Hospital-Acquired Legionnaires Disease in a University Hospital: Impact of the Copper-Silver Ionization System

Mòdol, Josep María; Sabrià, Miquel; Reynaga, Esteban; Pedro‐Botet, María Luisa; Sopena, Nieves; Tudela, Pere; Casas, Irma; Rey-Joly, Celestino

doi:10.1086/510430

Cited by 19 publications

(14 citation statements)

References 9 publications

(10 reference statements)

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“…Control of the microbial community was seen at higher levels of copper and silver (1.2 and 0.2 mg/L, respectively) than would normally be used in PDSs. There are other examples of the efficacy of the field application, or model evaluation, of CSI for the control of waterborne pathogens extant in the literature (see, among many others, USEPA , Lin et al , Hsiu‐Yun & Lin , Choi et al , Modol et al , Lin et al , CDC ).…”

Section: Copper–silver Ionizationmentioning

confidence: 99%

Copper and Silver Biocidal Mechanisms, Resistance Strategies, and Efficacy for Legionella Control

June

Dziewulski

2018

Journal AWWA

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Legionella pneumophila, regularly found within premise plumbing distribution systems of many large and complex buildings, is responsible for 90% of legionellosis cases. When properly applied and maintained, onsite water treatment offers options for pathogen inactivation and health protection. The addition of copper and silver ions by copper–silver ionization (CSI) is reviewed here. A literature survey was conducted to assess current knowledge about the biocidal mechanisms of copper and silver ions against Legionella spp. and their survival responses and resistance mechanisms. Understanding how copper and silver ions affect bacteria, how bacteria defend against metal ions, and environmental conditions that affect CSI efficacy may help better define conditions under which CSI, alone or in combination with other treatment(s), might offer reliable control of Legionella. Elevated dissolved oxygen, the sodium content of the water, combined disinfectants, and higher temperature may provide conditions under which Legionella spp. may be more susceptible to metal ions.

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Section: Copper–silver Ionizationmentioning

confidence: 99%

Copper and Silver Biocidal Mechanisms, Resistance Strategies, and Efficacy for Legionella Control

June

Dziewulski

2018

Journal AWWA

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“…Mòdol et al (2007) in an evaluation of the impact of the technique after the implementation of other techniques, reported a significant decrease in Legionella counts as w ell as reduction in nosocomial legionellosis (2.45 to 0.18 cases per 1000 patient discharges)…”

Section: Characterization Of Efficacy Advantages and Disadvantagesmentioning

confidence: 99%

Evidence based review of Legionella elimination in building water systems

Sedzro¹,

Banu²,

Akrong³

2017

Int. J. Water Res. Environ. Eng.

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Legionnaires disease can be acquired through exposure to Legionella pneumophila, a gram-negative bacteria ubiquitous in both natural and engineered water systems. Over the years, a number of disinfection techniques notably, chlorination, ozonation, thermal, UV and copper-silver ionization have been employed across different kinds of engineered water systems with diverse measures of success. Available evidence portends, most of the aforementioned techniques often have to be combined to achieve long-term efficacy. Remarkably, albeit the extensive research and reportage on Legionnaires outbreak in the developed world, very few studies have been carried out with regards to Africa. We reviewed existing literature on the application of the aforementioned techniques in buildings. Our study concurs with earlier studies; most of the disinfection techniques will have to be combined to achieve the desired efficacy. We found very scanty studies on Legionella or reportage of its outbreak within Africa. Our study also found very little in terms of any of the techniques been applied with the specific aim of reducing Legionella proliferation in engineered water systems within Africa. This is alarming, especially, on a continent where several communities have little or no access to quality water and healthcare. In light of the above, stronger measures such as sensitization, pro perly managed water distribution systems, as well as policies aimed at enforcing national and international guidelines on Legionella control is recommended.

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“…140e142 A Spanish hospital saw legionella infection rates fall from 2.45 to 0.18 cases per 1000 discharges following installation of a copperesilver ionisation system (P < 0.001). 140 Routine surveillance of hospital water supplies for legionella is highly recommended in cases of confirmed legionella infections; however, it is controversial as to whether such routine testing is needed in hospitals with no legionella infection history. 138,143 All water leaks and water damage should be repaired and remediated within 24 h to prevent growth of pathogenic bacteria and moulds.…”

Section: Preventing Waterborne Hospital Infectionsmentioning

confidence: 99%

Prevention of hospital-acquired infections: review of non-pharmacological interventions

Curtis

2008

Journal of Hospital Infection

143

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Hospital-acquired (nosocomial) infections (HAIs) increase morbidity, mortality and medical costs. In the USA alone, nosocomial infections cause about 1.7 million infections and 99 000 deaths per year. HAIs are spread by numerous routes including surfaces (especially hands), air, water, intravenous routes, oral routes and through surgery. Interventions such as proper hand and surface cleaning, better nutrition, sufficient numbers of nurses, better ventilator management, use of coated urinary and central venous catheters and use of high-efficiency particulate air (HEPA) filters have all been associated with significantly lower nosocomial infection rates. Multiple infection control techniques and strategies simultaneously ('bundling') may offer the best opportunity to reduce the morbidity and mortality toll of HAIs. Most of these infection control strategies will more than pay for themselves by saving the medical costs associated with nosocomial infections. Many non-pharmacological interventions to prevent many HAIs will also reduce the need for long or multiple-drug antibiotic courses for patients. Lower antibiotic drug usage will reduce risk of antibiotic-resistant organisms and should improve efficacy of antibiotics given to patients who do acquire infections.

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Hospital-Acquired Legionnaires Disease in a University Hospital: Impact of the Copper-Silver Ionization System

Cited by 19 publications

References 9 publications

Copper and Silver Biocidal Mechanisms, Resistance Strategies, and Efficacy for Legionella Control

Copper and Silver Biocidal Mechanisms, Resistance Strategies, and Efficacy for Legionella Control

Evidence based review of Legionella elimination in building water systems

Prevention of hospital-acquired infections: review of non-pharmacological interventions

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