Academic literature on the topic 'Sinks (Plumbing fixtures)'

Abstract Background “Green” construction approaches may place hospitals at risk for long-term contamination of potable water, presenting hazards for immunosuppressed patients. Remediation may be needed to manage these unanticipated consequences. An indolent, 11-year cluster of Sphingomonas koreensis infections at the NIH Clinical Center was traced to potable water. During the investigation, 4 sinks in 2 ICU rooms were found to have intractable contamination. Despite replacement of sink fixtures, faucet swabs and water continued to grow S. koreensis, and mean free chlorine residual (FCR) from the sinks was 0.27 mg/L (goal > 0.5). We undertook a major project to replace and reroute sections of pipes leading to the sinks (Figures 1 and 2). Methods Hot and cold water pipes were removed from the sinks to the supply pipes and replaced. Pipes were rerouted so that hot and cold water supplying the sinks returned in a loop to the domestic hot water heater to eliminate 10-meter drop-down sections of dead-leg pipe. Automatic faucets were replaced with manual faucets. Faucet biofilm was swabbed and cultured monthly for S. koreensis. Environmental samples were cultured on sheep blood agar for 5 days. Yellow colonies were subcultured and identified by MALDI-TOF MS (Bruker). Results Demolition of the wall behind the sinks revealed hot and cold water piping containing stagnant water. Water pooled in cold water pipe had heavy growth of S. koreensis; water from the hot water pipe could not be collected. Hot and cold water FCR for the sinks after piping changes averaged 0.74 and 1.07 mg/L, respectively, compared with 0.27 mg/L simultaneously from automated faucets in unmodified ICU rooms. Faucet cultures were negative for S. koreensis after replumbing, and have remained negative for >6 months. Conclusion New hospital construction strategies appear to increase potable water contamination risks; novel remediation approaches are needed. Replacing contaminated water pipes and rerouting pipes to minimize stagnation eradicated longstanding contamination of 2 ICU sinks. Although the experiment was conducted on a small scale, it demonstrates that plumbing flaws that jeopardize patient safety can be corrected through multidisciplinary collaboration and creative plumbing strategies. Disclosures All authors: No reported disclosures.

Background: Contaminated healthcare facility plumbing is increasingly recognized as a source of carbapenemase-producing organisms (CPOs). In August 2019, the Tennessee State Public Health Laboratory identified Tennessee’s twelfth VIM-producing carbapenem-resistant Pseudomonas aeruginosa (VIM-CRPA), from a patient in a long-term acute-care hospital. To determine a potential reservoir, the Tennessee Department of Health (TDH) reviewed healthcare exposures for all cases. Four cases (33%), including the most recent case and earliest from March 2018, had a history of admission to intensive care unit (ICU) room X at acute-care hospital A (ACH A), but the specimens were collected at other facilities. The Public Health Laboratory collaborated with ACH A to assess exposures, perform environmental sampling, and implement control measures. Methods: TDH conducted in-person infection prevention assessments with ACH A, including a review of the water management program. Initial recommendations included placing all patients admitted to room X on contact precautions, screening for CPO on room discharge, daily sink basin and counter cleaning, and other sink hygiene measures. TDH collected environmental and water samples from 5 ICU sinks (ie, the handwashing and bathroom sinks in room X and neighboring room Y [control] and 1 hallway sink) and assessed the presence of VIM-CRPA. Moreover, 5 patients and 4 environmental VIM-CRPA underwent whole-genome sequencing (WGS). Results: From February to June 2020, of 21 patients admitted to room X, 9 (43%) underwent discharge screening and 4 (44%) were colonized with VIM-CRPA. Average room X length of stay was longer for colonized patients (11.3 vs 4.8 days). Drain swabs from room X’s bathroom and handwashing sinks grew VIM-CRPA; VIM-CRPA was not detected in tap water or other swab samples. VIM-CRPA from the environment and patients were sequence type 253 and varied by 0–13 single-nucleotide variants. ACH A replaced room X’s sinks and external plumbing in July. Discharge screening and contact precautions for all patients were discontinued in November, 5 months following the last case and 12 consecutive negative patient discharge screens. Improved sink hygiene and mechanism testing for CRPA from clinical cultures continued, with no new cases identified. Conclusions: An ICU room with a persistently contaminated sink drain was a persistent reservoir of VIM-CRPA. The room X attack rate was high, with VIM-CRPA acquisition occurring in >40% of patients screened. The use of contaminated plumbing fixtures in ACH have the potential to facilitate transmission to patients but may be challenging to identify and remediate. All healthcare facilities should follow sink hygiene best practices.Funding: NoDisclosures: None

The aim of this study is to identify the opportunities that currently exist in the Egyptian market in order for Franke to make a decision on the expansion of their business into this market. In order for the Board of Directors to make a quality decision they require good and accurate information. In line with the Franke growth strategy Franke South Africa was given the clear directive to grow the market share on the African continent. With this continent being as diverse as it is and suffering from many years of poverty, a focused strategy is required. With this in hand a study of the African continent was undergone and a couple of markets were identified as targets for either a take-over or new formation. With the information gathered on Egypt it became clear that this would be the ideal market to establish another Franke operation. Egypt has many positive issues that attract a decision like this of which the local market size, geographical position, COMESA membership and the fact that the market is well structured form the backbone. Based on this Business Plan, which researches all the relevant issues required to make a quality decision, an investment could be qualified and supported. It focuses on the possible target as well as elaborates on the medium term forecasted performance of the new setup.
Thesis (MBA)-University of Natal, Durban, 2003.