Hostname: page-component-7c8c6479df-ws8qp Total loading time: 0 Render date: 2024-03-27T13:39:11.904Z Has data issue: false hasContentIssue false

Electronic-Eye Faucets: Legionella Species Contamination in Healthcare Settings

Published online by Cambridge University Press:  02 January 2015

Emily R. M. Sydnor*
Affiliation:
Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, Utah
Gregory Bova
Affiliation:
Johns Hopkins Health System, Johns Hopkins Hospital, Baltimore, Maryland
Anatoly Gimburg
Affiliation:
Johns Hopkins Health System, Johns Hopkins Hospital, Baltimore, Maryland
Sara E. Cosgrove
Affiliation:
Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
Trish M. Perl
Affiliation:
Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland Johns Hopkins Health System, Johns Hopkins Hospital, Baltimore, Maryland
Lisa L. Maragakis
Affiliation:
Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
*
University of Utah School of Medicine, Division of Infectious Diseases, 30 North 1900 East, Room 4B319, Salt Lake City, UT 84132 (emily.sydnor@hsc.utah.edu)

Abstract

Objective.

To compare heterotrophic plate counts (HPCs) and Legionella species growth from electronic and manual faucet water samples.

Design.

Proportions of water samples with growth and colony-forming units were compared using Fisher's exact test and the Wilcoxon rank-sum test, respectively.

Setting.

Two psychiatric units and 1 medical unit in a 1,000-bed university hospital.

Methods.

Water samples were collected from 20 newly installed electronic faucets and 20 existing manual faucets in 3 hospital units. Manual faucets were located in rooms adjacent to the electronic faucets and received water from the same source. Water samples were collected between December 15, 2008, and January 29, 2009. Four electronic faucets were dismantled, and faucet components were cultured. Legionella species and HPC cultures were performed using standard methods.

Results.

Nearly all electronic faucets (19/20 [95%]) grew Legionella species from at least 1 water sample, compared with less than half (9/20 [45%]) of manual faucets (P = .001). Fifty-four (50%) of 108 electronic faucet water cultures grew Legionella species, compared with 11 (15%) of 75 manual faucet water cultures (P< .001). After chlorine dioxide remediation, 4 (14%) of 28 electronic faucet and 1 (3%) of 30 manual faucet water cultures grew Legionella species (P = .19), and 8 (29%) electronic faucet and 2 (7%) manual faucet cultures had significant HPC growth (P = .04). All 12 (100%) of die internal faucet components from 2 electronic faucets grew Legionella species.

Conclusions.

Electronic faucets were more commonly contaminated with Legionella species and other bacteria and were less likely to be disinfected after chlorine dioxide remediation. Electronic faucet components may provide points of concentrated bacterial growth.

