Anaissie Elias J, Penzak Scott R, Dignani M Cecilia
Myeloma and Transplantation Research Center, University of Arkansas for Medical Sciences, Little Rock 72205, USA.
Arch Intern Med. 2002 Jul 8;162(13):1483-92. doi: 10.1001/archinte.162.13.1483.
Microbiologically contaminated drinking water is a cause of community-acquired infection, and guidelines for prevention of such infections have been established. Microbes in hospital water can also cause nosocomial infection, yet guidelines for preventing such infections do not exist. The purpose of this review is to assess the magnitude of the problem caused by waterborne nosocomial infections and to plea for immediate action for their prevention.
We conducted a MEDLINE search of the literature published between January 1, 1966, and December 31, 2001.
Investigations in which microorganisms (other than Legionella species) caused waterborne nosocomial infections and public health agency recommendations for drinking water.
Forty-three outbreaks of waterborne nosocomial infections have been reported, and an estimated 1400 deaths occur each year in the United States as a result of waterborne nosocomial pneumonias caused by Pseudomonas aeruginosa alone. Despite the availability of effective control measures, no clear guidelines exist for the prevention of these infections. By contrast, guidelines for the prevention of community-acquired waterborne infections are now routinely used. Hospitals caring for patients at high risk for infection do not enforce the standards of water quality recommended by US and United Kingdom public health agencies for the patients' community counterparts.
Because of the seriousness of these nosocomial waterborne infections and the availability, low cost, and proven effectiveness of sterile water, we recommend that hospitalized patients at high risk for infection avoid exposure to hospital water and use sterile water instead.
受微生物污染的饮用水是社区获得性感染的一个原因，并且已经制定了预防此类感染的指南。医院用水中的微生物也可导致医院感染，然而目前尚无预防此类感染的指南。本综述的目的是评估水源性医院感染所造成问题的严重程度，并呼吁立即采取行动预防这些感染。
我们对1966年1月1日至2001年12月31日期间发表的文献进行了MEDLINE检索。
关于微生物（除军团菌属外）引起水源性医院感染以及公共卫生机构对饮用水的建议的调查。
已报告了43起水源性医院感染暴发事件，仅在美国，据估计每年就有1400人因铜绿假单胞菌引起的水源性医院肺炎死亡。尽管有有效的控制措施，但尚无明确的预防这些感染的指南。相比之下，预防社区获得性水源性感染的指南现在已被常规使用。照顾感染高危患者的医院并未执行美国和英国公共卫生机构为患者所在社区制定的水质标准。
鉴于这些医院水源性感染的严重性以及无菌水的可得性、低成本和已证实的有效性，我们建议感染高危的住院患者避免接触医院用水，而改用无菌水。
