Decontamination waste pipes. One paper by Voigt et al2 showed


that residues of drugs can be regularly found in wastewater systems. The authors suggested that antibiotics are likely to persist through the washing process due to the formation of biofilms. Antibiotics in wastewater systems are not the only environmental issue that needs to be considered, however. Martin pointed out that Clostridioides difficile infections (CDIs) require the use of sporicidal surface disinfectants. Although sodium hypochlorite (bleach) is predominantly used in the US and the UK whenever sporicidal activity is required, peroxides or peroxyacetic acid (PAA) are recommended in Europe to prevent contaminating wastewater with Adsorbable Organically bound halogens (AOX). He also touched on probiotic cleaning which


was previously discussed at the Autumn Study Day 2023 by Prof. Elisabetta Caselli, talking about her results with probiotic cleaners. (CSC have invited her back as one of their speakers at the Federation of Infection Societies conference in November to expose this topic to a wider audience. For details visit: https://fitwise. eventsair.com/fis-2024/programme). It has been postulated that the absence


of a diverse composition of non-pathogenic environmental bacteria in the hospital environment may contribute to the development of nosocomial infection. Probiotic detergents deploy different bacterial species (e.g. Bacillus spp., Lactobacillus spp., and Streptoccocus spp.) Colonisation with probiotic bacteria can prevent the propagation of pathogens by increasing competition for nutrients and space, and secreting secondary metabolites that provide a survival advantage. Martin added that the effectiveness of probiotic cleaning procedures needs to be studied further before deriving any general recommendations for their use in hospital settings.


Water risks Jimmy Walker gave a thought-provoking presentation about the risks of water supplies in the built environment. He reminded delegates about the mantra CSC have used for many years “Cleanliness is next to Godliness” and yet water remains the elephant in the room. Jimmy showed many pictures of hospital


mains water supplies being held in tanks and pipes contaminated with microorganisms, encouraging wet biofilms, highlighting the need for robust management. Such images horrified the engineers within the room but was a practical example of why water management is essential. He highlighted the impact of water quality on surgical instruments and why it is necessary to have good strategies to manage water quality. This is why a system that can


produce higher qualities of water is often seen in decontamination units. Jimmy observed from his visit to Japan, that the hospital he visited had built a large reverse osmosis system on the outside of the hospital to provide the whole hospital with high quality water. Jimmy referred to a paper which showed that


more than 20% of water related outbreaks were from non-legionella bacteria and 33% included pathogens that were multidrug resistant.3 He went on to show that since surveillance of Legionnaires disease began in 1992, it has been rising year-on-year. However, it is not just Legionella but other waterborne bacteria as well. With the New Hospital Programme, there has been a lot of talk about single room hospitals. However, a letter to the editor of the Journal


of Hospital Infection recently highlighted concerning results of an audit of shower use, in one hospital, which showed that, on average, 86% of the showers were not in daily use by the patients for personal care – thereby presenting a water hygiene hazard.4


Pictures speak


thousands of words and Jimmy showed many other photographs of poorly used and managed areas. In Japan, his hosts had a problem with Legionella in their hot pipe system and they came up with a solution to remove all the hot pipe and install local heaters to every sink – so, during daily use, it heats the cold water up to the comfortable temperature of 43o


C to wash


hands and then it is pasteurised every night. Filters are a common management strategy, but Jimmy warned it is important that there is no leakage around the filter. He highlighted that it is about ‘controlling the exposure route’ and looking at all areas where water can be found – even in a toilet cistern. Additionally, there is increasing evidence that drains are a health hazard in their own right. Jimmy finished his talk with an adverse event at Papworth


New CSC Chair


Jimmy Walker handed over the role of Chair to John Prendergast. As Principal Decontamination Engineer, working within the specialist team at NHS Wales Shared Services Partnership/ Specialist Estates Services, John’s role is dedicated to all aspects of decontamination/ reprocessing techniques of medical devices. John is a member of a team that provides validation services, advice and guidance to Health Boards/Trusts within Wales and works closely with Welsh governmental departments to deliver policy and strategy in this unique and often complex field. John has worked within the NHS in Wales for the past 35 years. In 2012 John


Hospital resulting in a patient death due to mycobacterium waterborne infection. The result of the inquest has been an order for new guidance to be written for HTM 04-01 which will be led by Dr. Susanne Surman-Lee. As an interim solution, while this mammoth task is being undertaken, a Technical Bulletin is planned to be released later in the year. This article provides a snapshot review


of the CSC Annual Scientific Meeting. Other great presentations were delivered and more information on those can be found on the CSC website, along with details of the Autumn Study Day. Visit: https://centralsterilisingclub.org CSJ


References 1. Hygiene requirements for cleaning and disinfection of surfaces: recommendation of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute. GMS Hyg Infect Control. 2024 Mar 5;19:Doc13. doi: 10.3205/dgkh000468. PMID: 38655122; PMCID: PMC11035912.


2. Voigt AM, et al. The occurrence of antimicrobial substances in toilet, sink and shower drainpipes of clinical units: A neglected source of antibiotic residues. Int J Hyg Environ Health. 2019 Apr;222(3):455-467. doi: 10.1016/j.ijheh.2018.12.013. Epub 2019 Jan 6. PMID: 30622005.


3. Perkins KM, et al. Investigation of healthcare infection risks from water-related organisms: Summary of CDC consultations, 2014— 2017. Infection Control & Hospital Epidemiology. 2019;40(6):621-626. doi:10.1017/ice.2019.60.


4. Walker, J, et al. Standardized 100% single rooms in new hospital builds: a high-cost strategy with low use of showers, Journal of Hospital Infection, 17 April 2023. DOI:https://doi.org/10.1016/j. jhin.2023.04.002.


completed the ACIST course (qualifying course for Authorised Engineer - Decontamination) and was formally accepted onto the IHEEM register as an Authorised Engineer (Decontamination) late 2013. John has previously served in various roles on the CSC committee between 2011-2022.


September 2024 I www.clinicalservicesjournal.com 47


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