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The Efficacy of Residual Chlorine Content on the Control of Legionella Spp. In Hospital Water Systems.

ABSTRACT: BACKGROUND: Outbreaks of legionellosis may be a side effect of institution-water treatment. However, the long-term outcomes and the predictive factors of Legionella prevalence in such systems have still not been fully studied. This study was therefore conducted to investigate the prevalence of Legionella spp. and to evaluate the role of bacteriological water quality parameters on its prevalence and removal in hospital water systems. METHODS: A total of 45 samples were collected from distinct sites at seven hospitals in Tehran, Iran. The prevalence of this bacterium was assayed through a sensitive and specific technique for DNA detection using PCR. Multivariable stepwise regression analysis was used to explore the independent effects of the baseline factors on the incidence of Legionella. Two positive samples were also identified for species by DNA sequencing. RESULTS: Legionella were detected in 31.1% of samples. Showerheads and cold-water taps were the most and the least contaminated sources with 55.3 and 9 percent positive samples, respectively. Total mean of residual chlorine was 0.38 mg/L, with the peak value of 1.7 mg/L. Legionella detection was proportional to the residual chlorine content of water and the results indicated that residual chlorine content is a critical factor in the incidence and proliferation of Legionella (r=-0.33). The prevalence of Legionella also coincided with the prevalence of HPC and amoeba cysts. CONCLUSION: The high positive rate of Legionella colonization shows that hospital-acquired legionellosis might be under diagnosed in studied hospitals. Further, Legionella colonization is independent of the type of water, system characteristics and of preventive maintenance measures.

SUBMITTER: Rafiee M

PROVIDER: S-EPMC4449412 | biostudies-literature | 2014 May

REPOSITORIES: biostudies-literature

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The Efficacy of Residual Chlorine Content on the Control of Legionella Spp. In Hospital Water Systems.

Rafiee Mohammad M Mesdaghinia Alireza A Hajjaran Homa H Hajaghazadeh Mohammad M Miahipour Abolfazl A Jahangiri-Rad Mahsa M

Iranian journal of public health 20140501 5

<h4>Background</h4>Outbreaks of legionellosis may be a side effect of institution-water treatment. However, the long-term outcomes and the predictive factors of Legionella prevalence in such systems have still not been fully studied. This study was therefore conducted to investigate the prevalence of Legionella spp. and to evaluate the role of bacteriological water quality parameters on its prevalence and removal in hospital water systems.<h4>Methods</h4>A total of 45 samples were collected from ...[more]

PMID: 26060765

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Project description:Building water systems promote the regrowth and survival of opportunistic pathogens, such as Legionella pneumophila, especially within biofilms, where most drinking water microbes reside. However, compared to their planktonic form, disinfection efficacy for the biofilm-associated forms of water-based pathogens is unclear. The aim of this study was to determine the effectiveness of free chlorine and monochloramine in the inactivation of biofilm-associated L. pneumophila strain Philadelphia-1 serogroup 1 (LpP1s1). Mature (1.5- to 2-year-old) drinking water biofilms were developed on copper (Cu) and polyvinyl chloride (PVC) slides within biofilm annular reactors, then colonized with LpP1s1 at approximately 4 log10 CFU cm-2 and exposed to 2 mg liter-1 of free chlorine or monochloramine. Ct (disinfectant concentration × time, expressed as mg min liter-1) inactivation values for 2-, 3-, and 4-log10 reductions of planktonic and biofilm LpP1s1 were determined. For planktonic LpP1s1, free chlorine was more effective at inactivation than was monochloramine treatment, and for biofilm-associated LpP1s1, monochloramine was more effective on Cu biofilms while free chlorine was more effective on PVC biofilms. In contrast to monochloramine, free chlorine treatment of Cu and PVC biofilms, negatively impacted LpP1s1 16S rRNA gene transcript levels and may act synergistically with Cu surfaces to further reduce transcript levels. Moreover, LpP1s1 cells shed from biofilms into the bulk water were more resistant to disinfection than were prepared planktonic LpP1s1 cells. Results from this study indicate that biofilm association, disinfectant type, and substratum play an important role in the survival of Legionella pneumophila in building water systems.IMPORTANCE Microbial regrowth within building water systems are promoted by water stagnation, low disinfectant residual, high surface-to-volume ratio, amenable growth temperatures, and colonization of drinking water biofilms. Moreover, biofilms provide protection from environmental stresses, access to higher levels of nutrients, and opportunities for symbiotic interactions with other microbes. Disinfectant efficacy information is historically based on inactivation of pathogens in their planktonic, free-floating forms. However, due to the ecological importance of drinking water biofilms for pathogen survival, this study evaluated the efficacy of two common disinfectants, free chlorine and monochloramine, on Legionella pneumophila colonizing mature, drinking water biofilms established on copper and PVC surfaces. Results showed that inactivation was dependent on the disinfectant type and biofilm substratum. Overall, this, and other related research, will provide a better understanding of Legionella ecological stability and survival and aid policy makers in the management of exposure risks to water-based pathogens within building water systems.

Dataset Information

The Efficacy of Residual Chlorine Content on the Control of Legionella Spp. In Hospital Water Systems.

Publications

The Efficacy of Residual Chlorine Content on the Control of Legionella Spp. In Hospital Water Systems.

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