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The Impact of Aerators on Water Contamination by Emerging Gram-Negative Opportunists in At-Risk Hospital Departments

Published online by Cambridge University Press:  10 May 2016

Maria Luisa Cristina ,
Anna Maria Spagnolo ,
Beatrice Casini ,
Angelo Baggiani ,
Pietro Del Giudice ,
Silvio Brusaferro ,
Andrea Poscia ,
Umberto Moscato ,
Fernanda Perdelli  and
Paolo Orlando
Maria Luisa Cristina*
Affiliation:
Department of Health Sciences, University of Genova, Genova, Italy
Anna Maria Spagnolo
Affiliation:
Department of Health Sciences, University of Genova, Genova, Italy
Beatrice Casini
Affiliation:
Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
Angelo Baggiani
Affiliation:
Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
Pietro Del Giudice
Affiliation:
Department of Medical and Biological Sciences, University of Udine, Udine, Italy
Silvio Brusaferro
Affiliation:
Department of Medical and Biological Sciences, University of Udine, Udine, Italy
Andrea Poscia
Affiliation:
Hygiene Institute, Welfare Department of Public Health, Catholic University of Sacred Hearth, Rome, Italy
Umberto Moscato
Affiliation:
Hygiene Institute, Welfare Department of Public Health, Catholic University of Sacred Hearth, Rome, Italy
Fernanda Perdelli
Affiliation:
Department of Health Sciences, University of Genova, Genova, Italy
Paolo Orlando
Affiliation:
Department of Health Sciences, University of Genova, Genova, Italy
*
Department of Health Sciences, University of Genoa, Via Pastore, 1-16132 Genova, Italy (cristinaml@unige.it)
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Abstract

Objective.

Our aim was to evaluate the impact of aerators on water microbiological contamination in at-risk hospital departments, with a view to quantifying the possible risk of patient exposure to waterborne microorganisms.

Design.

We analyzed the microbiological and chemical-physical characteristics of hot and cold water in some critical hospital departments.

Setting.

Two hospitals in northern Italy.

Methods.

We took 304 water samples over a 1-year period, at 3-month intervals, from taps used by healthcare personnel for handwashing, surgical washing, and the washing of medical equipment. We analyzed heterotrophic plate counts (HPCs) at 36°C and 22°C, nonfastidious gram-negative bacteria (GNB-NE), and Legionella pneumophila.

Results.

The percentages of positivity and mean values of HPCs at 22°C, HPCs at 36°C, and GNB-NE loads were significantly higher at outlet points than in the plumbing system. In particular, GNB-NE positivity was higher at outlet points than in the plumbing system in both the cold water (31.58% vs 6.58% of samples were positive) and hot water (21.05% vs 3.95%) supplies. Our results also revealed contamination by L. pneumophila both in the plumbing system and at outlet points, with percentages of positive samples varying according to the serogroup examined (serogroups 1 and 2-14). The mean concentrations displayed statistically significant (P < .001) differences between the outlet points (27,382.89 ± 42,245.33 colony-forming units [cfu]/L) and the plumbing system (19,461.84 ± 29,982.11 cfu/L).

Conclusions.

These results reveal a high level of contamination of aerators by various species of gram-negative opportunists that are potentially very dangerous for immunocompromised patients and, therefore, the need to improve the management of these devices.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 35 , Issue 2 , February 2014 , pp. 122 - 129
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2014

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