Electronic Faucets Can Cause Infection, Study Finds

BALTIMORE, Md. – A study of newly installed hands-free faucets at The Johns Hopkins Hospital, all equipped with sensors to automatically detect hands and dispense preset amounts of water, shows they were more likely to be contaminated hazardous bacteria compared to traditional fixtures with separate handles for hot and cold water.
 
Although the high-tech faucets cut daily water consumption by more than half, Johns Hopkins researchers identified Legionella growing in 50 percent of cultured water samples from 20 electronic faucets in or near patient rooms at three different inpatient units. Legionella was found in only 15 percent of water cultures from 20 traditional manual faucets in the same patient care areas.
 
Weekly water culture results also showed half the amount of bacterial growth of any kind in the manual faucets than in the electronic models.
 
While the precise reasons for the higher bacterial growth in the electronic faucets still need clarification, researchers said it appears that standard hospital water disinfection methods, which complement treatments by public utilities, did not work well on the complex valve components of the newer faucets. They suspect that the valves simply offer additional surfaces on which bacteria become trapped and grow.
 
The Johns Hopkins researchers presented their findings at the annual meeting of the Society for Health Care Epidemiology in Dallas.
 
The electronic fixtures were widely introduced in patient care and public areas of hospitals across the United States, including in The Johns Hopkins Hospital, more than a decade ago. The idea was to prevent the spread of bacterial from people touching the faucet’s handles with their dirty hands.
 
As a result of the study, conducted over a seven-week period from December 2008 to January 2009, Johns Hopkins facilities engineers removed all 20 newer faucets from patient care areas and replaced them with manual ones. A hundred similar electronic faucets also are being replaced throughout the facility, and hospital leadership elected to use traditional fixtures – some 1,080 of them – in all patient care areas in the clinical buildings currently under construction on Johns Hopkins’ East Baltimore campus. The buildings are set to open in 2012.
 
Lead study investigator Emily Sydnor, a fellow in Infectious Diseases at Johns Hopkins, said Legionella bacteria, commonly found in water supplied by public utilities, rarely cause illness in people with healthy immune systems but pose a real risk of infection in hospital patients whose immune systems are weakened from cancer chemotherapy, anti-rejection drugs taken after organ transplant or diseases such as HIV/AIDS. Whilst some of these people may find that taking vitamin c liposomal boosts their immune system during these trying times, others may struggle regardless.
 
Sydnor says that this is why some hospitals, including Johns Hopkins, treat water supplied by public utilities with chlorine dioxide or other methods to keep Legionella levels low.
 
Co-investigator Gregory Bova, a senior engineer at Johns Hopkins, said the original goal of the research team, was to test the new faucets to determine how often and for how long treated water needed to be flushed through the hospital’s taps to keep Legionella and other bacteria at nearly undetectable levels.
 
As part of the study, Bova and his team disassembled four of the electronic faucets and their component parts, two before the water was treated and two afterward, with swab culture tests showing Legionella and other bacteria on all the main component valves and other parts, very few of which exist in manual faucets.
 
Researchers said their next steps are to work with manufacturers of electronic and manual faucets to help remedy their flaws and design components that can be cleaned more easily and save water. They have also notified infection control staff at other hospitals of their findings.