TY - JOUR
T1 - Survey of healthcare-associated sink infrastructure, and sink trap antibiotic residues and biochemistry, in twenty-nine UK hospitals
AU - The SinkBug Consortium
AU - Rodger, G.
AU - Chau, K. K.
AU - Bou, P. Aranega
AU - Moore, G.
AU - Roohi, A.
AU - Ambalkar, Shrikant
AU - Aziz, Kashif
AU - Bateman, Vhairi
AU - Bertram, Kevin
AU - Broadwell, Emily
AU - Chaput, Dominique
AU - Chourasia, Rinkuvijay
AU - Clare, Carly
AU - Cordey, Alan
AU - Darlow, Chris
AU - Dibbens, Michael
AU - Dietz, Vilde
AU - Edwards, Catherine
AU - Fleming, Vicki
AU - Goldenberg, Simon
AU - Goolden, Callum
AU - Graham, Clive
AU - Green, Anna
AU - Guyver, Hudson
AU - Halstead, Fenella
AU - Harrison, Tom
AU - Hookham, Lauren
AU - Hopkins, Katie
AU - Hopkins, Susan
AU - Hughes, Gareth
AU - Ibbotson, Wendy
AU - Davies, Rhys John
AU - Johnson, Alison
AU - Johnston, Claire
AU - Jones, Eben
AU - Jose, Sharon
AU - Joy, Justin
AU - Marek, Aleksandra
AU - Matlock, William
AU - Mawer, Damian
AU - May, Alex
AU - Mooney, Ciaran
AU - Muir, Alison
AU - Nye, Clemency
AU - Okoliegbe, Ijeoma
AU - Parcell, Benjamin
AU - Paterson, Suzanna
AU - Pritchard, Emma
AU - Quan, Phuong
AU - Winzor, Gemma
N1 - Publisher Copyright:
© 2025 The Authors
PY - 2025/5
Y1 - 2025/5
N2 - Background: Hospital sinks are linked to healthcare-associated infections. Antibiotics and chemicals in sink traps can select for pathogens and antimicrobial resistance (AMR). Optimizing sink design and usage can mitigate sink-to-patient dissemination of pathogens. Aim: To perform a large-scale survey of hospital sink infrastructure. Methods: Twenty-nine UK hospitals submitted photos and metadata for sinks across three wards (intensive care unit (ICU)/medical/surgical; January–March 2023). Photos were used to classify sink design as ‘optimal’ according to guidelines and published studies. Sink trap aspirates were dipstick-tested for antibiotics and chemistry. Logistic regression was used to characterize associations of ward type and sink location with optimal sink design or detectable trap antibiotics. Findings: Of 287 sinks surveyed, 111 were in ICUs, 92 in medical wards, and 84 in surgical wards; 77 were in medicines/drug preparation rooms, 97 on patient bays, 25 in patient side-rooms, and 88 in sluice rooms. Sink-to-bed ratios ranged from 0.23 to 2.83 sinks per patient bed and were higher on ICUs (1.21 versus 0.82 and 0.84 on medical and surgical wards, respectively; P = 0.04). The median sink-to-patient distance was 1.5 m (interquartile range: 1.00–2.21 m). Sink design varied widely; it was deemed ‘optimal’ for 65/122 (53%) sinks in patient bays/side-rooms and ‘optimal’ design was associated with side-room location (P = 0.03). Antibiotics were detected in 95/287 (33%) sink traps and were associated with medicines/drug preparation rooms (P <0.001). Sink trap chemicals detected included metals, chlorine, and fluoride. Conclusion: Sinks are common in hospitals, frequently close to patients, and often sub-optimally designed. Commonly used antibiotics were detected in a third of sink traps and may contribute to the selection of pathogens and AMR in these reservoirs, and subsequent transmission to patients.
AB - Background: Hospital sinks are linked to healthcare-associated infections. Antibiotics and chemicals in sink traps can select for pathogens and antimicrobial resistance (AMR). Optimizing sink design and usage can mitigate sink-to-patient dissemination of pathogens. Aim: To perform a large-scale survey of hospital sink infrastructure. Methods: Twenty-nine UK hospitals submitted photos and metadata for sinks across three wards (intensive care unit (ICU)/medical/surgical; January–March 2023). Photos were used to classify sink design as ‘optimal’ according to guidelines and published studies. Sink trap aspirates were dipstick-tested for antibiotics and chemistry. Logistic regression was used to characterize associations of ward type and sink location with optimal sink design or detectable trap antibiotics. Findings: Of 287 sinks surveyed, 111 were in ICUs, 92 in medical wards, and 84 in surgical wards; 77 were in medicines/drug preparation rooms, 97 on patient bays, 25 in patient side-rooms, and 88 in sluice rooms. Sink-to-bed ratios ranged from 0.23 to 2.83 sinks per patient bed and were higher on ICUs (1.21 versus 0.82 and 0.84 on medical and surgical wards, respectively; P = 0.04). The median sink-to-patient distance was 1.5 m (interquartile range: 1.00–2.21 m). Sink design varied widely; it was deemed ‘optimal’ for 65/122 (53%) sinks in patient bays/side-rooms and ‘optimal’ design was associated with side-room location (P = 0.03). Antibiotics were detected in 95/287 (33%) sink traps and were associated with medicines/drug preparation rooms (P <0.001). Sink trap chemicals detected included metals, chlorine, and fluoride. Conclusion: Sinks are common in hospitals, frequently close to patients, and often sub-optimally designed. Commonly used antibiotics were detected in a third of sink traps and may contribute to the selection of pathogens and AMR in these reservoirs, and subsequent transmission to patients.
KW - Antibiotics
KW - Antimicrobial resistance
KW - Hospital-associated infection
KW - Sink design
KW - Sink drains
KW - Sinks
UR - http://www.scopus.com/inward/record.url?scp=105003134920&partnerID=8YFLogxK
U2 - 10.1016/j.jhin.2025.02.002
DO - 10.1016/j.jhin.2025.02.002
M3 - Article
C2 - 39961513
AN - SCOPUS:105003134920
SN - 0195-6701
VL - 159
SP - 140
EP - 147
JO - Journal of Hospital Infection
JF - Journal of Hospital Infection
ER -