The Prevention of Waterborne Hospital-Acquired Infections

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On this blog, we have already learned that healthcare-associated infections can be spread through the water and plumbing systems of hospitals. There are many possible reservoirs for the growth and spread of harmful pathogens; including potable water, sinks, faucets, showers, bathtubs, toilets, etc. It is therefore crucial that healthcare facilities develop water-management programs, in order to reduce the risk of infection.

In a recent article from Infection Control Today 2019, it is stated that:

“facilities must develop and adhere to policies and procedures that inhibit microbial growth in building water systems that reduce the risk of growth and the spread of Legionella and other opportunistic pathogens in water.”

Kelly M. Pyrek, Infection Control Today, 2019

Infection Control Today (2019) discusses many different policies that should be adopted by healthcare facilities.

In terms of potable tap water and hospital water systems, recommendations include:

  • Hot water temperatures at the outlet should be at the highest temperature allowable, preferably >51C.
  • In the case of water disruptions, signs should be posted and the drinking of tap water should be prohibited.
  • Standards for potable water must be maintained (<1 coliform bacterium/100 mL).
  • Equipment should be rinsed first with either sterile water, filtered water or tap water and an alcohol rinse should follow.
  • Periodic monitoring of water samples should be done in order to test for Legionella growth.

In terms of sinks in hospitals, recommendations include:

  • The use of separate sinks for handwashing and disposal of contaminated fluids.
  • The decontamination or elimination of sinks if epidemic spread of gram-negative bacteria via sinks is suspected.

In terms of showers in hospitals, recommendations include:

  • Prohibit the use of showers in neutropenic patients.
  • Control Legionella colonization of potable water.

The article discusses many more recommendations for other water-related reservoirs that are potential sources of infection. For more information on these other reservoirs, please refer to Infection Control Today’s website.

In addition to this, it is recommended by Tim Keane, a consultant with Philadelphia-based Legionella Risk Management Inc, that healthcare facilities hire engineers that are “building water system expert(s) who specialize in risk management for building water systems” (Infection Control, 2019). This will provide healthcare facilities with the expertise needed to develop a concise water-management program.

Preventing the spread of infection is no easy task, especially when there are constantly new sources of HAIs in healthcare facilities. That being said, with the help of very specific programs and procedures, such as the recommendations described above, it is possible to reduce the risk of infection and the spread of bacteria.

Source:

Infection Control Today. Vol. 23. No. 3. March 2019.

Hospital Privacy Curtains: A Harbour for Infectious Agents

Source: Wikimedia Commons

On this blog, we have already reviewed many of the sources of a major health problem: hospital-acquired infections (HAIs). And yet, every day, researchers seem to discover new sources of HAIs. One of the latest discoveries is that hospital privacy curtains in hospital rooms are extremely contaminated with pathogens. A study conducted in Winnipeg, Canada, revealed that freshly hung hospital curtains with minimal contamination became more contaminated each day that they hung in the hospital rooms. Furthermore, after 14 days of being in the room, 87.5% of the curtains were tested positive for methicillin-resistant Staphylococcus aureus (MRSA).

Kevin Shek (Bsc), the leader of the study on hospital privacy curtains carrying pathogens, writes,

“We know that privacy curtains pose a high risk for cross-contamination because they are frequently touched but infrequently changed.”

Kevin Shek (2018)

Healthcare facilities have been placing a great amount of effort in reducing the risk of HAIs in terms of hand-washing and the cleaning of equipment and high-touch surfaces, however, other things such as curtains, mattresses, and bedsheets have often been overlooked. A survey that was conducted to determine how hospital privacy curtains are cleaned/changed revealed frightening results. Only about half of the hospitals had a written policy which specified how often the curtains needed to be changed. 37% of respondents answered that hospital curtains were changed only when visibly soiled. 13% of respondents answered that the curtains were changed only once per year. Considering the results obtained from the Winnipeg hospital study, where curtains became increasingly more contaminated with each day that they remain in a patient’s room, the responses from the survey are alarming.

In terms of controlling the spread of infection, hospitals really need to consider that almost anything in the facility could be contaminated. Hospital cleaning is becoming increasingly complicated, as there are so many places where harmful pathogens can be found. It will be increasingly important that healthcare facilities develop new protocols and policies to prevent HAIs.

Sources:

https://www.infectioncontroltoday.com/transmission-prevention/new-study-says-hospital-privacy-curtains-may-harbor-infectious-pathogens

https://www.infectioncontroltoday.com/transmission-prevention/hospital-privacy-curtains-and-bed-sheets-soft-surface-contamination-and