INFECTION PREVENTION AND CONTROL
being contains more bacteria than people on the planet, or cells in the human body. For most these organisms pose no risk unless they become unwell. It is inevitable that AMR will enter the wastewater systems of healthcare facilities. These drains are home to a living community, with constant movement of pathogens from patient to drain, and then back to the patient.
Sudden awareness? Why have the issues with the wastewater system only recently come to light? Wastewater systems were originally designed to prevent faecal contamination of water systems with cholera and typhoid. These are mostly diseases of the past, and there has been little change in the design of wastewater systems for over 50 years. Of concern is that many innovations which are being introduced in the name of sustainability – such as low- volume flush toilets, are making matters worse, certainly within the healthcare setting. As the volume of water is reduced, so is the ability to move toilet contents along the more horizontal pipes; if this doesn’t happen, blockages increase. Another innovation which has backfired is the deliberate slowing down of filling of the toilet cistern. In areas where there is a high demand for toilet use, the cistern has often not filled in time for the next person, so material cannot be flushed, and again predisposes to blockages. However, this is moving away from answering the question – which is why are these problems only being recognised now? The answer is that if there is any solace to be gained from AMR, it is the fact that bacteria become more visible within the healthcare setting as they stand out. AMR pathogens have specific, often alarming, antibiotic susceptibility patterns, making outbreaks easier to notice compared with more sensitive pathogens. This
is now identifying routes of transmission which until now have gone unrecognised, but have been used by the more sensitive bacteria in the past. Everyday procedures in a hospital, previously
unchallenged, are now being identified as a risk of spread of AMR. Filling a bowl with water to wash a patient, filling a jug of water to give to a patient, and even a patient taking a shower, are increasingly now recognised as ways that AMR is being spread within the hospital environment. The risks from wastewater systems are not just within
the immediate vicinity of the patient either. Hospital-wide outbreaks have originated from hospitals’ main kitchens. Splashing of wastewater from drains of nearby sinks onto salads, or jet hosing of floor drainage systems, has led to multi-drug organisms reaching patients on uncooked food. Large amounts of biologically active antibiotics enter
hospital wastewater systems throughout the day in patient urine, faeces, or direct discharge of unused antibiotics into sinks. The consequences of this on the microbial flora of the wastewater system are incompletely understood, but it might be this very exposure which is driving AMR. The damage is not just within the healthcare facility, but
Figure 5: Placing either a clean wash bowl or a patient water jug in a sink inadvertently makes contact with the drain. These items may now spread AMR to the patient.
Redefine Healthcare Excellence with Innovative Humidification Technology
Maintaining proper humidity levels is crucial for protecting the health of patients and staff by reducing the spread of airborne infections and HAIs, and for optimising the performance of medical equipment in healthcare facilities.
Transform your facilities operations with DriSteem’s cutting-edge humidification and high-efficiency dispersion systems. Our technology minimises contaminant buildup, reduces the need for frequent water drains, helps you conserve energy, reduces water usage, and minimises operating costs.
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www.humiditymatters.co.uk
Visit us on 8-9 October at the Healthcare Estates Exhibition:
Stand B44
Learn about DriSteem at
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