Dangerous Bacteria Loerden in hospital zinc drains, despite rigorous cleaning, the study is investigating

We hope to be cured when we stay in the hospital. But too often we get new infections there. Such “healthcare-associated infections” (HAI) are a growing problem worldwide, which means that an estimated 6% of global hospital budgets are admitted.

In the EU alone, Hais beats more than 3.5 million cases per year, which resulted in 2.5 million disability -wise life years, a cost of a maximum of € 24 billion and 90,000 deaths. They are also the sixth most important cause of death in the US.

Patients with reduced immune defenses and in some hospitals, poor compliance with hygiene protocols, let Hai’s thrive. Moreover, antibiotics are widely used in hospitals, which tend to select for hardy, resistant bacterial strains. When such resistance genes are on mobile genetic elements, they can even jump between bacteria, which may lead to new diseases.

“Here we show that hospital zinc -gasste bacterial populations that change over time, despite impeccable cleaning protocols in the specific hospital we have looked at,” Dr. Margarita Gomila, a professor at the University of the Balearic Islands in Spain, and the senior author of a study in Frontiers in Microbiology.

“These results emphasize that the management of bacterial growth in drains and preventing colonization by new tribes of such difficult to infective niches are probably a worldwide problem.”

Rigorous cleaning protocols

Gomila and her colleagues focused on Sink drains in a single modern university hospital on the island of Mallorca, built in 2001 and managed by the health care of the Balearic Islands.

Cleaning protocols are state-of-the-art: sinks and their drains are routinely cleaned with bleach, as well as disinfected with chemicals and steam under pressure, or every month in non-patient areas. Once a year, drain pipes are hyperchlorinated at low temperature.

Four times between February 2022 and February 2023 they used cotton cotton swabs to taste six drains in each of the five departments: two for Intensive Care, including a brand new one; one department each for hematology, short stay and general medicine; As well as a laboratory for microbiology.

They came to the sampled bacteria on five different media and at two different temperatures, and identified the resulting 1,058 isolates with DNA barcoding and mass spectrometry. They then used an automated platform to test whether each of the 219 isolates were resistant to a series of antibiotics.

The authors identified a total of 67 different types of drains. The diversity in most drains went up and down over time without a clear pattern – seasonal or otherwise. The greatest diversity took place in general medicine and intensive care, while the least isolates were found in the Microbiology laboratory.

It is striking that the new Intensive Care, opened in July 2022, already showed a high degree of bacterial diversity from the opening, on the same footing with its longer -established twins.

Dominant about departments were six Stenotrophomonas species as well as Pseudomonas Aeruginosa, a pathogen that is known to cause the fan-associated pneumonia and sepsis, and characterized by the WHO as one of the biggest threats for people in terms of antibiotic resistance. At least 16 other Pseudomonas species were also found at different times and in different departments, but especially in the neighborhood with a short stay.

Andere beruchte ziekenhuis-geassocieerde pathogenen die herhaaldelijk werden aangetroffen, waren Klebsiella pneumoniae in de Algemene Geneeskunde Ward, Acinetobacter Johnsonii en Acinetobacter Ursingii in algemene geneeskunde en intensieve zorg, Enterobacter Mori en Enterobacter quasiroggenkampii in de korte stay-wijk en Staphylococus Aureus in Intensive Care and Hematology.

“The bacteria we have found can come from many sources, from patients, medical staff and even the environment around the hospital. Once based in sink off, they can spread out, making significant risks for immunocompromising patients,” said Gomila.

Antibiotic resistance

Of the species found here, Klebsiella, Enterobacter and P. Aeruginosa come to the so-called Eskape group bacteria, which is known to thrive in hospital environments and show frequent multi-resistance and a high potential for causing illness.

In the current study, 21% of P. Aeruginosa -Isolates appeared to be resistant to at least one class antibiotics. Multiple Klebsiella and Enterobacter tribes were proven resistant to the third generation of antibiotic cephalosporine, but not for the carbapenems that are used today against multi-resistant infections.

The Blavim gene, which makes its carriers resistant, even against Carbapenems, sporadically detected in a minority of P. Aeruginosa tribes of the two Intensive Care departments, the general medicine department and the short-stay department.

The authors concluded that hospital drains can serve as reservoirs for both known and emerging pathogens, some of which show strong antibiotic resistance.

“Cleaning protocols are important and must often be applied, especially in departments that are kept separate, precisely to delay the spread of potentially harmful bacteria. But to achieve the problem, it is essential to study the source of these bacteria and their routes from transmission, “said first author José Laço, a Ph.D. Student in the Gomila laboratory.