Sink-related cleaning practices to prevent transmission of pathogens in healthcare settings

Each year, millions of infections are acquired in healthcare facilities. The hospital water environment (including sinks, showers and toilets) are now recognised as important environmental drivers of these infections- many of which can be prevented by hygiene and infection control measures, including effective cleaning. However, the most effective methods of cleaning the hospital water enviroment are still not known, so current practices may not prevent infections. Concerningly, recent evidence has emerged suggesting that current practices may inadvertently alter the bacterial population in these environmental reservoirs- potentially causing harm to patients. Furthermore, current practices rely on the widespread use of chemical disinfectants, which have ecological and environmental consequences. With the support of the Marie Skłodowska Curie Actions programme, SELECTION will develop a novel and environmentally considerate method for hospital sink cleaning. SELECTION will first optimise this method under controlled experimental conditions. A study will then be undertaken in a hospital setting to compare this novel approach with current cleaning practices. To understand the effectiveness of these interventions, we will measure the amount of bacteria present in sinks when cleaned with these different methods, and also use metagenomics and bioinformatics approaches to charecterise how different cleaning interventions change the microbial population within these reservoirs. We will interview healthcare workers involved in the implementation of cleaning interventions in the hospital (including cleaning staff, healthcare engineers and infection prevention and control specialists) to understand their perceptions of the novel intervention and outline the roadmap and barriers to implementation in healthcare settings beyond this research study. SELECTION will inform hospital cleaning strategies and infection prevention and control practices.