Antibiotics are now commonly used to treat infections – they have saved countless lives since the 1930s. However, there are increasingly more germs that even modern antibiotics are no longer effective against: a study* estimates that in 2019 alone, almost 5 million deaths were caused by antibiotic resistance – and the World Health Organisation (WHO) is already talking about a silent pandemic.
Such resistance (from the Latin word ‘to resist’) is a particular problem in healthcare facilities such as hospitals and nursing homes: in places where people are supposed to recover, it complicates the treatment of infections, leads to longer periods of illness and increased mortality – and it drives up healthcare costs.
Washbasins and air dryers: hotspots for multi-resistant germs
The spread of germs and antimicrobial resistance (AMR for short) is particularly prevalent in environments where there is more traffic of people who frequently wash and dry their hands. A recent study** has now looked at the level of resistant germs in industrial settings. It examined the sinks at washbasins and nearby air dryers and found an alarming number of resistant germs, with up to 43 different types.
The hand dryers contained different microbes with different resistance profiles than the washbasins, which can be explained by the different external conditions in the sinks and on the airflow dryers. However, the amount of resistance genes – i.e. the genes that lead to antibiotic resistance – is comparable between the siphons and airflow dryers in absolute terms.
Clear objective: prevent the spread of germs in washrooms
Studies conducted in recent years have shown that when air dryers are used in washrooms, contamination with germs on surfaces and in the surrounding area is higher than when hands are dried with paper towels – this also applies to multi-resistant germs. In the healthcare sector, professional associations therefore recommend paper towels rather than air dryers: they are proven to be the most hygienic method of drying hands.
The current study also sheds further light on the design of washrooms. For example, the water jet should be as splash-free as possible and not directed directly at the sink to prevent the spread of (different!) germs or aerosols. And whether combined fittings – consisting of a central tap and air dryer nozzles attached directly to each side and pointing into the basin – are a good idea is certainly open to question.
The big issue remains: preventing infections and contagion!
Only new and more effective antibiotics, which require further research, can prevent the ‘silent pandemic’ of antibiotic resistance. However, the study shows how important it is to monitor hygiene solutions in frequently used washrooms to ensure they are effective against the spread of antimicrobial resistance.
The clever design of washrooms and their provision with paper towels can make an important contribution here – and can prevent or reduce infection and cross-contamination in a simple, cost-effective way. This applies not only to healthcare, but also to schools, restaurants, offices and all public areas where many people use the same washrooms on a daily basis. After all, health affects not only each and every one of us, but society as a whole.
* Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022;399:629-655.
** https://bmcmicrobiol.biomedcentral.com/articles/10.1186/s12866-025-04054-9
