Table 4.
Manipulationsa of Exposure to Sink Drainage Systems in Effort to Reduce Patient or Health Care Worker Colonization or Infection
| Intervention Type | No. of Studies | No. (%) of Studies With Elimination or Reduction in Organism Acquisition | Proportion (%) of Successful Studies Reporting Co-intervention(s) | Durabilityb of Success in Studies Reporting Elimination or Reduction in Organism Acquisition, Duration, No. (%) of Studies | No. (%) of Studies With Reduction in Sink Drain Contamination but no Data on Impact on Organism Acquisition Before Other Interventions | No. (%) of Studies Reporting Unsuccessful Attempts to Reduce Sink Drain Contamination or Organism Acquisition |
|---|---|---|---|---|---|---|
| Additional sink cleaningc | 17 | 8 (47)d | 6 (75) | >6 mo: 4 (50%) <6 mo: 1 (13%) Uncertain: 3 (38%) |
3 (18)e | 5 (29)f |
| Repair or replacement of all or part of sink drainage | 10 | 8 (80) | 7 (88) | <6 mo: 1 (13%) >6 mo: 2 (25%) Uncertain: 5 (63%) |
2 (20) | |
| Installation of heater–vibrator trap devices | 6 | 4 (67) | 1 (25) | >6 mo: 3 (75%) Uncertain: 1 (25%) |
2 (33) | |
| Replacement, cleaning, or disinfection of taps thought contaminated from drain | 1 | 1 (100) | 1 (100) | >6 mo: 1 (100%) | ||
| Sink removal, relocation, or closure of unit not otherwise detailed | 3 | 3 (100) | 2 (67) | >6 mo: 1 (33%) Uncertain: 2 (67%) |
||
| Additional sink cleaning, repair, or replacement of all or part of sink drainage | 8 | 8 (100) | 5 (63) | <6 mo: 1 (13%) >6 mo: 3 38%) Uncertain: 4 (50%) |
||
| Installation of heater–vibrator trap devices, taps redirected away from drain | 1 | 1 (100) | 0 | >6 mo: 1 (100%) | ||
| Replacement of traps, distance and barrier between drain and workspace or patient, taps redirected away from drain, water pressure reduced | 1 | 1 (100) | 0 | >6 mo: 1 (100%) | ||
| Exchange and disinfection of traps, use of sink for patient care or placement of materials adjacent to sink forbidden, use of reusable hair wash basins stopped | 1 | 1 (100) | 1 (100) | >6 mo: 1 (100%) |
aAdditional details and references provided in Supplementary Table 3.
bDurability of successful reduction in organism acquisition by patients or health care workers determined based on reported periods with significantly reduced or no new cases of colonization or infection attributed to sinks, or time to manuscript submission/receipt in those who had reported sustained effect.
cUnclear effect of manipulation of exposure for 1 study with additional cleaning (disinfectant poured down drains).
dAdditional sink drain cleaning that was reported to result in some success without structural sink intervention included the use of chlorine or bleach products (n = 4), formalin (n = 1), or acetic acid (n = 1) with or without dismantling and physical cleaning, sink disinfection or cleaning not further specified (n = 2).
eAdditional sink drain cleaning that without structural sink intervention was reported to result in some reduction in drain contamination but not patient acquisition: accelerated H2O2 gel poured into drains and weekly cleaning with a sodium hypochlorite solution (n = 1), use of phenolics or paracetic acid (n = 1), use of bleach or chlorine and sodium hydroxide and alkyldimethyl amine oxide with steam cleaning (n = 1).
fAdditional sink drain cleaning that without structural sink intervention was reported unsuccessful included the use of bleach products with mechanical brushing (n = 1) or with phenolic flushing (n = 1), or with steam cleaning (n = 1), or the use of hydrogen peroxide (n = 1), or sink cleaning not further specified (n = 1).