Objectives: 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 multicenter study (1 January-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: 73 ICUs participated in the study; 50.9% (606/1,191) 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% (363/1,191) were close to the bed (<2m) with no barrier around the sink. MDR-associated bloodstream infection incidence rates >0.70/1,000 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). Conclusions: our data showed frequent and multifactorial infectious risks associated with contaminated sinks in ICUs.
Auteur : Valentin Anne-Sophie, Dos Santos Sandra, Goube Florent, Gimenes Rémi, Decalonne Marie, Mereghetti Laurent, Daniau Côme, van der Mee-Marquet Nathalie
Clinical Microbiology and Infection, 2021, p. 1-21
