Environmental Cultures and Hospital-Acquired Legionnaires' Disease: A 5-Year Prospective Study in 20 Hospitals in Catalonia, Spain

Leal, Miquel Sabrià; Deltell, Josep Maria Mòdol; Núñez, Marian García; Sosa, Esteban Alberto Reynaga; Montoya, Ma Luisa Pedro-Botet; Galindo, Nieves Sopena; Barroso, Celestino Rey-Joly

doi:10.1017/s019594170007750x

Cited by 21 publications

(20 citation statements)

References 23 publications

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“…Twelve studies did not apply routine clinical surveillance for hospital-acquired pneumonia. 5,6,[13][14][15][16][17][18][19][20][21][22] This was not surprising because these studies were not designed for such a purpose. This fatal flaw in the Allen et al article would lead to an underestimate of cases of Legionnaires' disease and artifactually lower the sensitivity.…”

Section: Inadequate or Absent Concurrent Surveillancementioning

confidence: 99%

“…5,6,13,18,21,23,24 For example, a Taiwan hospital was sampled on multiple occasions but only in 4-6 outlets in a 1,266-bed hospital; this is a gross underrepresentation of the water system of this hospital. 13 …”

Section: Inadequate Environmental Culture Samplingmentioning

confidence: 99%

“…The 30% cut-point was found to be predictive in other surveys of Legionnaires' disease. [5][6][7] It would be an oversimplification to assume that a single number could serve as a precise and absolute indicator of risk for disease occurrence. However, given the negative sequelae and morbidity of Legionnaires' disease, this parameter could serve as a decision point for proactive preventive actions and adopting the most accurate tests in-hospital.…”

mentioning

confidence: 99%

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Editorial commentary: Risk assessment and prediction for health care–associated Legionnaires' disease: Percent distal site positivity as a cut-point

Pierre¹,

Stout²,

2014

American Journal of Infection Control

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Section: Inadequate or Absent Concurrent Surveillancementioning

confidence: 99%

Section: Inadequate Environmental Culture Samplingmentioning

confidence: 99%

mentioning

confidence: 99%

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Editorial commentary: Risk assessment and prediction for health care–associated Legionnaires' disease: Percent distal site positivity as a cut-point

Pierre¹,

Stout²,

2014

American Journal of Infection Control

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“…Weiterhin zeigen die Ergebnisse von Surveillancestudien, dass sich bei Nachweis von Legionellen im Hausinstallationssystem die Aufmerksamkeit für nosokomiale Legionellosen bei Ärzten deutlich erhöht [8,9]. In medizinischen Einrichtungen müs-sen je nach Disposition der Patienten unterschiedliche Anforderungen an zulässige Legionellenkonzentrationen gestellt werden [1,9].…”

Section: Relevante Wasserassoziierte Nosokomiale Infektionserregerunclassified

“…Aktuel le epidemiologische und hygienisch-mikrobiologische Untersuchungen unter Einbeziehung moderner molekularbiologischer Typisierungsverfahren zeigen, dass dem Hausinstallationssystem in medizinischen Einrichtungen als Infektionsreservoir eine bislang unterschätzte Bedeutung zukommt [1][2][3][4][5][6][7][8]. Beachtet wurde in der Vergangenheit vor allem das Risiko einer vorhandenen Infektionsgefährdung durch Legionellen aus Hausinstallationssystemen [9][10][11].…”

unclassified

Wasser als Infektionsquelle in medizinischen Einrichtungen, Prävention und Kontrolle

Exner¹,

Krämer

Kistemann³

et al. 2007

Bundesgesundheitsbl.

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New epidemiological and microbiological investigations using molecular typing methods to link patient and environmental strains demonstrate a strong association between water-borne pathogens and nosocomial infections. Avoiding patient exposure to these pathogens results in a decreased incidence of water-borne nosocomial infections. There remains a tremendous potential to reduce hospital acquired infections previously viewed as inevitable and unavoidable through intervention and preventive measures. The characteristics of water application in health care facilities, the vulnerability of patients, the spectrum of relevant pathogens and their ecologic aspects, legal issues and important measures for prevention and control are discussed.

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Legionella reduction after conversion to monochloramine for residual disinfection

Weintraub¹,

Flannery²,

Vugia³

et al. 2008

Journal AWWA

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Previous studies have shown that monochloramine disinfection of municipal water supplies is associated with decreased risk of healthcare‐associated Legionnaires— disease. A twoyear, prospective environmental study was conducted to determine whether converting from chlorine to monochloramine for water disinfection would decrease Legionella colonization of hot water systems. Water and biofilm samples were collected from 53 buildings. Prevalence ratios comparing Legionella colonization before and after monochloramine disinfection were adjusted for water system characteristics. Legionella colonized 60% of the hot water systems before monochloramine conversion versus 4% after conversion. The median number of colonized sites per building declined significantly with monochloramine disinfection. Increased prevalence of Legionella colonization was associated with water heater temperatures below 50oC, buildings taller than 10 stories, and interruptions in water service. Although no outbreaks of Legionnaires— disease were found, the study provides support that use of monochloramine in water supplies may reduce Legionella transmission and incidence of Legionnaires— disease.

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Environmental Cultures and Hospital-Acquired Legionnaires' Disease: A 5-Year Prospective Study in 20 Hospitals in Catalonia, Spain

Cited by 21 publications

References 23 publications

Editorial commentary: Risk assessment and prediction for health care–associated Legionnaires' disease: Percent distal site positivity as a cut-point

Editorial commentary: Risk assessment and prediction for health care–associated Legionnaires' disease: Percent distal site positivity as a cut-point

Wasser als Infektionsquelle in medizinischen Einrichtungen, Prävention und Kontrolle

Legionella reduction after conversion to monochloramine for residual disinfection

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