Miss Tracey McKewen1, Dr. Sarah Browning1,2,3, Sally Munnoch1
1Hunter New England Health – Infection Prevention Service, Australia, 2HMRI Infection Research Program, Australia, 3University of Newcastle, School of Medicine and Public Health, Australia
Biography:
Tracey McKewen – Clinical Nurse Consultant with the Infection Prevention Service HNELHD. Background of Bachelor of Nursing, Master of Nursing, Master of Clinical Epidemiology, and Master of Public Health. She began working with the Infection Prevention Service in 2020 and has a keen interest in the control of CPE.
Abstract:
Background
Patient-room sinks are known reservoirs of Carbapenemase-producing Enterobacterales (CPE) due to biofilm accumulation. Optimal sink disinfection methods in the setting of outbreaks remain unclear, with rapid recolonisation of CPE containing P trap biofilm reported post chemical and mechanical strategies. A prolonged CPE outbreak in an Adult/Paediatric Intensive Care Unit (ICU), ongoing despite implementation of multiple infection control strategies and sink disinfection programs, prompted a review of methods used for sink cleaning and decontamination.
Methods
In September 2023, we commenced a sink maintenance program within our ICU. This included P-trap and aerator replacement, grate scrubbing and thermostatic valve flushing (70 degrees Celsius for two minutes). We provided initial education to Engineering Staff on asepsis and appropriate infection control measures to ensure that the patient environment remained free from contamination during component exchange.
Results
We have conducted four rounds of sink maintenance. Patients fitting the outbreak case definition has decreased from 20 pre intervention, to less than four within each subsequent maintenance periods. Further analysis to assess the impact of other interventions on the number of patients associated with the outbreak is required.
Conclusion
Initially results suggest the maintenance program contributed to a temporary reduction in CPE transmission. However, the detection of additional cases between each round of sink maintenance raises concerns about environmental contamination during component exchange. Continued monitoring, targeted education, and process optimisation are essential to sustain the control of CPE in our facility.