Short-Lived Success: Carbapenem-Resistant Enterobacterales Recolonization in Sinks Following Repeated Peroxide-Peracetic Acid-Based Foam Disinfection

Short-Lived Success: Carbapenem-Resistant Enterobacterales Recolonization in Sinks Following Repeated Peroxide-Peracetic Acid-Based Foam Disinfection | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Short-Lived Success: Carbapenem-Resistant Enterobacterales Recolonization in Sinks Following Repeated Peroxide-Peracetic Acid-Based Foam Disinfection Shireen Kotay, Aubrey Hetzler, Sharvari Narendra, Kevin Chau, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8674914/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Sink-drains/traps in healthcare facilities are recognized reservoirs of drug-resistant Gram-negative bacilli, yet effective remediation strategies remain uncertain. Using culture-based and metagenomic approaches, we evaluated the impact of a peroxide peracetic-acid(PPAA)-foam disinfectant applied at 3-, 5- or 7-day intervals over four-weeks in a controlled Sinklab and a hospital setting. Across all application frequencies and repeated applications, PPAA-foam was ineffective in reducing carbapenemase-producing Enterobacterales counts from baseline over 28days. Instead, treatment induced pronounced microbiome dysbiosis in sink-drains and traps, characterized by reduced community diversity, enrichment of Enterobacterales, and amplification of resistance determinants, including blaKPC and blaNDM. Hospital sinks exhibited comparable transient effects following PPAA-foam treatment, with rapid post-treatment recovery of both microbial communities and resistome. Together, these findings demonstrate that repeated chemical disinfection in established plumbing systems may destabilize drain microbiomes and paradoxically reinforce the persistence of high-risk pathogens and antimicrobial resistance, underscoring the need for ecologically informed alternatives to chemical-only interventions. Biological sciences/Microbiology/Environmental microbiology/Water microbiology Earth and environmental sciences/Ecology/Microbial ecology Biological sciences/Microbiology/Clinical microbiology hospital sinks drain P-trap biofilms CPE disinfectants microbiome Full Text Additional Declarations There is NO Competing Interest. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8674914","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":579463404,"identity":"ab504f11-f8fa-4b42-9111-3e453335c2ec","order_by":0,"name":"Shireen 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Using culture-based and metagenomic approaches, we evaluated the impact of a peroxide peracetic-acid(PPAA)-foam disinfectant applied at 3-, 5- or 7-day intervals over four-weeks in a controlled Sinklab and a hospital setting. Across all application frequencies and repeated applications, PPAA-foam was ineffective in reducing carbapenemase-producing Enterobacterales counts from baseline over 28days. Instead, treatment induced pronounced microbiome dysbiosis in sink-drains and traps, characterized by reduced community diversity, enrichment of Enterobacterales, and amplification of resistance determinants, including blaKPC and blaNDM. Hospital sinks exhibited comparable transient effects following PPAA-foam treatment, with rapid post-treatment recovery of both microbial communities and resistome. 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