Hospital washbasin water: risk of legionella-contaminated aerosol inhalation

Cassier, Pierre; Landelle, Caroline; Reyrolle, M.; Nicolle, Marie-Christine; Slimani, Sami; Etienne, Jérôme; Vanhems, Philippe; Jarraud, Sophie

doi:10.1016/j.jhin.2013.08.001

Cited by 9 publications

(6 citation statements)

References 9 publications

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“…Currently, there are over 60 species of Legionella reported; however, the main cause of Legionnaires' disease worldwide is L. pneumophila [3,4]. Legionella is transmitted to humans by aspiration of contaminated water and inhalation of contaminated aerosols and/or air conditioning gases [5][6][7]. Common factors contributing to Legionella persistence in water systems include biofilm formation, growth in amoebae, growth in nutrient-poor environments, and disinfectant resistance or tolerance [8,9].…”

Section: Introductionmentioning

confidence: 99%

Investigation of the presence of <i>Legionella pneumophila</i> in water samples from Erzurum and surrounding provinces in Turkey

Yılmaz¹,

Orhan²

2021

Ann Agric Environ Med.

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Introduction and objective. Legionnaires' disease, which is a waterborne disease leading to pneumonia that can result in death, is one of the major health issues today. The study aims to carry out a three-year retrospective review of routine Legionella follow-up analyses in various samples taken mostly from hospitals in the province of Erzurum and nearby provinces, and to discover a the frequency of isolation of the agent and serogroups from each kind of media. Materials and method. The study included a total of 2,025 water samples taken from hospitals, hotels, Turkish baths and shopping malls in Erzurum,and 13 nearby cities between 2016 and 2018. Samples were filtered by 0.45 μm-diameter membrane filter paper in the Public Health Laboratory of Erzurum and examined for L. pneumophila using culture method, according to the criteria set out in ISO 11731-2. Results. The presence of L. pneumophila was found in 65 of the 2,025 water samples taken in hospitals, and in none of 40 samples taken in hotels, Turkish baths and shopping malls. L. pneumophila serogroup 2-14 was detected in 46 (70.8%) of 65 samples found positive, whereas L. pneumophila serogroup 1 was detected in 18 (27.7%). Furthermore, both the L. pneumophila serogroup 2-14 and L. pneumophila serogroup 1 were detected simultaneously in one example (1.5%). The first three samples indicate that the highest positivity rates were in hot water taps (11.6%), hot water tanks (6.1%) and shower heads (4.8%). Conclusions. The Prevalence rat of L. pneumophila was found to be quite low compared to other studies conducted in the western regions of Turkey. Legionella positivity was found to be higher in the hot water systems of hospitals and related points, compared to the other sample points.

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Section: Introductionmentioning

confidence: 99%

Investigation of the presence of <i>Legionella pneumophila</i> in water samples from Erzurum and surrounding provinces in Turkey

Yılmaz¹,

Orhan²

2021

Ann Agric Environ Med.

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“…Transmission of Legionella to humans occurs through the inhalation of contaminated aerosols or aspiration of contaminated water (Blatt et al, 1993; Bartram et al, 2007; Cassier et al, 2013; Hines et al, 2014). Worldwide, incidences of Legionnaires’ disease are often linked to manufactured water systems (Beer et al, 2015) and in the United States, Legionella is the primary cause of all drinking water related outbreaks (Centers for Disease Control and Prevention, 2013).…”

Section: Introductionmentioning

confidence: 99%

Legionella Persistence in Manufactured Water Systems: Pasteurization Potentially Selecting for Thermal Tolerance

2017

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Legionella is an opportunistic waterborne pathogen of increasing public health significance. Pasteurization, otherwise known as super-heat and flush (increasing water temperature to above 70°C and flushing all outlets), has been identified as an important mechanism for the disinfection of Legionella in manufactured water systems. However, several studies have reported that this procedure was ineffective at remediating water distribution systems as Legionella was able to maintain long term persistent contamination. Up to 25% of L. pneumophila cells survived heat treatment of 70°C, but all of these were in a viable but non-culturable state. This demonstrates the limitations of the culture method of Legionella detection currently used to evaluate disinfection protocols. In addition, it has been demonstrated that pasteurization and nutrient starvation can select for thermal tolerant strains, where L. pneumophila was consistently identified as having greater thermal tolerance compared to other Legionella species. This review demonstrates that further research is needed to investigate the effectiveness of pasteurization as a disinfection method. In particular, it focuses on the potential for pasteurization to select for thermal tolerant L. pneumophila strains which, as the primary causative agent of Legionnaires disease, have greater public health significance compared to other Legionella species.

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“…A systematic review found 25 relevant articles and concluded that there was a plausible evidence for the transmission of P. aeruginosa from water systems to patients, although the route of transmission remained unclear (6). Several published papers have also reported that aerosols and splash water have been detected up to one metre away from sinks and gram-negative bacteria have been found in aerosols produced by running water in up to 93% of sinks (3,7,8). Even if the tap water flowing into the sink is pathogen free, and direct effusion is minimised by tap water pouring beside the sink drain instead of directly into it, pathogens can still contaminate the environment and healthcare workers' hands and pose a patient infection risk (2,(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Self‐disinfecting sink drains reduce the Pseudomonas aeruginosa bioburden in a neonatal intensive care unit

et al. 2015

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Hospital washbasin water: risk of legionella-contaminated aerosol inhalation

Cited by 9 publications

References 9 publications

Investigation of the presence of <i>Legionella pneumophila</i> in water samples from Erzurum and surrounding provinces in Turkey

Investigation of the presence of <i>Legionella pneumophila</i> in water samples from Erzurum and surrounding provinces in Turkey

Legionella Persistence in Manufactured Water Systems: Pasteurization Potentially Selecting for Thermal Tolerance

Self‐disinfecting sink drains reduce the Pseudomonas aeruginosa bioburden in a neonatal intensive care unit

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