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Outbreaks of healthcare-associated infections linked to water-containing hospital equipment: a literature review

BACKGROUND: Healthcare-associated infections (HAIs) are a significant cause of morbidity and mortality in hospitalized patients. Water in the environment can be a source of infection linked to outbreaks and environmental transmission in hospitals. Water safety in hospitals remains a challenge. This...

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Autores principales: Yiek, Wing-Kee, Coenen, Olga, Nillesen, Mayke, van Ingen, Jakko, Bowles, Edmée, Tostmann, Alma
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8108015/
https://www.ncbi.nlm.nih.gov/pubmed/33971944
http://dx.doi.org/10.1186/s13756-021-00935-6
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author Yiek, Wing-Kee
Coenen, Olga
Nillesen, Mayke
van Ingen, Jakko
Bowles, Edmée
Tostmann, Alma
author_facet Yiek, Wing-Kee
Coenen, Olga
Nillesen, Mayke
van Ingen, Jakko
Bowles, Edmée
Tostmann, Alma
author_sort Yiek, Wing-Kee
collection PubMed
description BACKGROUND: Healthcare-associated infections (HAIs) are a significant cause of morbidity and mortality in hospitalized patients. Water in the environment can be a source of infection linked to outbreaks and environmental transmission in hospitals. Water safety in hospitals remains a challenge. This article has summarized available scientific literature to obtain an overview of outbreaks linked to water-containing hospital equipment and strategies to prevent such outbreaks. METHODS: We made a list of water-containing hospital equipment and devices in which water is being used in a semi-closed circuit. A literature search was performed in PubMed with a search strategy containing the names of these medical devices and one or more of the following words: outbreak, environmental contamination, transmission, infection. For each medical device, we summarized the following information: the function of the medical device, causes of contamination, the described outbreaks and possible prevention strategies. RESULTS: The following water-containing medical equipment  or devices were identified: heater-cooler units, hemodialysis equipment, neonatal incubators, dental unit waterlines, fluid warmers, nebulizers, water traps, water baths, blanketrol, scalp cooling, and thermic stimulators. Of the latter three, no literature could be found. Of all other devices, one or more outbreaks associated with these devices were reported in the literature. CONCLUSIONS: The water reservoirs in water-containing medical devices can be a source of microbial growth and transmissions to patients, despite the semi-closed water circuit. Proper handling and proper cleaning and disinfection can help to reduce the microbial burden and, consequently, transmission to patients. However, these devices are often difficult to clean and disinfect because they cannot be adequately opened or disassembled, and the manufacturer’s cleaning guidelines are often not feasible to execute. The development of equipment without water or fluid containers should be stimulated. Precise cleaning and disinfection guidelines and instructions are essential for instructing healthcare workers and hospital cleaning staff to prevent potential transmission to patients.
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spelling pubmed-81080152021-05-10 Outbreaks of healthcare-associated infections linked to water-containing hospital equipment: a literature review Yiek, Wing-Kee Coenen, Olga Nillesen, Mayke van Ingen, Jakko Bowles, Edmée Tostmann, Alma Antimicrob Resist Infect Control Review BACKGROUND: Healthcare-associated infections (HAIs) are a significant cause of morbidity and mortality in hospitalized patients. Water in the environment can be a source of infection linked to outbreaks and environmental transmission in hospitals. Water safety in hospitals remains a challenge. This article has summarized available scientific literature to obtain an overview of outbreaks linked to water-containing hospital equipment and strategies to prevent such outbreaks. METHODS: We made a list of water-containing hospital equipment and devices in which water is being used in a semi-closed circuit. A literature search was performed in PubMed with a search strategy containing the names of these medical devices and one or more of the following words: outbreak, environmental contamination, transmission, infection. For each medical device, we summarized the following information: the function of the medical device, causes of contamination, the described outbreaks and possible prevention strategies. RESULTS: The following water-containing medical equipment  or devices were identified: heater-cooler units, hemodialysis equipment, neonatal incubators, dental unit waterlines, fluid warmers, nebulizers, water traps, water baths, blanketrol, scalp cooling, and thermic stimulators. Of the latter three, no literature could be found. Of all other devices, one or more outbreaks associated with these devices were reported in the literature. CONCLUSIONS: The water reservoirs in water-containing medical devices can be a source of microbial growth and transmissions to patients, despite the semi-closed water circuit. Proper handling and proper cleaning and disinfection can help to reduce the microbial burden and, consequently, transmission to patients. However, these devices are often difficult to clean and disinfect because they cannot be adequately opened or disassembled, and the manufacturer’s cleaning guidelines are often not feasible to execute. The development of equipment without water or fluid containers should be stimulated. Precise cleaning and disinfection guidelines and instructions are essential for instructing healthcare workers and hospital cleaning staff to prevent potential transmission to patients. BioMed Central 2021-05-10 /pmc/articles/PMC8108015/ /pubmed/33971944 http://dx.doi.org/10.1186/s13756-021-00935-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Review
Yiek, Wing-Kee
Coenen, Olga
Nillesen, Mayke
van Ingen, Jakko
Bowles, Edmée
Tostmann, Alma
Outbreaks of healthcare-associated infections linked to water-containing hospital equipment: a literature review
title Outbreaks of healthcare-associated infections linked to water-containing hospital equipment: a literature review
title_full Outbreaks of healthcare-associated infections linked to water-containing hospital equipment: a literature review
title_fullStr Outbreaks of healthcare-associated infections linked to water-containing hospital equipment: a literature review
title_full_unstemmed Outbreaks of healthcare-associated infections linked to water-containing hospital equipment: a literature review
title_short Outbreaks of healthcare-associated infections linked to water-containing hospital equipment: a literature review
title_sort outbreaks of healthcare-associated infections linked to water-containing hospital equipment: a literature review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8108015/
https://www.ncbi.nlm.nih.gov/pubmed/33971944
http://dx.doi.org/10.1186/s13756-021-00935-6
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