Contaminated Handwashing Sinks Were the Source of a Clonal KPC Klebsiella Outbreak.
Key Takeaway
Seven carbapenem-resistant Klebsiella oxytoca isolates were recovered from the handwashing sink drains of a hematology ward, and molecular typing showed they were a single clone carrying the KPC-2 carbapenemase. The contaminated handwashing sinks were identified as the reservoir behind the outbreak.
The Study
Leitner and colleagues investigated a clonal outbreak of KPC-2-producing Klebsiella oxytoca on a hematology ward at the Medical University of Graz, Austria. Environmental sampling recovered seven carbapenem-resistant K. oxytoca isolates from the drains of handwashing sinks in four patient rooms and the medication room. All isolates carried the blaKPC-2 and blaTEM-1 resistance genes and were genetically indistinguishable, identifying the contaminated handwashing sinks as the source of the outbreak.
Key Findings
The organism came from the sink drains
Seven carbapenem-resistant Klebsiella oxytoca isolates were recovered from the handwashing sink drains in four patient rooms and the medication room.
A single clone caused the outbreak
Molecular typing showed the isolates were genetically indistinguishable, confirming a clonal outbreak arising from a common environmental source.
KPC-2 carbapenemase
All isolates carried the blaKPC-2 and blaTEM-1 resistance genes, marking them as carbapenemase-producing organisms.
Handwashing sinks were the reservoir
The contaminated handwashing sinks were identified as the likely reservoir of the outbreak on the hematology ward.
What This Means For Your Facility
This outbreak on a hematology ward, where patients are especially vulnerable, was traced directly to the drains of handwashing sinks. It is a reminder that the sink meant to support hand hygiene can itself hold the reservoir when the drain is contaminated. The same standing-water trap exists in sinks and floor drains across commercial, food-service, and healthcare buildings.
Green Drain is a waterless one-way valve that allows water to drain but restricts the retrograde movement of air and aerosols from the drainage system. It removes the standing water a conventional trap relies on and closes when the drain is not in use. It does not remediate an existing biofilm. This study did not test a trap seal; in the SGS aerosol-retention test (Report QDF25-0049810-01), the GD3 retained over 99.9% of an aerosolized MS2 bacteriophage viral surrogate in a controlled bench test. As a supportive engineering control, it complements, and does not replace, cleaning, hand hygiene, and stewardship.
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Related Research
Remove the Standing-Water Reservoir
Green Drain removes the standing water a conventional trap relies on and restricts the retrograde movement of air and aerosols from the drainage system. It does not remediate an existing biofilm. A supportive engineering control that complements, not replaces, your infection prevention program.