title: Self-disinfecting sink drains reduce the Pseudomonas aeruginosa bioburden in a neonatal intensive care unit.
abstract: OBJECTIVE
  Water in sink drains is a known source of gram-negative bacteria. We aimed to evaluate the impact of self-disinfecting sink drains on the emission of aerosolised bacteria and on Pseudomonas aeruginosa acquisition among neonates.
  
  
  METHODS
  Aerosol bacterial growth and patient Pseudomonas aeruginosa acquisition rates were measured at baseline (Phase One), for 13 months after sinks were relocated or redesigned during refurbishment (Phase Two) and for 13 months after introducing self-disinfecting sink drains (Phase Three).
  
  
  RESULTS
  Cultures were positive for bacterial growth in 56%, 24% and 13% of the tested aerosols in Phases One, Two and Three, respectively. Comparing Phases Two and Three produced an odds ratio (OR) of 0.47, with a 95% confidence interval (CI) of 0.22-0.99 (p = 0.047), for all bacteria and an OR of 0.31 and CI of 0.12-0.79 (p = 0.013) for Pseudomonas aeruginosa. Rates of Pseudomonas aeruginosa positive clinical cultures were 0.34, 0.27 and 0.13 per 1000 patient days during the respective phases, with a significant increase of time to the next positive clinical culture in Phase Three.
  
  
  CONCLUSIONS
  Self-disinfecting sink drains were superior to sink replacements in preventing emissions from aerosols pathogens and may reduce hospital-acquired infections. The bioburden reduction should be confirmed in a larger multicentre trial.
authors.affiliation: Department of Pediatrics, McMaster University, Hamilton, ON, Canada.|Hamilton Health Sciences, Hamilton, ON, Canada.
authors.forename: Christoph
authors.identifier: http://orcid.org/0000-0002-8137-4383
authors.initials: C
authors.lastname: Fusch
authors.affiliation: Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Pogorzelski
authors.affiliation: Hamilton Health Sciences, Hamilton, ON, Canada.|Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Main
authors.affiliation: Hamilton Health Sciences, Hamilton, ON, Canada.
authors.forename: Carrie-Lynn
authors.initials: CL
authors.lastname: Meyer
authors.affiliation: Department of Pediatrics, McMaster University, Hamilton, ON, Canada.|Hamilton Health Sciences, Hamilton, ON, Canada.
authors.forename: Salhab
authors.initials: S
authors.lastname: El Helou
authors.affiliation: Hamilton Health Sciences, Hamilton, ON, Canada.|Department of Medicine, McMaster University, Hamilton, ON, Canada.|Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.|Michael G. DeGroote Institute for Infectious Diseases Research, McMaster University, Hamilton, ON, Canada.
authors.forename: Dominik
authors.initials: D
authors.lastname: Mertz
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D004202:Disinfectants; D004203:Disinfection / Q000379:methods*; D004866:Equipment Contamination / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D011552:Pseudomonas Infections / Q000517:prevention & control*; D011550:Pseudomonas aeruginosa / Q000254:growth & development / Q000302:isolation & purification*; D013997:Time Factors
chemical_list: D004202:Disinfectants
keywords: Aerosolised bacteria; Gram-negative bacteria; Neonatal intensive care unit; Pseudomonas aeruginosa; Self-disinfecting sink drain