Mathys Werner, Stanke Juliane, Harmuth Margarita, Junge-Mathys Elisabeth
Institute for Hygiene, University of Muenster, Robert-Koch-Str. 41, 48129 Muenster, Germany.
Int J Hyg Environ Health. 2008 Mar;211(1-2):179-85. doi: 10.1016/j.ijheh.2007.02.004. Epub 2007 Apr 3.
A total of 452 samples from hot water systems of randomly selected single family residences in the suburbs of two German cities were analysed for the occurrence of Legionella. Technical data were documented using a standardized questionnaire to evaluate possible factors promoting the growth of the bacterium in these small plumbing systems. All houses were supplied with treated groundwater from public water works. Drinking water quality was within the limits specified in the German regulations for drinking water and the water was not chlorinated. The results showed that plumbing systems in private houses that provided hot water from instantaneous water heaters were free of Legionella compared with a prevalence of 12% in houses with storage tanks and recirculating hot water where maximum counts of Legionella reached 100,000 CFU/100ml. The presence of L. pneumophila accounted for 93.9% of all Legionella positive specimens of which 71.8% belonged to serogroup 1. The volume of the storage tank, interrupting circulation for several hours daily and intermittently raising hot water temperatures to >60 degrees C had no influence on Legionella counts. Plumbing systems with copper pipes were more frequently contaminated than those made of synthetic materials or galvanized steel. An inhibitory effect due to copper was not present. Newly constructed systems (<2 years) were not colonized. The type of hot water preparation had a marked influence. More than 50% of all houses using district heating systems were colonized by Legionella. Their significantly lower hot water temperature is thought to be the key factor leading to intensified growth of Legionella. Although hot water systems using solar energy to supplement conventional hot water supplies operate at temperatures 3 degrees C lower than conventional systems, this technique does not seem to promote proliferation of the bacterium. Our data show convincingly that the temperature of the hot water is probably the most important or perhaps the only determinant factor for multiplication of Legionella. Water with a temperature below 46 degrees C was most frequently colonized and contained the highest concentrations of legionellae. It is evident that the same factors affecting colonization by Legionella in large buildings also exist in small residential water systems. If temperatures are low there is no difference between large and small systems and Legionella counts are high in both. Since private residences are an important source of community-acquired legionellosis, these findings emphasize the need for preventive control measures in small residential buildings. In some situations it may be necessary to install filtration devices at the point-of-use.
对德国两个城市郊区随机选取的单户住宅热水系统中的452个样本进行了军团菌检测分析。使用标准化问卷记录技术数据,以评估这些小型管道系统中促进该细菌生长的可能因素。所有房屋均由公共自来水厂供应经处理的地下水。饮用水质量符合德国饮用水法规规定的限值,且水未经过氯化处理。结果显示,与配备储水箱和循环热水的房屋中12%的患病率相比,使用即热式热水器提供热水的私人住宅管道系统中没有军团菌,后者军团菌的最高计数达到100,000 CFU/100ml。嗜肺军团菌占所有军团菌阳性标本的93.9%,其中71.8%属于血清群1。储水箱的容积、每天中断循环数小时以及间歇性地将热水温度提高到>60摄氏度对军团菌计数没有影响。铜管管道系统比合成材料或镀锌钢管制成的管道系统更频繁地受到污染。不存在铜的抑制作用。新建系统(<2年)未被定植。热水制备类型有显著影响。使用区域供热系统的所有房屋中有超过50%被军团菌定植。它们明显较低的热水温度被认为是导致军团菌生长加剧的关键因素。尽管使用太阳能补充传统热水供应的热水系统运行温度比传统系统低3摄氏度,但这项技术似乎并未促进该细菌的增殖。我们的数据令人信服地表明,热水温度可能是军团菌繁殖的最重要因素,或者也许是唯一的决定因素。温度低于46摄氏度的水最常被定植,且含有最高浓度的军团菌。显然,影响大型建筑中军团菌定植的相同因素也存在于小型住宅供水系统中。如果温度较低,大型和小型系统之间没有差异,两者的军团菌计数都很高。由于私人住宅是社区获得性军团病的重要来源,这些发现强调了小型住宅建筑中预防控制措施的必要性。在某些情况下,可能有必要在使用点安装过滤装置。