The impact of pipeline changes and temperature increase in a hospital historically colonised with Legionella.
S Quero, N Párraga-Niño, M Garcia-Núñez, M L Pedro-Botet, L Gavaldà, L Mateu, M Sabrià, J M Mòdol
Author Information
S Quero: Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias I Pujol, Carretera de Can Ruti, Camí de les Escoles s/n, 08916, Badalona, Barcelona, Spain. squero@igtp.cat.
N Párraga-Niño: Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias I Pujol, Carretera de Can Ruti, Camí de les Escoles s/n, 08916, Badalona, Barcelona, Spain.
M Garcia-Núñez: Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias I Pujol, Carretera de Can Ruti, Camí de les Escoles s/n, 08916, Badalona, Barcelona, Spain.
M L Pedro-Botet: CIBER de Enfermedades Respiratorias, CIBERES, Av. de Monforte de Lemos, 3-5, 28029, Madrid, Spain.
L Gavaldà: Hospital Universitari de Bellvitge-IDIBELL, Feixa Llarga, s/n., 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
L Mateu: Hospital Universitari Germans Trias i Pujol, Carretera de Canyet, s/n, 08916, Badalona, Barcelona, Spain.
M Sabrià: CIBER de Enfermedades Respiratorias, CIBERES, Av. de Monforte de Lemos, 3-5, 28029, Madrid, Spain.
J M Mòdol: Hospital Universitari Germans Trias i Pujol, Carretera de Canyet, s/n, 08916, Badalona, Barcelona, Spain.
Healthcare-related Legionnaires' disease has a devastating impact on high risk patients, with a case fatality rate of 30-50%. Legionella prevention and control in hospitals is therefore crucial. To control Legionella water colonisation in a hospital setting we evaluated the effect of pipeline improvements and temperature increase, analysing 237 samples over a 2-year period (first year: 129, second year: 108). In the first year, 25.58% of samples were positive for Legionella and 16.67% for amoeba. Assessing the distance of the points analysed from the hot water tank, the most distal points presented higher proportion of Legionella colonisation and lower temperatures (nearest points: 6.4% colonised, and temperature 61.4 °C; most distal points: 50% and temperature 59.1 °C). After the first year, the hot water system was repaired and the temperature stabilised. This led to a dramatic reduction in Legionella colonisation, which was negative in all the samples analysed; however, amoeba colonisation remained stable. This study shows the importance of keeping the temperature stable throughout the circuit, at around 60 °C. Special attention should be paid to the most distal points of the circuit; a fall in temperature at these weak points would favour the colonisation and spread of Legionella, because amoeba (the main Legionella reservoir) are not affected by temperature.
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