Prevention is at the core for stopping AMR emergence . It is well known that the environment plays a key role in the development and transmission of AMR microbes . Conversely , the environment is a key area for active prevention of AMR . In the hospitals , the sink has been shown to contribute to the rise of
AMR .” fans will have the ability to adapt flow rate to ensure appropriate operation in concert with room fluctuations of the heating , ventilation , and air conditioning ( HVAC ) systems air flow and pressures . All fans are connected via a low voltage control wire to the healthcare facility Building Automation System ( BAS ) so that if a fan fails , the engineering department can receive the failure signal and repair or replace the fan / motor immediately . A hatch is required for access by engineering . The advantage of this system is that unlike the “ Crapper ” design this system will substantially reduce the moisture in the waste system lines thereby minimizing dangerous wet biofilms . Dry biofilms are still expected to persist but will be treated using disinfectant applications .
A horizontal drain line will be installed at an applicable distance away from the sink or varying number of sinks on the front end of the drain system . These lines will have a closure gate or ball valve that can isolate the drain for short periods of time ( Figure 3 ). This allows for completely filling the system with the appropriate disinfectant . The goal of this procedure is to remove any dry biofilm that may propagate in the waste lines . The valve should be placed such that there is an easy to locate access hatch that is appropriately marked as such . Conversely , a remote-control valve can be used to allow for energization of the circuit without manual interventions . It is also possible to install a remotely controlled ice plug device at the point required for fluid restriction as a redundant feature . It is also possible to use these valves to close off the drain line in the case of a negative pressure fan failure stopping sewer gas escaping into the room , during fan repair .
To ensure appropriate function of the system regular auditing of the drain lines via ATP tests , protein tests , or microbial culture are recommended to ensure there is no or very little dry biofilm in the section of the drain line closest to the sink ( s ). Remember a dead biofilm that is still on the surfaces will enhance the regrowth of new biofilm .
The advantage of the EasyFlow concept over the “ Crapper ” design is :
1 . Proactive biofilm through engineered infection prevention 2 . Continuous drying of waste drain lines 3 . Efficient removal of dry biofilms 4 . Redundancy 5 . Process control monitors 6 . Active reduction of AMR bacterial dispersal to the hospital-built environment and community
Summary
For 140 years the same design for sinks has been used that enhances the growth biofilms . These biofilms will harbor bacteria and fungi . The microbes in the biofilms will share genetic elements allowing for transfer of AMR between divergent species and enhance the growth of HAI microbes . Sink biofilms drive the transfer of HAI and AMR microbes into the hospital-built environment through splashing as well as dispersal into the community by release into the municipal waste stream .
The EasyFlow concept removes the P-trap greatly reducing the ability of biofilms to form by lowing the
a w on the surfaces of associated sink and drain lines . This will reduce the ability of microbes to transfer AMR elements to others and eliminate the biofilm on the sink strainer abolishing dispersion of pathogens into the hospital-built environment . Ultimately enhancing the lives and wellbeing of both patients and care givers .
Richard Dixon is board member and co-founder of the Coalition for Community & Healthcare Acquired Infection Reduction ( CHAIR ); a Canadian Standards Association former standards writer : Vice-chair Infection Control During Construction , Renovations & Maintenance of Healthcare Facilities . chair , Cleaning and Disinfection of Health Care Facilities , Member Health Care Facilities ( building new health care facilities ), Special Requirements for Plumbing Installations in Health Care Facilities ; and a research consultant for Vancouver Coastal Health ( Environmental & Patient Care ). He may be reached at : DixonConsulting @ gmail . com or ( 226 ) 698-1768 ( Canada ) or ( 772 ) 269-6491 ( U . S .)
David Koenig , PhD , is currently chief technology officer of DKMicrobios and a board member of the Environmental Services Optimization Playbook ( EvSOP ). He is formerly a research technical leader with Kimberly Clark Corporation ( infection control , human microbiome , and skin health ), as well as a former microbiologist for the NASA Johnson Space Center ( ISS environmental and water subsystems , ISS Crew Health subsystem , Lunar / Mars Regenerative life support systems ), and formerly a microbiologist for Betz Paperchem ( biofilm control ). He may be reached at : dkmicrobios @ gmail . com or ( 920 ) 527-8243 .
To access the references for this article , visit : https :// www . healthcarehygienemagazine . com / surface-hygiene /
32 september 2023 • www . healthcarehygienemagazine . com