Analysis: Sinks, showers and the sink splash zone are a big part of the problem behind the rise (and rise) of superbugs in hospitals<\/p>\n
By Deirdre Fitzgerald-Hughes<\/a>, RCSI<\/a><\/p>\n By 2050, infections caused by antibiotic-resistant bacteria, often called ‘superbugs’, could kill more people each year than cancer<\/a>. That’s up to 10 million lives lost annually. In response, world leaders at a special United Nations Assembly in 2024<\/a> committed to reducing deaths from these infections by 10% by 2030.<\/p>\n But solving this problem isn\u2019t straightforward. It affects everything from how we treat people and animals to how we manage farms and water systems. That\u2019s why Ireland and many other countries have national plans that take a ‘One Health’ approach<\/a>, meaning they look at human, animal and environmental health together.<\/p>\n Clean hands, clean spaces<\/p>\n One thing we learned from the Covid pandemic is how important hygiene is. Washing hand<\/a>s and keeping surfaces clean helps protect people and keeps hospitals running. In fact, the WHO says<\/a> hand and environmental hygiene are key to preventing infections in healthcare settings.<\/p>\n We need your consent to load this rte-player contentWe use rte-player to manage extra content that can set cookies on your device and collect data about your activity. Please review their details and accept them to load the content.Manage Preferences<\/a><\/p>\n From RT\u00c9 Radio 1’s Drivetime, HSE urges proper washing for World Hand Hygiene Day<\/p>\n A recent report<\/a> by the OECD used a prediction model to look at different ways to fight superbugs. It found that improving hygiene in hospitals could save over $7 billion in healthcare costs each year and boost productivity by another $6.4 billion.<\/p>\n The rise of a dangerous superbug<\/p>\n One of the most dangerous superbugs is called carbapenemase-producing Enterobacterales<\/a>, or CPE. When someone gets a CPE infection, there are often no antibiotics left that can treat it. CPE can spread easily between patients, staff and even through the hospital environment. It can live quietly in a person\u2019s gut without causing symptoms, but that person can still pass it on\u2014or later develop a serious infection themselves.<\/p>\n CPE outbreaks in hospitals can cause major problems: wards may close, surgeries get delayed, and hospital admissions are cancelled. They are also costly to manage. A UK-based study estimated<\/a> that a ten-month CPE outbreak cost almost \u20ac1.15m.<\/p>\n We need your consent to load this rte-player contentWe use rte-player to manage extra content that can set cookies on your device and collect data about your activity. Please review their details and accept them to load the content.Manage Preferences<\/a><\/p>\n From RT\u00c9 Radio 1’s Today with Claire Byrne, can antibiotic-resistant superbug be stopped?<\/p>\n Following the trail of bugs<\/p>\n Thanks to advances in genetic science, hospitals can now track how CPE spreads with much more accuracy. This has helped infection control teams find sources of outbreaks that used to go unnoticed. Surprisingly, hospital sinks and showers are often part of the problem.<\/p>\n Even though sinks are essential for hygiene, they can also collect bacteria like CPE. These bacteria form sticky layers called biofilms inside pipes and drains, making them hard to clean. Disinfectants often can\u2019t reach them, and over time, the bacteria can adapt and survive.<\/p>\n How sinks can spread superbugs<\/p>\n Drains aren\u2019t sealed off from the rest of the room. Studies show that water splashing from sinks can create tiny droplets that travel up to two metres, a sink splash zone<\/a> far enough to reach patients. Hospitals try to clean sinks and showers during outbreaks using strong disinfectants, but these don\u2019t work well in drains full of biofilms and organic matter.<\/p>\n Nutrient-rich liquids like feeding formulas are sometimes poured down sinks which act as food for bacteria like CPE<\/p>\n Sometimes, the cleaning process itself pushes bacteria deeper into the plumbing. These bacteria can end up in hospital wastewater, which flows into public treatment plants. Even if the bacteria don\u2019t survive, their DNA, especially the parts that make them resistant to antibiotics, can still reach the environment and animals.<\/p>\n Changing how we use sinks<\/p>\n We need to rethink how we use and clean hospital sinks. For example, nutrient-rich liquids like feeding formulas are sometimes poured down sinks which act as food for bacteria like CPE<\/a>. Giving hospital staff clear guidance on how to use sinks and offering better disposal options could help stop bacteria from growing there.<\/p>\n New tech, cleaner drains<\/p>\n New technologies are being developed to clean drains without using harsh chemicals. These include ultraviolet (UV) light, sound waves, and heating systems built into the drain. One exciting idea being developed in Ireland is called photodynamic disinfection. It uses LED light and a special surface inside the drain to kill bacteria. This eco-friendly method is part of a new research project<\/a> involving scientists and healthcare workers from RCSI, DCU<\/a> and Beaumont Hospital<\/a>.<\/p>\n Although still in early stages, such innovations could one day allow hospitals to disinfect sinks and drains safely and sustainably at the flick of a switch.<\/p>\n Follow RT\u00c9 Brainstorm on WhatsApp<\/a> and Instagram<\/a> for more stories and updates<\/p>\n Prof Deirdre Fitzgerald-Hughes<\/a> is Associate Professor in Clinical Microbiology at RCSI<\/a>. She is a Research Ireland<\/a> awardee<\/p>\n The views expressed here are those of the author and do not represent or reflect the views of RT\u00c9<\/p>\n