsen PA, Murray BE, Persing DH, Swaminathan B. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995; 33 2233–9.
| 1:CAS:528:DyaK2MXoslSisLc%3D&md5=b566939af8dd3bbd404f325f0f384520CAS | 7494007PubMed |

[5]  Kerr KG, Snelling AM. Pseudomonas aeruginosa: a formidable and ever-present adversary. J Hosp Infect 2009; 73 338–44.
Pseudomonas aeruginosa: a formidable and ever-present adversary.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1MjmsFOjtg%3D%3D&md5=df7fde98dfb17538d5ae54a107de6261CAS | 19699552PubMed |

[6]  Hota S, Hirji Z, Stockton K, Lemieux C, Dedier H, Wolfaardt G, Gardam MA. Outbreak of multidrug-resistant Pseudomonas aeruginosa colonization and infection secondary to imperfect intensive care unit room design. Infect Control Hosp Epidemiol 2009; 30 25–33.
Outbreak of multidrug-resistant Pseudomonas aeruginosa colonization and infection secondary to imperfect intensive care unit room design.Crossref | GoogleScholarGoogle Scholar | 19046054PubMed |