title: Under-utilization of taps in intensive care unit as a cause of reservoirs of nonfermenting gram-negative bacilli.
abstract: The under-utilisation of taps is associated with the generation of reservoirs of non-fermenting gram-negative bacilli with the ability to disseminate. We describe the detection and approach of the problem in an ICU.
  
  
  
  Observational descriptive study in an ICU with individual cubicles with their own sink. We collected clinical samples from patients and environmental samples from tap aerators and reviewed the unit's hygiene measures.
  
  
  
  We detected four cases due to Chryseobacterium indologenes, one to Elizabethkingia meningoseptica and another to Pseudomonas aeruginosa; they were identified both in clinical and the environmental samples. The healthcare professionals reported that almost every hand hygiene opportunity was performed with a hydroalcoholic solution. After considered the daily flushing of water outlets as inefficient, it was decided to remove them.
  
  
  
  National recommendations were insufficient for preventing, detecting and controlling tap contamination in units with a high risk of infection. The management of taps in these units needs to be improved.
authors.affiliation: Servicio de Medicina Preventiva, Hospital Universitario Infanta Elena, Valdemoro, Madrid, España. Electronic address: lalocascam@yahoo.es.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: de-Las-Casas-Cámara
authors.affiliation: Servicio de Medicina Preventiva, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, España.
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Martín-Ríos
authors.affiliation: Servicio de Medicina Preventiva, Hospital Universitario Infanta Elena, Valdemoro, Madrid, España.
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Adillo-Montero
authors.affiliation: Servicio de Microbiología y Parasitología, Hospital Universitario Infanta Elena, Valdemoro, Madrid, España.
authors.forename: María Carmen
authors.initials: MC
authors.lastname: Muñoz-Egea
authors.affiliation: Servicio de Microbiología y Parasitología, IIS-Fundación Jiménez Díaz, Madrid, España.
authors.forename: Javier
authors.initials: J
authors.lastname: Zapardiel-Ferrero
authors.affiliation: Servicio de Microbiología y Parasitología, IIS-Fundación Jiménez Díaz, Madrid, España.
authors.forename: Concepción
authors.initials: C
authors.lastname: Pérez-Jorge Peremarch
mesh_terms: D000328:Adult; D000368:Aged; D004197:Disease Reservoirs / Q000382:microbiology*; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged
keywords: Aireador de grifo; Bacilo gramnegativo no fermentador; Intensive care unit; Non-fermenting gram-negative bacilli; Surveillance; Tap aerator; Unidad de cuidados intensivos; Vigilancia