Warren Bobby G, Smith Becky A, Barrett Aaron, Graves Amanda M, Nelson Alicia, Gettler Erin, Lewis Sarah S, Anderson Deverick J
Division of Infectious Diseases, Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina.
Disinfection, Resistance and Transmission Epidemiology (DiRTE) Lab, Duke University School of Medicine, Durham, North Carolina.
Infect Control Hosp Epidemiol. 2024 Mar;45(3):302-309. doi: 10.1017/ice.2023.289. Epub 2024 Jan 19.
The origins and timing of inpatient room sink contamination with carbapenem-resistant organisms (CROs) are poorly understood.
We performed a prospective observational study to describe the timing, rate, and frequency of CRO contamination of in-room handwashing sinks in 2 intensive care units (ICU) in a newly constructed hospital bed tower. Study units, A and B, were opened to patient care in succession. The patients in unit A were moved to a new unit in the same bed tower, unit B. Each unit was similarly designed with 26 rooms and in-room sinks. Microbiological samples were taken every 4 weeks from 3 locations from each study sink: the top of the bowl, the drain cover, and the p-trap. The primary outcome was sink conversion events (SCEs), defined as CRO contamination of a sink in which CRO had not previously been detected.
Sink samples were obtained 22 times from September 2020 to June 2022, giving 1,638 total environmental cultures. In total, 2,814 patients were admitted to study units while sink sampling occurred. We observed 35 SCEs (73%) overall; 9 sinks (41%) in unit A became contaminated with CRO by month 10, and all 26 sinks became contaminated in unit B by month 7. Overall, 299 CRO isolates were recovered; the most common species were and .
CRO contamination of sinks in 2 newly constructed ICUs was rapid and cumulative. Our findings support in-room sinks as reservoirs of CRO and emphasize the need for prevention strategies to mitigate contamination of hands and surfaces from CRO-colonized sinks.
耐碳青霉烯类抗菌药物（CRO）污染住院病房水槽的源头和时间尚不清楚。
我们进行了一项前瞻性观察性研究，以描述新建医院病床塔楼中2个重症监护病房（ICU）内病房洗手池CRO污染的时间、发生率和频率。研究单元A和B相继开放接收患者。单元A的患者被转移到同一病床塔楼的新单元B。每个单元设计相似，有26间病房和室内水槽。每隔4周从每个研究水槽的3个位置采集微生物样本：水槽盆顶部、排水盖和存水弯。主要结局是水槽转换事件（SCE），定义为水槽被CRO污染，而此前未检测到CRO。
从2020年9月至2022年6月共采集水槽样本22次，共获得1638份环境培养物。在进行水槽采样期间，研究单元共收治2814例患者。我们总共观察到35次SCE（73%）；到第10个月时，单元A中有9个水槽（41%）被CRO污染，到第7个月时，单元B中的所有26个水槽均被污染。总体而言，共分离出299株CRO；最常见的菌种是 和 。
新建的2个ICU水槽的CRO污染迅速且具有累积性。我们的研究结果支持室内水槽是CRO的储存源，并强调需要采取预防策略，以减轻来自被CRO定植的水槽对手部和物体表面的污染。
