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Chapter 121 : Disinfection of Hospital Water Systems and the Prevention of Legionellosis: What is the Evidence?

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Disinfection of Hospital Water Systems and the Prevention of Legionellosis: What is the Evidence?, Page 1 of 2

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Abstract:

The contaminated hospital water system (HWS) is often identified as the source of spp.. In this case, disinfection of the HWS is required, aiming at the prevention of nosocomial Legionnaires’ disease (LD). This chapter analyzes the literature for evidence of different disinfection methods and their success in preventing nosocomial LD. The authors found 45 studies describing disinfection methods in HWS, 16 in which the outcome LD was included in this review. Nine authors reported three or more interventions to achieve disinfection of the HWS. Based on the study-quality rating system, rates for each disinfection method was calculated. Chlorine dioxide (rate 2.0) was used in one study with the outcome being LD only, where several disinfection methods for LD control were implemented. Once a system is technically well maintained, and a low spp. count is achieved, a single method, e.g., copper/ silver ions or high warm-water maintenance temperature (>55°C at distal outlets) for the prevention of LD might be sufficient.

Citation: Reichardt C, Martin M, Rüden H, Eckmanns T. 2006. Disinfection of Hospital Water Systems and the Prevention of Legionellosis: What is the Evidence?, p 501-504. 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.ch121

Key Concept Ranking

Chlorine Dioxide
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Randomized Controlled Trial
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References

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1. Anonymous. 1997. Sustained transmission of nosocomial Legionnaires’ disease: Arizona and Ohio. Morbid. Mortal. Wkly. Rep. 46:416421.
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12. Snyder, M. B.,, M. Siwicki,, J. Wireman,, D. Pohlod,, M. Grimes,, S. Bowman-Riney, and, L. D. Saravolatz. 1990. Reduction in Legionella pneumophila through heat flushing followed by continuous supplemental chlorination of hospital hot water. J. Infect. Dis. 162:127132.
13. Stout, J. E.,, Y. S. Lin,, A. M. Goetz, and, R. R. Muder. 1998. Controlling Legionella in hospital water systems: experience with the superheat-and-flush method and copper-silver ionization. Infect. Control Hosp. Epidemiol. 19:911914.
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Tables

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TABLE 1

Rating system for study quality

Citation: Reichardt C, Martin M, Rüden H, Eckmanns T. 2006. Disinfection of Hospital Water Systems and the Prevention of Legionellosis: What is the Evidence?, p 501-504. 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.ch121
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TABLE 2

Intervention studies with outcome Legionnaires’ disease

Citation: Reichardt C, Martin M, Rüden H, Eckmanns T. 2006. Disinfection of Hospital Water Systems and the Prevention of Legionellosis: What is the Evidence?, p 501-504. 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.ch121

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