Department of Public Health Sciences, University of Modena and Reggio Emilia, Italy.
J Hosp Infect. 2011 Jan;77(1):47-51. doi: 10.1016/j.jhin.2010.09.012. Epub 2010 Dec 4.
We report our ten-year experience of hyperchlorination, thermal shock, chlorine dioxide, monochloramine, boilers and point-of-use filters for controlling legionella contamination in a hospital hot water distribution system. Shock disinfections were associated with a return to pre-treatment contamination levels within one or two months. We found that chlorine dioxide successfully maintained levels at <100 cfu/L, whilst preliminary experiments gave satisfactory results with monochloramine. No contamination was observed applying point-of-use filters and electric boilers at temperatures of >58°C and no cases of nosocomial legionellosis were detected in the ten-year observation period. Our performance ranking in reducing legionella contamination was filter, boiler, chlorine dioxide, hyperchlorination and thermal shock. Chlorine dioxide was the least expensive procedure followed by thermal shock, hyperchlorination, boiler and filter. We suggest adopting chlorine dioxide and electric boilers in parallel.
我们报告了十年来在医院热水分配系统中使用次氯酸钠、热冲击、二氧化氯、一氯胺、锅炉和即时使用过滤器控制军团菌污染的经验。冲击消毒在一到两个月内会使污染水平恢复到处理前的水平。我们发现二氧化氯能成功地将水平保持在<100 cfu/L，而初步实验表明一氯胺的效果令人满意。在应用即时使用过滤器和 58°C 以上的电锅炉时没有观察到污染，在十年的观察期内也没有发现医院获得性军团菌病病例。我们在降低军团菌污染方面的表现排名依次为：过滤器、锅炉、二氧化氯、高氯酸钠和热冲击。二氧化氯是最便宜的方法，其次是热冲击、高氯酸钠、锅炉和过滤器。我们建议并行采用二氧化氯和电锅炉。
