Hospital water and prevention of waterborne infections

Abstract

The hospital water system may constitute a reservoir for microorganisms, such as Pseudomonas aeruginosa, Burkholderia cepacia, Stenotrophomonas maltophilia, Legionella pneumophila, Acinetobacter spp., mycetes, non-tubercular mycobacteria, and so on, which can cause healthcare-associated infections. Indeed, it has been revealed that 20-50% of cases of nosocomial colonization/infection due to P. aeruginosa are sustained by waterborne strains. Waterborne infections can be spread not only through the ingestion of contaminated water but also by contact with or the inhalation of aerosols. Immunocompromised patients are particularly susceptible to infection by such microorganisms, many of which are multi-resistant to antibiotics. Healthcare effects range from colonization of the airways and urinary tracts to bacteraemia and disseminated infections. In 2011, the WHO issued guidelines on the quality of water for human consumption, including hospital water supplies. In risk assessment and management, these guidelines adopt criteria centred on preventive measures rather than remedial action alone. The guidelines recommend the adoption of a Water Safety Plan for water-risk management. By providing safe water, proper implementation of the Water Safety Plan ensures patient safety and reduces costs, in that waterborne infections prolong hospitalisation and increase morbidity, mortality, treatment costs and compensation claims

Microbial Contamination of Dental Unit Waterlines and Potential Risk of Infection: A Narrative Review

“…Thus, biofilms form as a result of a process of microbial attachment to the substrate, cell proliferation and matrix production, which may be followed by detachment [38][39][40][41] (Figure 3). Indeed, during the normal use of the dental unit, portions of biofilm may detach from the substrate and be conveyed to the external environment through the sprays of handpieces.…”

Evaluation of Multidrug-Resistant P. aeruginosa in Healthcare Facility Water Systems

“…In greater detail, water sources and water-related devices are often contaminated with pathogens [ 18 , 19 , 20 ], which may be responsible for healthcare-associated infections, including P. aeruginosa [ 21 , 22 , 23 , 24 , 25 , 26 , 27 ].…”

Evaluation of Microbiological and Free-Living Protozoa Contamination in Dental Unit Waterlines

“…The association of Legionella with free-living amoebae was first reported in 1980 [41]. L. pneumophila has been shown to be able to parasitize and multiply in more than twenty different protozoan species, including Acanthamoeba, Naegleria and Vermamoeba [42,43].…”