Infect Control Hosp Epidemiol 2012;33(3):235-240

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Hargreaves, J, Shireley, L, Hansen, S, et al. Bacterial contamination associated with electronic faucets: a new risk for healthcare facilities. Infect Control Hosp Epidemiol 2001;22(4):202205.CrossRefGoogle ScholarPubMed
2. Halabi, M, Wiesholzer-Pittl, M, Schoberl, J, Mittermayer, H. Non-touch fittings in hospitals: a possible source of Pseudomonas aeruginosa and Legionella spp. J Hosp Infect 2001;49(2):117121.Google Scholar
3. Leprat, R, Denizot, V, Bertrand, X, Talon, D. Non-touch fittings in hospitals: a possible source of Pseudomonas aeruginosa and Legionella spp. J Hosp Infect 2003;53(1):77.Google Scholar
4. Chaberny, IF, Gastmeier, P. Should electronic faucets be recommended in hospitals? Infect Control Hosp Epidemiol 2004;25(11):9971000.Google Scholar
5. Merrer, J, Girou, E, Ducellier, D, et al. Should electronic faucets be used in intensive care and hematology units? Intensive Care Med 2005;31(12):17151718.CrossRefGoogle ScholarPubMed
6. van der Mee-Marquet, N, Bloc, D, Briand, L, Besnier, JM, Quentin, R. Non-touch fittings in hospitals: a procedure to eradicate Pseudomonas aeruginosa contamination. J Hosp Infect 2005;60(3):235239.Google Scholar
7. Livni, G, Yaniv, I, Samra, Z, et al. Outbreak of Mycobacterium mucogenicum bacteraemia due to contaminated water supply in a paediatric haematology- oncology department. J Hosp Infect 2008;70(3):253258.CrossRefGoogle Scholar
8. Bert, F, Maubec, E, Bruneau, B, Berry, P, Lambert-Zechovsky, N. Multi-resistant Pseudomonas aeruginosa outbreak associated with contaminated tap water in a neurosurgery intensive care unit. J Hosp Infect 1998;39(1):5362.CrossRefGoogle Scholar
9. Ferroni, A, Nguyen, L, Pron, B, Quesne, G, Brusset, MC, Berche, P. Outbreak of nosocomial urinary tract infections due to Pseudomonas aeruginosa in a paediatric surgical unit associated with tap-water contamination. J Hosp Infect 1998;39(4):301307.Google Scholar
10. Goetz, AM, Stout, JE, Jacobs, SL, et al. Nosocomial legionnaires' disease discovered in community hospitals following cultures of the water system: seek and ye shall find. Am J Infect Control 1998;26(1):811.Google Scholar
11. Trautmann, M, Michalsky, T, Wiedeck, H, Radosavljevic, V, Ruhnke, M. Tap water colonization with Pseudomonas aeruginosa in a surgical intensive care unit (ICU) and relation to Pseudomonas infections of ICU patients. Infect Control Hosp Epidemiol 2001;22(1):4952.Google Scholar
12. American Public Health Association, American Water Works Association, Water Environment Federation. Heterotrophic plate count, SM 9215B. In: Standard Methods for the Examination of Water and Wastewater. 21st edition. Washington, DC: American Public Health Association, 2005.Google Scholar
13. Berthelot, P, Chord, F, Mallaval, F, Grattard, F, Brajon, D, Pozzetto, B. Magnetic valves as a source of faucet contamination with Pseudomonas aeruginosa? Intensive Care Med 2006;32(8):1271.Google Scholar
14. Johnson, JT, Yu, VL, Best, MG, et al. Nosocomial legionellosis in surgical patients with head-and-neck cancer: implications for epidemiological reservoir and mode of transmission. Lancet 1985;2(8450):298300.Google Scholar
15. Stout, JE, Yu, VL. Nosocomial Legeionella infection. In: Mayhall, CG, ed. Hospital Epidemiology and Infection Control. Philadelphia: Lippincott Williams & Wilkins, 2004.Google Scholar
16. Dominguez, A, Alvarez, J, Sabria, M, et al. Factors influencing the case-fatality rate of Legionnaires' disease. Int J Tuberc Lung Dis 2009;13(3):407412.Google Scholar
17. Kool, JL, Fiore, AE, Kioski, CM, et al. More than 10 years of unrecognized nosocomial transmission of legionnaires' disease among transplant patients. Infect Control Hosp Epidemiol 1998;19(12):898904.Google Scholar
18. Kool, JL, Bergmire-Sweat, D, Butler, JC, et al. Hospital characteristics associated with colonization of water systems by Legionella and risk of nosocomial legionnaires' disease: a cohort study of 15 hospitals. Infect Control Hosp Epidemiol 1999;20(12):798805.Google Scholar
19. Stout, JE, Muder, RR, Mietzner, S, et al. Role of environmental surveillance in determining the risk of hospital-acquired legionellosis: a national surveillance study with clinical correlations. Infect Control Hosp Epidemiol 2007;28(7):818824.Google Scholar
20. Rogers, J, Dowsett, AB, Dennis, PJ, Lee, JV, Keevil, CW. Influence of plumbing materials on biofilm formation and growth of Legionella pneumophila in potable water systems. Appl Environ Microbiol 1994;60(6):18421851.Google Scholar
21. van der Kooij, D, Veenendaal, HR, Scheffer, WJ. Biofilm formation and multiplication of Legionella in a model warm water system with pipes of copper, stainless steel and cross-linked polyethylene. Water Res 2005;39(13):27892798.Google Scholar