Department of Intensive Care, Leiden University Medical Centre, Leiden, the Netherlands.
Department of Infectious Diseases, Leiden University Medical Centre, Leiden, the Netherlands.
J Hosp Infect. 2019 May;102(1):70-74. doi: 10.1016/j.jhin.2019.01.003. Epub 2019 Jan 9.
Sink drains in intensive care units (ICUs) are frequently colonized with bacteria such as Pseudomonas aeruginosa.
To study the influence of installing disinfecting devices on sink drains on colonization of sinks and patients in an ICU during a prolonged outbreak of multidrug-resistant P. aeruginosa.
From 2010, there was a clonal outbreak of multidrug-resistant P. aeruginosa (MDR-PA). In April 2013, in ICU subunit A, the siphons draining these sinks were replaced by devices applying heat and electromechanical vibration to disinfect the draining fluid. In the other units, siphons were replaced by new polyvinyl chloride plastic siphons (control). In February 2016 the disinfecting devices were also placed at ICU subunit B.
Baseline colonization rate of sinks was 51% in ICU A and 46% in ICU B. In ICU A colonization decreased to 5% (P < 0.001) after the intervention whereas it was 62% in ICU B (control). After installing the disinfection devices in ICU B, colonization rate was 8.0 and 2.4% in ICU A and B, respectively (both P < 0.001 compared with baseline). Colonization in ICU patients decreased from 8.3 to 0 per 1000 admitted patients (P < 0.001) and from 2.7 to 0.5 per 1000 admitted patients (P = 0.1) in ICU A and B respectively.
Colonization with MDR-PA in sink drains in an ICU was effectively managed by installing disinfection devices to the siphons of sinks. Colonization of patients was also significantly reduced, suggesting that sink drains can be a source of clinical outbreaks with P. aeruginosa and that disinfecting devices may help to interrupt these outbreaks.
重症监护病房（ICU）的水槽排水管经常被铜绿假单胞菌等细菌定植。
研究在多药耐药铜绿假单胞菌（MDR-PA）长期暴发期间，在 ICU 中安装消毒装置对水槽和患者水槽定植的影响。
从 2010 年开始，出现了 MDR-PA 的克隆暴发。2013 年 4 月，在 ICU 亚单位 A，这些水槽的虹吸管被应用热和机电振动来消毒排水液的设备所取代。在其他单位，虹吸管被新的聚氯乙烯塑料虹吸管（对照）所取代。2016 年 2 月，消毒设备也被放置在 ICU 亚单位 B。
ICU A 的水槽基线定植率为 51%，ICU B 的水槽基线定植率为 46%。干预后，ICU A 的定植率下降至 5%（P<0.001），而 ICU B 的定植率为 62%（对照）。在 ICU B 安装消毒设备后，ICU A 和 B 的定植率分别为 8.0%和 2.4%（均 P<0.001 与基线相比）。ICU 患者的定植率从每 1000 名住院患者 8.3 例降至 0 例（P<0.001），从每 1000 名住院患者 2.7 例降至 0.5 例（P=0.1），分别在 ICU A 和 B。
通过在水槽虹吸管上安装消毒装置，有效控制了 ICU 水槽排水管中 MDR-PA 的定植。患者的定植率也显著降低，这表明水槽排水管可能是铜绿假单胞菌临床暴发的源头，消毒装置可能有助于中断这些暴发。
