Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
Int J Environ Res Public Health. 2024 Jul 18;21(7):939. doi: 10.3390/ijerph21070939.
A better understanding of risk factors and the predictive capability of water management program (WMP) data in detecting are needed to inform the efforts aimed at reducing growth and preventing outbreaks of Legionnaires' disease. Using WMPs and testing data from a national lodging organization in the United States, we aimed to (1) identify factors associated with detection and (2) assess the ability of WMP disinfectant and temperature metrics to predict detection. We conducted a logistic regression analysis to identify WMP metrics associated with serogroup 1 (SG1) detection. We also estimated the predictive values for each of the WMP metrics and SG1 detection. Of 5435 testing observations from 2018 to 2020, 411 (7.6%) had SG1 detection, and 1606 (29.5%) had either SG1 or non-SG1 detection. We found failures in commonly collected WMP metrics, particularly at the primary test point for total disinfectant levels in hot water, to be associated with SG1 detection. These findings highlight that establishing and regularly monitoring water quality parameters for WMPs may be important for preventing growth and subsequent disease. However, while unsuitable water quality parameter results are associated with detection, this study found that they had poor predictive value, due in part to the low prevalence of SG1 detection in this dataset. These findings suggest that testing provides critical information to validate if a WMP is working, which cannot be obtained through water quality parameter measurements alone.
为了减少军团菌的生长和预防军团病的爆发，我们需要更好地了解风险因素以及水管理计划（WMP）数据在检测中的预测能力。本研究使用来自美国一家全国性住宿组织的 WMP 和检测数据，旨在：(1) 确定与检测相关的因素；(2) 评估 WMP 消毒剂和温度指标预测检测的能力。我们进行了逻辑回归分析，以确定与血清群 1（SG1）检测相关的 WMP 指标。我们还估计了每个 WMP 指标和 SG1 检测的预测值。在 2018 年至 2020 年的 5435 次检测观察中，有 411 次（7.6%）检测到 SG1，有 1606 次（29.5%）检测到 SG1 或非 SG1。我们发现，常见的 WMP 指标出现故障，特别是在热水中总消毒剂水平的主要检测点，与 SG1 的检测有关。这些发现强调了为 WMP 建立和定期监测水质参数对于预防军团菌的生长和随后的疾病可能很重要。然而，尽管不合适的水质参数结果与检测有关，但本研究发现，由于该数据集 SG1 检测的低患病率，它们的预测值较差。这些发现表明，检测提供了关键信息，可以验证 WMP 是否有效，而这仅凭水质参数测量是无法获得的。
