Spatiotemporal dynamics and stability of multi-kingdom microbial communities in hospital sinks acting as persistent pathogen reservoirs

Hospital sink drains serve as persistent reservoirs for nosocomial pathogens, but understanding their associated microbial communities remains limited. The study characterizes multi-kingdom microbial communities in 14 sinks from a former intensive care unit (ICU) over a 17-month period during renovation and transition to clinical use.

This comprehensive analysis, integrating multi-kingdom meta-taxonomic profiling, culturomics, and phenotypic resistance testing, reveals a highly conserved multi-kingdom core within these sinks that remains resilient despite significant structural changes and periods of inactivity. While this core remains constant, community composition changes along a temporal gradient due to structural and anthropogenic shifts.

Each sink develops as a unique microecosystem influenced by local environmental factors. Network modeling demonstrates these communities are structured ecological units, with multidrug-resistant WHO-priority pathogens embedded within them alongside often-neglected fungi and protozoa. The findings emphasize that hospital sink drains are persistent and structured multi-kingdom microbial reservoirs, housing clinically relevant multidrug-resistant organisms (MDROs).

Their temporal stability and unique signatures underscore the necessity to consider the broader microbial community when monitoring hospital environmental reservoirs and devising infection-control strategies.