Ms Megan Gritt1, Ms Stephanie. J Curtis1,2, Ms Sue Borrell1, Professor Allen Cheng2,3, Ms Denise Del Rosario Kelly1, Ms Susan C. McLellan1, Ms Amanda Dennison1, Ms Jacqueline Williams1, Dr Adam W. J. Jenney1, Ms Tania Birthisel1,2, Ms Wendy Grant1, Ms Leah McDonald1, Professor Steve McGloughlin1,2, Mr Mark Curtis1, Ms Annabelle Maclure1, Ms Kelly Ryan1, Ms Nova Sta Maria1, Ms Pauline Bass1, Professor Anton Y. Peleg1,2, Associate Professor Andrew J. Stewardson1,2
1Alfred Health, Melbourne, Australia, 2Monash University, Melbourne, Australia, 3Monash Health, Melbourne, Australia
Biography:
Megan is an Infection Prevention Nurse Consultant at Alfred Health with a strong background in infectious diseases. She is passionate about mentoring staff, and improving practices around MROs. With experience across clinical care, project coordination, she is committed to making infection prevention both practical and impactful.
Abstract:
Introduction
Clinical handbasins are an important reservoir for carbapenemase-producing organisms (CPO). Evidence-based guidance is not yet available for handbasin decontamination. We describe a novel approach for suppressing CPO colonisation of the proximal drain of handbasins within a 45-bed intensive care unit (ICU) in response to an outbreak.
Methods
We selected a phosphoric acid-based cleaning agent (Blue Thunder, Momar Australia) to suppress biofilm formation and bacterial growth. Each treatment involved pouring 250mL of the agent into the sink trap via the sink basin, 30-minute dwell time, then flushing through with water. Treatment commenced with an induction phase (2-3 times/week) followed by a maintenance phase (weekly-fortnightly treatment). We screened sink drains for CPO contamination at baseline, and intermittently thereafter. In parallel, we implemented a ‘sink hygiene’ campaign to discourage inappropriate disposal of liquids via handbasins.
Results
Forty-nine clinical handbasins in 45 cubicles were included. During the first intervention period, February 2017 to April 2020, CPO-positivity declined from 80% (39/49) to 10% (5/49) (p<0.001). Treatment was ceased from April 2020 until March 2022 due to the COVID-19 pandemic. After this pause, CPO-positivity increased to 73% (36/49), before falling to 2% (1/49) (p<0.001) with decontamination resumption. Two months after commencing induction treatment, 29% (14/49) and 0% (0/49) were CPO-positive in the first and second intervention periods, respectively. Most CPO isolates were IMP-4-producing Serratia marcescens.
Conclusion
We found that a phosphoric acid-based cleaning agent is effective in supressing CPO colonisation of clinical handbasins. Maintenance treatment was essential, with cessation resulting in relapse.