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Ultraviolet Light Disinfection of Hospital Water for Preventing Nosocomial Legionella Infection: A 13-Year Follow-Up

Published online by Cambridge University Press:  02 January 2015

Keri K. Hall ,
Eve T. Giannetta ,
Sandra I. Getchell-White ,
Lisa J. Durbin  and
Barry M. Farr
Keri K. Hall
Affiliation:
University of Virginia Health System, Charlottesville, Virginia
Eve T. Giannetta
Affiliation:
University of Virginia Health System, Charlottesville, Virginia
Sandra I. Getchell-White
Affiliation:
University of Virginia Health System, Charlottesville, Virginia
Lisa J. Durbin
Affiliation:
University of Virginia Health System, Charlottesville, Virginia
Barry M. Farr*
Affiliation:
University of Virginia Health System, Charlottesville, Virginia
*
University of Virginia Health System, P.O. Box 800473, Charlottesville, VA 22908-1337
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Abstract

Background and Objective:

CDC has estimated that 23% of Legionella infections are nosocomial. When a new hospital was being constructed and a substantial increase in transplantation was anticipated, an ultraviolet light apparatus was installed in the water main of the new building because 27% of water samples from taps in the old hospital contained Legionella. This study reports the rate of nosocomial Legionella infection and water contamination since opening the new hospital.

Methods:

Charts of all patients with positive Legionella cultures, direct immunofluorescent antibody (DFA), or urine antigen between April 1989 and November 2001 were reviewed. Frequencies of DFAs and urine antigens were obtained from the laboratory.

Results:

None of the 930 cultures of hospital water have been positive since moving into the new building. Fifty-three (0.02%) of 219,521 patients had a positive Legionella test; 41 had pneumonia (40 community acquired). One definite L. pneumophila pneumonia confirmed by culture and DFA in August 1994 was nosocomial (0.0005%) by dates. This patient was transferred after prolonged hospitalization in another country, was transplanted 11 days after admission, and developed symptoms 5 days after liver transplant. However, tap water from the patient's room did not grow Legionella. Seventeen (2.5%) of 670 urine antigens were positive for Legionella (none nosocomial). Thirty-three (1.2%) of 2,671 DFAs were positive, including 7 patients (21%) without evidence of pneumonia and 6 (18%) who had an alternative diagnosis.

Conclusion:

Ultraviolet light usage was associated with negative water cultures and lack of clearly documented nosocomial Legionella infection for 13 years at this hospital.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 8 , August 2003 , pp. 580 - 583
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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