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Self-cleaning technology advancements are often improve the efficiency of cleaning, but it never hurts to double check if any collateral affects come from it. Such is the example of a recent study done by Tokyo Medical University in Japan on water-jet nozzles in electric toilets. 

The study, which was presented at the virtual European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) looked into the possibility of the jet nozzles being an unintended hotbed for multi-drug resistant superbugs — Pseudomonas aeruginosa (MDRP) — in hospitals, EurekAlert! reports. These electric toilets, which are also commonplace in over 80 percent of households in Japan, utilize a pencil-sized nozzle post-flush that is is released from underneath a seat to spray the toilet bowl, self-cleaning itself after the process.

While innovative in theory, the concern is the self-cleaning technology creates a moist atmosphere conducive to hosting to MRDP strains. Over time, the overuse of antibiotics in hospitals has led to the evolution of the strain, making it multi-drug resistant and leading to the transmission of sepsis, pneumonia and other life-threatening illnesses among patients using the same toilet. 

In over ten visits between September 2020 and January 2021, hospital researchers took samples from electric toilets in the hematology ward following the usage from three patients suffering from MFRP infections — two of them having severe cases of sepsis. Strains that qualified for the study needed to show resistance to multiple antibiotics.

After comparing samples from the toilet nozzles to infected patients, all three had the same MRDP strain, indicating the possibility of a toilet-induced transfer.

"In short, our findings imply that multidrug-resistant P. aeruginosa bacteria were being transmitted within the patient community, and critically that the infection may be spread within hospitals via contaminated electric toilet nozzles", says Dr Nakamura. "With good hospital hygiene, which includes handwashing and environmental cleaning, we can control the spread of these pathogens, especially within in settings where patients' immune systems are compromised."

While the sample size on the study is small, it serves as a reminder for facilities especially those in the medical or residential field to consider possible complications that can come from investing in self-cleaning technologies. Along the same topic of safe toilet usage, check out this article on how applying toilet paper to seats on public toilets can do more harm than good.