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Controlling Legionella in Hospital Water Systems: Experience With the Superheat-and-Flush Method and Copper-Silver Ionization

Published online by Cambridge University Press:  02 January 2015

Janet E. Stout ,
Yu-Sen E. Lin ,
Angella M. Goetz  and
Robert R. Muder
Janet E. Stout
Affiliation:
Special Pathogens Laboratory and Infectious Disease Section, Veterans' Affairs Pittsburgh Health Care System, University Drive Division University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Yu-Sen E. Lin
Affiliation:
Special Pathogens Laboratory and Infectious Disease Section, Veterans' Affairs Pittsburgh Health Care System, University Drive Division
Angella M. Goetz
Affiliation:
Special Pathogens Laboratory and Infectious Disease Section, Veterans' Affairs Pittsburgh Health Care System, University Drive Division
Robert R. Muder*
Affiliation:
Special Pathogens Laboratory and Infectious Disease Section, Veterans' Affairs Pittsburgh Health Care System, University Drive Division University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
*
VA Medical Center, Infectious Disease Section, University Drive C, Pittsburgh, PA 15240
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Abstract

Objective:

To evaluate the effect of copper-silver ionization on Legionella colonization and nosocomial legionnaires' disease and to compare the efficacy of metal ions versus the super-heat-and-flush method of disinfection.

Design:

Prospective determination over a 36-month period of copper and silver ion concentrations in the recirculating hot-water system, Legionella colonization of the hospital water distribution system, and cases of nosocomial legionnaires' disease. Retrospective comparison of results with the previous 13 years, during which the superheat-and-flush method was used.

Setting:

The Pittsburgh Veterans' Affairs Health Care System (University Drive Division) acut-care hospital.

Intervention:

Three copper-silver ionization systems were installed on the hot-water distribution system in November 1994.

Results:

The average number of cases of legionnaires‘ disease per year and the percentage of distal sites positive for Legionella pneumophila for the superheat-and-flush method versus the copper-silver ionization method was six cases with 15% positivity versus two cases with 4% positivity, respectively. The reduction in Legionella colonization after copper-silver ionization was significant (P<.05) compared to the superheat and flush. Mean copper and silver ion concentrations (mg/L) were 0.29 and 0.054 from hot-water tanks, and 0.17 and 0.04 from distal outlets, respectively.

Conclusions:

We conclude that a properly maintained and monitored copper-silver ionization system was more effective than the superheat-and-flush method for reducing the recovery of Legionella from the hospital water distribution system.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 19 , Issue 12 , December 1998 , pp. 911 - 914
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

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