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Chapter 116 : Review of Nosocomial Outbreaks

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Abstract:

This chapter reviews the evidence of different disinfection methods to stop outbreaks of Legionnaires’ diseases (LD). Articles describing original outbreaks of were selected for the review. Full reports of potentially relevant publications were obtained and checked for eligibility. Decisions on which trials to include were based on full text articles. The following parameters were extracted: country, year of publication, year of outbreak, duration of outbreak, source of outbreak, facility and department, number of patients involved, number of health care workers involved, mortality, disinfection methods, and success of methods. outbreaks have a significant impact on patient morbidity and mortality in hospitals. In 68% of outbreaks, the source was the hospital water system or showers. In these cases, disinfection methods focusing on the water system should be chosen. The success of these disinfection methods depends on the status of the water system and the disinfection method used. This implies that technical measurements are very important factors for termination of outbreaks, despite other effective disinfection methods such as chlorination (70.6%) and elevating temperature once per month (71.4%). The safest interventions are sterile water for patient care or point-of-use filters. Interestingly, the number of published outbreaks has decreased since the 1980s, whereas the literature about did not. Whether or not this is due to better plumbing design of hospital water systems and more successful disinfection methods remains to be proven.

Citation: Eckmanns T, Reichhardt C, Martin M, Nietschke-Tiemann F, Rüden H. 2006. Review of Nosocomial Outbreaks, p 483-485. In Cianciotto N, Kwaik Y, Edelstein P, Fields B, Geary D, Harrison T, Joseph C, Ratcliff R, Stout J, Swanson M (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555815660.ch116

Key Concept Ranking

Chlorine Dioxide
0.53125
Water
0.41410315
Legionella
0.4140477
0.53125
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Figures

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FIGURE 1

Numbers of published outbreaks and published articles about in PubMed in 5-year periods for the 5pyear periods fort he years 1977 to 2005. (Outbreaks lasting over 1 year were counted for the first year of the outrbreak. Three studies gave no outbreak year.)

Citation: Eckmanns T, Reichhardt C, Martin M, Nietschke-Tiemann F, Rüden H. 2006. Review of Nosocomial Outbreaks, p 483-485. In Cianciotto N, Kwaik Y, Edelstein P, Fields B, Geary D, Harrison T, Joseph C, Ratcliff R, Stout J, Swanson M (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555815660.ch116
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References

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1. Joseph, C. A.,, J. M. Watson,, T. G. Harrison, and, C. L. Bartlett. 1994. Nosocomial Legionnaires’ disease in England and Wales, 1980-92. Epidemiol. Infect. 112:329345.
2. Centers for Disease Control. 2004. Guidelines for prevention of healthcare-associated pneumonia, 2003. Morbid. Mortal. Wkly. Rep. 53:136.
3. Benin, A. L.,, R. F. Benson, and, R. E. Besser. 2002. Trends in Legionnaires disease, 1980-1998: declining mortality and new patterns of diagnosis. Clin. Infect. Dis. 35:10391046.

Tables

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TABLE 1

Methods used to terminate the outbreaks and percent of success

Citation: Eckmanns T, Reichhardt C, Martin M, Nietschke-Tiemann F, Rüden H. 2006. Review of Nosocomial Outbreaks, p 483-485. In Cianciotto N, Kwaik Y, Edelstein P, Fields B, Geary D, Harrison T, Joseph C, Ratcliff R, Stout J, Swanson M (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555815660.ch116

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