. Author manuscript; available in PMC: 2021 Feb 15.

Published in final edited form as: Infect Control Hosp Epidemiol. 2019 Apr 3;40(6):621–626. doi: 10.1017/ice.2019.60

Table 3.

Possible Exposure Pathways and Routes of Transmission Involved in Water-Related Investigations, Division of Healthcare Quality Promotion, CDC, United States, 2014–2017

Injection/medication preparation near sink^a

Nutrition (including breast milk and infant formula) preparation near sink^a

Patient care supplies stored by sinks and toilets in intensive care unit^a

Contaminated compounded nasal spray used prior to laryngoscopy

Contaminated water from neonatal intensive care unit (NICU) sinks^a

Contaminated water from operating room scrub sinks^a

Contaminated sink drains^a

Contaminated dialysis wall boxes^a

Use of nonsterile ice for patient care among immunocompromised patients^a

Use of contaminated water in dental water lines^10,11,a

Water introduction during respiratory therapy^a

Use of tap water during bronchoscopy procedures^a

Use of nonsterile water for humidification reservoirs of infant incubators in NICU^a

Use of consumer-grade humidifier in operating room during LASIK procedures¹²

Use of nonsterile water and inadequate disinfection of heater-cooler devices used during cardiac surgery^13–15,a

Intrinsic contamination of medical products due to water contamination at production site^16–17,a

Poor medical device reprocessing procedures^a

Contaminated automated endoscope reprocessors

Poor cleaning and disinfection of hydrotherapy rooms and equipment^a

Water from contaminated shower heads^a

Improperly cleaned mobile shower trolleys

Hot tub use by surgical personnel^a

Water contamination of specimens/reagents in the laboratory^a

Building water leaks in patient care areas

Indicates a potential exposure pathway or route of transmission that was documented as the possible source of infection in two or more investigations.