Drainage systems, an occluded source of sanitation related outbreaks

Blom, Kristina

Despite good sanitation, problems arise when the sanitation system is not working properly in case of e.g. leakage and backflow caused by blockages or dried out traps. It is beyond proof that wastewater, sewages, or drains act as cradles for emerging new microorganisms with increasing ability to resist antibiotics and possibly armed with virulence factors obtained from other encountered species [47, 50, 51] . The cradles consist of microbial biofilm, where transfer of genes coding resistance and virulence is promoted [47, 62] . The pressure for selection of resistant microbes is probably higher in healthcare settings due to the turnover of many sick patients shedding along with administered antibiotics down the drains. Drains have been reported to be the source of several outbreaks. However, outbreaks are not often linked to the environment unless the outbreak isolate possesses an unusual multi-resistant profile [7] . The threat of mortality rate equaling the pre-antibiotic era is immediate and not for future. If no efficient antibiotics, current infections can't be treated and sensitive interventions will not be possible to pursue. Therefore, preventive actions are urgent and must be taken to reduce infections causing us to focus on the fundamental need for a safe and maintained sanitation system.