Patients’ Bath Basins as Potential Sources of Infection: A Multicenter Sampling Study

Background Nosocomial infections are a marked burden on the US health care system and are linked to a high number of patient deaths.

Objective To identify and quantify bacteria in patients’ bath basins and evaluate the basins as a possible reservoir for bacterial colonization and a risk factor for subsequent hospital-acquired infection.

Methods In a prospective study at 3 acute care hospitals, 92 bath basins, including basins from 3 intensive care units, were evaluated. Sterile culture sponges were used to obtain samples from the basins. The culture sponges were sent to an outside laboratory, and qualitative and quantitative microbial tests were conducted and the results reported.

Results Some form of bacteria grew in 98% of the samples (90 sponges), either by plating or on enrichment (95% confidence interval, 92%–99.7%). The organisms with the highest positive rates of growth on enrichment were enterococci (54%), gram-negative organisms (32%), Staphylococcus aureus (23%), vancomycin-resistant enterococci (13%), methicillin-resistant S aureus (8%), Pseudomonas aeruginosa (5%), Candida albicans (3%), and Escherichia coli (2%). Mean plate counts, in colony-forming units, were 10 187 for gram-negative organisms, 99 for E coli, 30 for P aeruginosa, 86 for S aureus, 207 for enterococci, and 31 for vancomycin-resistant enterococci.

Conclusions Bath basins are a reservoir for bacteria and may be a source of transmission of hospital-acquired infections. Increased awareness of bath basins as a possible source of transmission of hospital-acquired infections is needed, particularly for high-risk patients.