INFECTION PREVENTION AND CONTROL
Bacteria from drains are reaching hospital sinks
Dr James Soothill MBBS, MD, FRCPath, a Consultant Microbiologist at London’s Great Ormond Street Hospital for Children, discusses his invention and development of what he dubs ‘a cost-effective, robust, low-maintenance approach to prevent the ascent of antibiotic-resistant bacteria from drains into hospital sinks’ – the ‘so-called’ Tuba Drain.
I have been a Consultant Microbiologist at Great Ormond Street Hospital for the past 20 years; my work focuses on the prevention, diagnosis, and treatment of hospital infection. While I have no formal training in engineering, I’m the named inventor on three patents – including, most recently, the Tuba Drain. During my time at GOSH I have been alarmed by the growing number of patients admitted carrying highly antibiotic-resistant bacteria, and with infections by such bacteria. Now, each month, I’m noticing that the number seems to be higher than in the previous one. The development of the Tuba Drain resulted from me
looking at a window in my office door that looks onto a sink with a visible trap. This led me to think of how upwards splash could prevented by the insertion of a bent tube into the system. The Tuba Drain (TD) is a component for a sink drain that prevents resistant bacteria ascending into sinks and hence transferring to staff and patients, so has the potential to help reverse the rise in antibiotic-resistant bacteria.
Exponential rises
Despite international concern about antimicrobial resistance, efforts to control the immediate problem of rapid and increasing spread of resistance have been lacking. Ever since COVID, the term ‘exponential rise’ has widely been wrongly used. The true meaning is illustrated by the following story: There is a legend that a man asked a king to be paid
for his services in rice. On day 1 he would have one grain of rice placed on a square on a chessboard, on the second day two grains on the second square, and for the following 62 days on each day he would have double the amount of the previous day. The king suggested that this was too little. The total was more rice than there was in the world. The number of hospital patients in England and Wales
carrying in their guts multi-resistant bacteria has been rising at an ever-increasing rate (possibly exponential) – see the graph in Figure 1 for a related measure. The data ends in 2016, since at that point there became too many to measure. There is no reason to suppose that this possibly exponential rise has ceased since. That gives some idea of where we are headed unless major efforts are made now. The carriage of resistance is now beginning to translate into deaths in the UK, and has been for some time elsewhere. This is why the lethargy about transmission is beginning to be replaced by concern. (Better very late than never!) At a time when many new hospitals are being built in the UK, there is now a widespread view that more
account needs to be taken of infection control needs when designing new hospitals. This has led to the creation of the Built Environment Infection Prevention Initiative by the Healthcare Infection Society, and the release of its The Silent Pandemic report,1
which demands urgent action.
Key recommendations include involving IPC professionals from the earliest stages of design and planning, introducing mandatory IPC training across disciplines, and standardising best-practice design frameworks for infection prevention.
Efforts needed urgently Efforts that are needed urgently are approaches to decolonise patients, but also – importantly – efforts to stop bacteria carried in sink drains from ascending into sinks and so onto the hands of staff, who then transmit them to patients. Many hospital outbreaks of near-untreatable infection have been caused by the ascent of multi-resistant bacteria from drains into sinks.2
The concern is now so
great that desperate hospitals are resorting to removing, and not replacing, sinks in their intensive care units. This makes it impossible for staff to wash their hands close to where they are working. Not all sinks can be removed, so safer sinks are needed.
3000 2500 2000 1500 1000 500 500 332 00
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 3
2 0 4 2 23 74 August 2025 Health Estate Journal 41 3000 2826 2500 2123 2000 1648 1500 1045 1000 744 571
Figure 1: Annual numbers of multi-resistant bacterial isolates in England and Wales.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68
