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546 Hospital Bath Basins are Frequently Contaminated with Multi-Drug Resistant Human Pathogens

Sunday, April 3, 2011
Trinity Ballroom (Hilton Anatole)
Dror Marchaim, MD , Detroit Medical Center, Wayne State University, Detroit, MI
Odaliz Abreu-Lanfranco, MD , Detroit Medical Center, Wayne State University, Detroit, MI
Alexis R. Taylor, MS , Detroit Medical Center, Wayne State University, Detroit, MI
Suchitha Bheemreddy, MD , Detroit Medical Center, Wayne State University, Detroit, MI
Bharath Sunkara, MD , Detroit Medical Center, Wayne State University, Detroit, MI
Ashish Bhargava , Detroit Medical Center, Wayne State University, Detroit, MI
Palaniappan Manickam, MD, MPH , Detroit Medical Center, Wayne State University, Detroit, MI
Judy Moshos, MT , Detroit Medical Center, Wayne State University, Detroit, MI
Thomas Chevalier, RN , Detroit Medical Center, Wayne State University, Detroit, MI
Connie G. Bohlinger, MS , Detroit Medical Center, Wayne State University, Detroit, MI
Paula Robinson, BSN, RN , Wayne State University, Detroit Medical Center, Detroit, MI
Jacqueline I. Han, MT , Detroit Medical Center, Wayne State University, Detroit, MI
Beth Toftey, MT, MPH , Detroit Medical Center, Wayne State University, Detroit, MI
Kristin Rice, MPH , Detroit Medical Center, Wayne State University, Detroit, MI
Beth Dziekan, MS , Detroit Medical Center, Wayne State University, Detroit, MI
Lynn Semproch, MT, MPH , Detroit Medical Center, Wayne State University, Detroit, MI
Katherine Preney, RN , Detroit Medical Center, Wayne State University, Detroit, MI
Elaine Flanagan, MSA , Detroit Medical Center, Wayne State University, Detroit, MI
Kayoko Hayakawa, MD, PhD , Detroit Medical Center, Wayne State University, Detroit, MI
Teena Chopra, MD , Detroit Medical Center, Wayne State University, Detroit, MI
Jason M. Pogue, PharmD , Detroit Medical Center, Wayne State University, Detroit, MI
Paul R. Lephart, PhD , Detroit Medical Center, Wayne State University, Detroit, MI
Sorabh Dhar, MD , Detroit Medical Center, Wayne State University, Detroit, MI
Keith S. Kaye, MD, MPH , Detroit Medical Center, Wayne State University, Detroit, MI
Background: Hospital-acquired infections (HAIs) are the 5th leading cause of death in US hospitals. Patient-to-patient transmission of pathogens is common and will often lead to infection, which increase morbidity, mortality, and hospital costs. Environmental contamination is increasingly recognized as playing an important role in the spread of HAIs in the hospital and many objects can serve as unrecognized reservoirs for pathogens.

Objective: The aim of the study was to investigate the role of bath basins as potential reservoirs for pathogens that can cause HAIs in hospital settings.

Methods: A prospective multicenter trial, involving 64 hospitals from 25 different states and provinces in US and Canada, was conducted between 03/2008 – 10/2010. Local Infection Preventionists randomly cultured basins, using a uniform standardized collecting method.  At the time of culture, the basins were not visibly contaminated and were considered to be “clean”.  All microbiological processing was conducted by an external central laboratory, blinded to the origin of samples. All bacteriologic processing was conducted according to Clinical and Laboratory Standards Institute criteria. Samples were additionally processed, by using selective media, to diagnose the presence of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and Gram-negative bacilli (GNB).

Results: Overall, 792 basins were sampled during the study period, and 513 (65%) of them were contaminated with 1 or more of the following: VRE, MRSA, or GNB. There were 276 (34.85%) basins from 58 (90.63%) hospitals that were colonized with VRE, 382 (48.23%) basins from 63 (98.4%) hospitals that were colonized with GNB, and 24 (3.03%) basins from 19 (29.7%) hospitals that were colonized with MRSA.

Conclusions: In this study, hospital basins were frequently contaminated with common nosocomial pathogens. In today’s era, where there is a growing need for hospitals to reduce HAI rates, diagnosing hidden hospital reservoirs of pathogens can facilitate interventions to improve the safety of patients’ and decrease infection rates.