Survey of healthcare-associated sink infrastructure, and sink trap antibiotic residues and biochemistry, in twenty-nine UK hospitals
Year: 2025
Type: article
Abstract: BACKGROUND: Hospital sinks are linked to healthcare-associated infections. Antibiotics and chemicals in sink traps can select for pathogens and antimicrobial resistance (AMR). Optimizing sink design and usage can mitigate sink-to-patient dissemination of pathogens. AIM: To perform a large-scale survey of hospital sink infrastructure. METHODS: Twenty-nine UK hospitals submitted photos and metadata for sinks across three wards (intensive care unit (ICU)/medical/surgical; January-March 2023). Photos were used to classify sink design as 'optimal' according to guidelines and published studies. Sink trap aspirates were dipstick-tested for antibiotics and chemistry. Logistic regression was used to characterize associations of ward type and sink location with optimal sink design or detectable trap antibiotics. FINDINGS: Of 287 sinks surveyed, 111 were in ICUs, 92 in medical wards, and 84 in surgical wards; 77 were in medicines/drug preparation rooms, 97 on patient bays, 25 in patient side-rooms, and 88 in sluice rooms. Sink-to-bed ratios ranged from 0.23 to 2.83 sinks per patient bed and were higher on ICUs (1.21 versus 0.82 and 0.84 on medical and surgical wards, respectively; P = 0.04). The median sink-to-patient distance was 1.5 m (interquartile range: 1.00-2.21 m). Sink design varied widely; it was deemed 'optimal' for 65/122 (53%) sinks in patient bays/side-rooms and 'optimal' design was associated with side-room location (P = 0.03). Antibiotics were detected in 95/287 (33%) sink traps and were associated with medicines/drug preparation rooms (P <0.001). Sink trap chemicals detected included metals, chlorine, and fluoride. CONCLUSION: Sinks are common in hospitals, frequently close to patients, and often sub-optimally designed. Commonly used antibiotics were detected in a third of sink traps and may contribute to the selection of pathogens and AMR in these reservoirs, and subsequent transmission to patients.
Source: Journal of Hospital Infection
Authors: G. Rodger, K.K. Chau, P. Aranega Bou, G. Moore, A. Roohi, Shrikant Ambalkar, Kashif Aziz, Vhairi Bateman, Kevin Bertram, Emily Broadwell, Dominique Chaput, Rinkuvijay Chourasia, Carly Clare, Alan Cordey, Chris Darlow, Michael Dibbens, Vilde Dietz, Catherine Edwards, Vicki Fleming, Simon Goldenberg, Callum Goolden, Clive Graham, Anna Green, Hudson Guyver, Fenella Halstead, Tom Harrison, Lauren Hookham, Katie Hopkins, Susan Hopkins, Gareth Hughes, Wendy Ibbotson, Rhys John Davies, Alison Johnson, Claire Johnston, Eben Jones, Sharon Jose, Justin Joy, Aleksandra Marek, William Matlock, Damian Mawer, Alex May, Ciaran Mooney, Alison Muir, Clemency Nye, Ijeoma Okoliegbe, Benjamin Parcell, Suzanna Paterson, Emma Pritchard, Phuong Quan, Stuart Reid, Nurfarah Sabtu, Avinandan Saha, Kavita Sethi, Shanya Sivakumaran, Asanka Tennegedara, Sarah Walker, Mariela Webs, Becky Wilson, Lorna Wilson, Gemma Winzor, Nick Wong, Dominic Worku, A.S. Walker, N. Stoesser
Institutions: Public Health England, University of Oxford, UK Health Security Agency, John Radcliffe Hospital, NIHR Oxford Biomedical Research Centre, Kings Mill Hospital, Leicester Royal Infirmary, Aberdeen Royal Infirmary, West Cumberland Hospital, Cumberland Infirmary, Leeds Teaching Hospitals NHS Trust, Glasgow Royal Infirmary, Royal Alexandra Hospital, Queen Elizabeth University Hospital, University Hospital Coventry, Queen's Medical Centre, University Hospital Llandough, Manchester Royal Infirmary, Royal Liverpool University Hospital, St Thomas' Hospital, Balfour Hospital, Royal Preston Hospital, Northern General Hospital, James Paget University Hospital, County Hospital, Stoke Mandeville Hospital, Heartlands Hospital, University Hospital of Wales, Morriston Hospital, Southmead Hospital, Ninewells Hospital, York Hospital, Royal Victoria Hospital
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,000
OpenAlex ID: W4407597127