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Electronic-Eye Faucets: Legionella Species Contamination in Healthcare Settings

  • Emily R. M. Sydnor (a1) (a2), Gregory Bova (a3), Anatoly Gimburg (a3), Sara E. Cosgrove (a1), Trish M. Perl (a1) (a3) and Lisa L. Maragakis (a1)...

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


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


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


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.


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.


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

Corresponding author
University of Utah School of Medicine, Division of Infectious Diseases, 30 North 1900 East, Room 4B319, Salt Lake City, UT 84132 (
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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.
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.
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.
4. Chaberny, IF, Gastmeier, P. Should electronic faucets be recommended in hospitals? Infect Control Hosp Epidemiol 2004;25(11):9971000.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
15. Stout, JE, Yu, VL. Nosocomial Legeionella infection. In: Mayhall, CG, ed. Hospital Epidemiology and Infection Control. Philadelphia: Lippincott Williams & Wilkins, 2004.
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.
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.
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.
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.
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.
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.
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