The hospital sink drain microbiome as a melting pot for AMR transmission to nosocomial pathogens

doi:10.1038/s44259-025-00137-9

Review

. 2025 Jul 29;3(1):68.

doi: 10.1038/s44259-025-00137-9.

The hospital sink drain microbiome as a melting pot for AMR transmission to nosocomial pathogens

Gregory E McCallum¹, James P J Hall²

Affiliations

¹ Department of Evolution, Ecology and Behaviour, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK. G.E.McCallum@liverpool.ac.uk.
² Department of Evolution, Ecology and Behaviour, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK. j.p.j.hall@liverpool.ac.uk.

PMID: 40730864
PMCID: PMC12307617
DOI: 10.1038/s44259-025-00137-9

Review

The hospital sink drain microbiome as a melting pot for AMR transmission to nosocomial pathogens

Gregory E McCallum et al. NPJ Antimicrob Resist. 2025.

. 2025 Jul 29;3(1):68.

doi: 10.1038/s44259-025-00137-9.

Authors

Gregory E McCallum¹, James P J Hall²

Affiliations

¹ Department of Evolution, Ecology and Behaviour, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK. G.E.McCallum@liverpool.ac.uk.
² Department of Evolution, Ecology and Behaviour, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK. j.p.j.hall@liverpool.ac.uk.

PMID: 40730864
PMCID: PMC12307617
DOI: 10.1038/s44259-025-00137-9

Abstract

The hospital sink drain microbiome can harbour opportunistic pathogens and antimicrobial resistance genes (ARGs). Aspects of this habitat, such as exposure to disinfectants, antibiotics, nutrients, and body fluids could exacerbate horizontal gene transfer of ARGs and clinically impactful pathogen resistance. Here, we explore features of the hospital sink drain that may favour ARG acquisition and transmission, highlight studies providing evidence of transfer, and consider strategies to mitigate these risks.

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Conflict of interest statement

Competing interests: The authors declare no competing interests.

Figures

**Fig. 1**
The hospital sink drain microbiome as a melting pot for AMR transmission to nosocomial pathogens.

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References

1. Sati, H. et al. The WHO Bacterial Priority Pathogens List 2024: a prioritisation study to guide research, development, and public health strategies against antimicrobial resistance. Lancet Infect. Dis.0, 10.1016/S1473-3099(25)00118-5 (2025). - PubMed
1. Gilbert, J. A. & Stephens, B. Microbiology of the built environment. Nat. Rev. Microbiol.16, 661–670 (2018). - PubMed
1. Partridge, S. R., Kwong, S. M., Firth, N. & Jensen, S. O. Mobile genetic elements associated with antimicrobial resistance. Clin. Microbiol. Rev.31, e00088–17 (2018). - PMC - PubMed
1. Wang, R. et al. The global distribution and spread of the mobilized colistin resistance gene mcr-1. Nat. Commun.9, 1179 (2018). - PMC - PubMed
1. Kopotsa, K., Osei Sekyere, J. & Mbelle, N. M. Plasmid evolution in carbapenemase-producing Enterobacteriaceae: a review. Ann. N. Y. Acad. Sci.1457, 61–91 (2019). - PubMed

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[1] Sati, H. et al. The WHO Bacterial Priority Pathogens List 2024: a prioritisation study to guide research, development, and public health strategies against antimicrobial resistance. Lancet Infect. Dis.0, 10.1016/S1473-3099(25)00118-5 (2025). - PubMed

[2] Sati, H. et al. The WHO Bacterial Priority Pathogens List 2024: a prioritisation study to guide research, development, and public health strategies against antimicrobial resistance. Lancet Infect. Dis.0, 10.1016/S1473-3099(25)00118-5 (2025). - PubMed

[3] Gilbert, J. A. & Stephens, B. Microbiology of the built environment. Nat. Rev. Microbiol.16, 661–670 (2018). - PubMed

[4] Gilbert, J. A. & Stephens, B. Microbiology of the built environment. Nat. Rev. Microbiol.16, 661–670 (2018). - PubMed

[5] Partridge, S. R., Kwong, S. M., Firth, N. & Jensen, S. O. Mobile genetic elements associated with antimicrobial resistance. Clin. Microbiol. Rev.31, e00088–17 (2018). - PMC - PubMed

[6] Partridge, S. R., Kwong, S. M., Firth, N. & Jensen, S. O. Mobile genetic elements associated with antimicrobial resistance. Clin. Microbiol. Rev.31, e00088–17 (2018). - PMC - PubMed

[7] Wang, R. et al. The global distribution and spread of the mobilized colistin resistance gene mcr-1. Nat. Commun.9, 1179 (2018). - PMC - PubMed

[8] Wang, R. et al. The global distribution and spread of the mobilized colistin resistance gene mcr-1. Nat. Commun.9, 1179 (2018). - PMC - PubMed

[9] Kopotsa, K., Osei Sekyere, J. & Mbelle, N. M. Plasmid evolution in carbapenemase-producing Enterobacteriaceae: a review. Ann. N. Y. Acad. Sci.1457, 61–91 (2019). - PubMed

[10] Kopotsa, K., Osei Sekyere, J. & Mbelle, N. M. Plasmid evolution in carbapenemase-producing Enterobacteriaceae: a review. Ann. N. Y. Acad. Sci.1457, 61–91 (2019). - PubMed

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The hospital sink drain microbiome as a melting pot for AMR transmission to nosocomial pathogens

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The hospital sink drain microbiome as a melting pot for AMR transmission to nosocomial pathogens

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Abstract

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