Sheffer Patricia J, Stout Janet E, Wagener Marilyn M, Muder Robert R
VA Pittsburgh Health Care System, Pittsburgh, Pennsylvania, USA.
Am J Infect Control. 2005 Jun;33(5 Suppl 1):S20-5. doi: 10.1016/j.ajic.2005.03.012.
Legionella species cause health care-acquired infections in which immunocompromised patients are disproportionately affected. Epidemiologic studies have demonstrated that point-of-use water fixtures are the reservoirs for these infections. The current approach to prevention is system-wide chemical disinfection of the hospital water system. These methods affect both low-risk and high-risk areas. A more effective approach to prevention may be a targeted approach aimed at protecting high-risk patients. One option is the application of a physical barrier (filter) at the point-of-use water fixture.
To evaluate the ability of point-of-use filters to eliminate Legionella and other pathogens from water.
One hundred twenty-milliliter hot water samples were collected from 7 faucets (4 with filters and 3 without) immediately and after a 1-minute flush. Samples were collected every 2 or 3 days for 1 week. This cycle was repeated for 12 weeks. Samples were cultured for Legionella, total heterotrophic plate count (HPC) bacteria, and Mycobacterium species.
Five hundred ninety-four samples were collected over 12 cycles. No Legionella or Mycobacterium were isolated from the faucets with filters between T = 0 and T = 8 days. The mean concentration of L pneumophila and Mycobacterium from the control faucets was 104.5 CFU/mL and 0.44 CFU/mL, respectively. The filters achieved a greater than 99% reduction in HPC bacteria in the immediate and postflush samples.
Point-of-use filters completely eliminated L pneumophila and Mycobacterium from hot water samples. These filter units could prevent exposure of high-risk patients to waterborne pathogens.
军团菌可引发医疗保健相关感染,免疫功能低下的患者受影响尤为严重。流行病学研究表明,使用点的水装置是这些感染的源头。当前的预防方法是对医院供水系统进行全系统化学消毒。这些方法对低风险和高风险区域都会产生影响。一种更有效的预防方法可能是针对高风险患者的靶向方法。一种选择是在使用点的水装置处应用物理屏障(过滤器)。
评估使用点过滤器从水中清除军团菌和其他病原体的能力。
从7个水龙头(4个装有过滤器,3个未装)立即采集120毫升热水样本,并在冲洗1分钟后采集。每2或3天采集一次样本,持续1周。这个周期重复12周。对样本进行军团菌、总异养平板计数(HPC)细菌和分枝杆菌属的培养。
在12个周期内共采集了594个样本。在T = 0至T = 8天期间,装有过滤器的水龙头未分离出军团菌或分枝杆菌。对照水龙头中嗜肺军团菌和分枝杆菌的平均浓度分别为104.5 CFU/mL和0.