Lanarkshire, United Kingdom

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Hospital toilets might look clean, but they're highly contaminated and might be exposing people to drug-resistant superbugs.

According to a new study presented at the ESCMID Global Congress in Barcelona between April 27 and 30, patient toilets in UK hospitals have more contamination than staff toilets, of which women's bathrooms were the cleanest, while unisex and unisex-disabled toilets were the most contaminated.

The research team found harmful bacteria, fungi and multi-drug resistant germs lurking on the surfaces of toilets in UK hospitals, including floors, ceilings and door handles. They collected microbe samples from the toilets in three general hospitals in Lanarkshire in the United Kingdom. They swabbed several surfaces in six kinds of toilets - male and female for staff and patients and disabled and unisex, around four hours after being cleaned. These surfaces included the flush, handrails, door handles, faucets, floor, shelves, tops of doors and air vents.

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After testing these samples, the research team discovered that most of these surfaces hosted dangerous bacteria, including E. coli and Staphylococcus aureus. They also had several species that cause infections in the bloodstream, chest, urinary tract and diseases like pneumonia. Most patient toilets had drug-resistant superbugs (strains of bacteria, viruses, fungi and parasites that have grown resistant to medications commonly used to treat infections, like antibiotics).

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Due to this evolved resistance, infections caused by superbugs can cause prolonged illnesses and more hospitalisations. For instance, Staphylococcus aureus has developed resistance against Methicilin and Mycobacterium tuberculosis is a multidrug-resistant superbug.

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Stephanie Dancer, a consultant biologist at NHS Lanarkshire and study researcher, said, "Every type of toilet in all three hospitals receives the same cleaning (type and frequency) every day but given our findings, we think that patient toilets should be cleaned more often."

The unisex toilets were the most contaminated and had the highest levels of microbes on their surfaces. A common reason behind this can be that people, especially men, use those toilets more as the female-only toilets were significantly and consistently cleaner than the male-only toilets. 

"The move to convert traditional male and female facilities to unisex facilities in some hospitals raises concern that people might be exposed to higher risks of contamination," Dancer said. "For example, hand hygiene surveys show that women are more likely to clean their hands after bathroom use than men, so we decided to investigate which microbes were present on different surfaces in toilets and how many of them there were," she added. 

Researchers also found that surfaces like floors and tops of doors had lighter levels of bacteria than high-touch surfaces.

(With inputs from agencies)