Impact of lockdown on the microbiological status of the hospital water network during COVID-19 pandemic

Giglio, Osvalda De; Diella, Giusy; Lopuzzo, Marco; Triggiano, Francesco; Calia, Carla; Pousis, Chrysovalentinos; Fasano, Fabrizio; Caggiano, Giuseppina; Calabrese, Giuseppe; Rafaschieri, Vincenza; Carpagnano, Federica; Carlucci, Matilde; Gesualdo, Loreto; Ricci, Maria Luisa; Scaturro, Maria; Rota, Maria Cristina; Bonadonna, Lucia; Lucentini, Luca; Montagna, Maria Teresa

doi:10.1016/j.envres.2020.110231

Cited by 28 publications

(27 citation statements)

References 14 publications

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“…These are all critical aspects related to Legionella persistence in man-made systems that contribute to a higher or lower legionellosis risk. The studies considered in Table 1 cover different water settings, including cooling towers [55][56][57], premise plumbing from hospitals [51,52,54,[58][59][60][61][62][63][64] and hotels [45,48,[64][65][66][67][68][69], residential potable water systems [46,70,71], and other facilities [72][73][74][75][76][77][78].…”

Section: Main Research Topicsmentioning

confidence: 99%

“…Chemical Disinfection Programs shape bacterial communities and reduce Legionella positivities (chlorination, chloramine, chlorine dioxide, copper-silver ionization, hydrogen peroxide and silver salts, NEOW) [51,52,54,56,61,62,66,72,73,[79][80][81] Effective temperature control reduces Legionella incidence [60,70,82] Water stagnation vs. water flushing [48,59,65,71,78,83]…”

Section: Microbial Control Strategiesmentioning

confidence: 99%

“…Water stagnation is known to be a critical factor for water-quality decrease, with an inherent impact on Legionella prevalence [93]. For example, De Giglio et al [59] assessed the microbiological water quality in an Italian hospital over 3 months during the COVID-19 lockdown. The authors found higher concentrations of L. pneumophila after the lockdown, which was attributed to building inoccupation.…”

Section: Water Stagnation Vs Water Flushingmentioning

confidence: 99%

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Legionella and Biofilms—Integrated Surveillance to Bridge Science and Real-Field Demands

2021

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Legionella is responsible for the life-threatening pneumonia commonly known as Legionnaires’ disease or legionellosis. Legionellosis is known to be preventable if proper measures are put into practice. Despite the efforts to improve preventive approaches, Legionella control remains one of the most challenging issues in the water treatment industry. Legionellosis incidence is on the rise and is expected to keep increasing as global challenges become a reality. This puts great emphasis on prevention, which must be grounded in strengthened Legionella management practices. Herein, an overview of field-based studies (the system as a test rig) is provided to unravel the common roots of research and the main contributions to Legionella’s understanding. The perpetuation of a water-focused monitoring approach and the importance of protozoa and biofilms will then be discussed as bottom-line questions for reliable Legionella real-field surveillance. Finally, an integrated monitoring model is proposed to study and control Legionella in water systems by combining discrete and continuous information about water and biofilm. Although the successful implementation of such a model requires a broader discussion across the scientific community and practitioners, this might be a starting point to build more consistent Legionella management strategies that can effectively mitigate legionellosis risks by reinforcing a pro-active Legionella prevention philosophy.

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Section: Main Research Topicsmentioning

confidence: 99%

Section: Microbial Control Strategiesmentioning

confidence: 99%

Section: Water Stagnation Vs Water Flushingmentioning

confidence: 99%

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Legionella and Biofilms—Integrated Surveillance to Bridge Science and Real-Field Demands

2021

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“…In recent years, particular attention has been paid to nosocomial legionellosis [ 8 , 10 , 11 , 12 , 13 , 14 ]. The association between drinking water and nosocomial legionellosis was first described about 40 years ago [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Management of Microbiological Contamination of the Water Network of a Newly Built Hospital Pavilion

et al. 2021

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The good installation, as well as commissioning plan, of a water network is a crucial step in reducing the risk of waterborne diseases. The aim of this study was to monitor the microbiological quality of water from a newly built pavilion before it commenced operation. Overall, 91 water samples were tested for coliforms, Escherichia coli, enterococci, Pseudomonas aeruginosa and Legionella at three different times: T0 (without any water treatment), T1 (after treatment with hydrogen peroxide and silver ions at initial concentration of 20 mg/L and after flushing of water for 20 min/day for seven successive days) and T2 (15 days later). Coliforms were detected in 47.3% of samples at T0, 36.3% at T1 and 4.4% at T2. E. coli was isolated in 4.4% of the samples only at T1, while enterococci appeared in 12.1% of the samples at T1 and in 2.2% at T2. P. aeruginosa was isolated in 50.5% of the samples at T0, 29.7% at T1 and 1.1% at T2. Legionella pneumophila serogroup 8 was isolated in 80.2% of the samples at T0, 36.3% at T1 and 2.2% at T2. Our results confirmed the need for a water safety plan in new hospital pavilions to prevent the risk of waterborne diseases.

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“…Similarly, 1.4 cases of LD per 100,000 populations were reported by the European Centre for Disease Prevention and Control in 2016. Recently, a study in Italy reported an incidence rate of 48.9 cases per 100,000 populations for legionellosis in 2018, of which 3.4% was of nosocomially acquired cases [42] . In Hong Kong, the incidence of LD was increasing from 0.16 cases/100,000 population in 2005 to 0.91 cases/100,000 population in 2015 [43] .…”

Section: Epidemiology Of Legionnaires' Diseasementioning

confidence: 99%

Legionella pneumophila — The causative agent of Legionnaires’ disease

Tan¹,

Tee²,

Khan³

et al. 2021

Prog Micobes Mol Biol

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Over the years, Legionella pneumophila has increasingly become a public health threat that causes sporadic and epidemic community-acquired and nosocomial-acquired pneumonia. Thus, this review aims to discuss the current knowledge of L. pneumophila, focusing on the global epidemiology, clinical features, diagnosis and treatment of Legionnaires’ disease (LD). Legionella bacteria are Gram-negative rod-shaped bacteria that are ubiquitous in aquatic environments. L. pneumophila was first discovered in 1976 and recognized as the causative agent of LD. L. pneumophila is a facultative intracellular pathogen that infects and replicates within eukaryotic host cells such as macrophages and protozoan. Diagnosis of LD remains a significant challenge as the clinical manifestation of LD is hardly distinguishable from pneumonia caused by other respiratory pathogens. Therefore, early testing and appropriate treatment are keys to alleviating the rising morbidity and mortality caused by LD.

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Impact of lockdown on the microbiological status of the hospital water network during COVID-19 pandemic

Cited by 28 publications

References 14 publications

Legionella and Biofilms—Integrated Surveillance to Bridge Science and Real-Field Demands

Legionella and Biofilms—Integrated Surveillance to Bridge Science and Real-Field Demands

Management of Microbiological Contamination of the Water Network of a Newly Built Hospital Pavilion

Legionella pneumophila — The causative agent of Legionnaires’ disease

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