Hospitals and nursing homes

In terms of Legionella control, hospitals and nursing homes are of particular importance because of the vulnerability of the patients/clients. The elderly and immune compromised are particularly vulnerable to Legionnaires’ disease.

The Hydrosense test identifies the presence of Legionella pneumophila serogroup 1 (sg1) in water. Serogroup 1, accounts for over 80% of community acquired Legionnaires’ disease and virtually all major outbreaks, due to the higher virulence of the organism. This virulence makes it highly likely that immune compromised patients will develop disease following exposure. The faster the risk is identified the quicker remedial action can be taken to protect patients and staff.

Testing programmes may wish to focus on high risk areas of facilities, e.g.:

  • Geriatric departments
  • Cancer wards
  • Transplant wards
  • Neonatal intensive care failities

The Hydrosense test is specific for sg1, and will not detect other serogroups and species which may cause infection particularly in healthcare settings. There are no field tests for these serogroups and therefore the only monitoring tool is lab culture tests.

In many ways the use of the Hydrosense test in healthcare environments is similar to hotels and spas. Often the water temperatures in a healthcare setting are intentionally kept low to avoid scald risk in vulnerable patients – often via the use of thermostatic mixer valves.

Hospital Acquired Infeactions (HAIs) from Legionnaires’ Disease are not uncommon but often attract less public attention than MRSA or C. Difficile. However Legionella should be easier to manage that other nosocomial infection risks as the problem is contained within the water systems – quickly detecting a problem is key to rapidly eliminating the risk. Infection control teams should not ignore the risk of legionellosis in managing their environments.

Fire hoses and sprinkler systems are often overlooked in Legionella risk assessments because the risk from fire exceeds the risk of infection. Hospital engineering teams need to consider how routine testing and maintenance on such equipment could produce contaminated aerosols in the proximity of vulnerable individuals – and consideration should be given to testing equipment for Legionella immediately prior to test.