RESEARCH PAPER
Prevalence of Legionella pneumophila in water distribution systems in hospitals and public buildings of the Lublin region of eastern Poland
 
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1
Department of Medical Microbiology Medical University of Lublin, Poland
 
2
Pope John Paul II State School of Higher Education in Biała Podlaska, Poland
 
 
Corresponding author
Agnieszka Sikora   

Department of Medical Microbiology Medical University of Lublin, Poland
 
 
Ann Agric Environ Med. 2015;22(2):195-201
 
KEYWORDS
ABSTRACT
Objective:
The aim of this study was to determine the prevalence of L. pneumophila in water supply systems, hospitals and public buildings in the Lublin region of eastern Poland.

Material and Methods:
The study was carried out in 26 different objects in the Lublin region. The number of Legionella bacteria in water samples was determined by the membrane filtration method and/or by surface inoculation in accordance with the standards.

Results:
The study showed the presence of L. pneumophila in 166 hot water samples (74.77%). In 34.33% (n=57) of water samples the count of tested bacteria exceeded the acceptable level of >100 CFU/100 ml. Of the samples where an acceptable level of bacteria was exceeded, 49 samples had an average level of L. pneumophila (100–1,000 CFU/100 ml), and the level in 8 samples was high (>1,000 CFU/100 ml).

Conclusions:
The water samples collected form the hot water supply system of hospitals and public buildings showed exceeded counts of L. pneumophila, indicating the risk of infection. The constant monitoring of water distribution systems is an important element of the control of infections caused by these organisms.

 
REFERENCES (38)
1.
Bartram J, Yves Ch, Lee JV, Pond K, Surman-Lee S. Legionella and prevention of legionellosis. World Health Ogranization, 2007.
 
2.
Matuszewska R, Krogulska B. Problem występowania pałeczek Legionella w instalacjach i urządzeniach wytwarzających aerozol wodno-powietrzny w obiektach służby zdrowia. Nowa Med. 2009; 1: 56–60 (in Polish).
 
3.
Breiman RF, Butler JC. Legionnaires´disease: clinical, epidemiological, and public health perspectives. Semin Respir Infect. 1998; 13(2): 84–89.
 
4.
Legionella: human health criteria document. Environmental Protection Agency, United States, 1999.
 
5.
Erdogan H, Arslan H. Colonization of Legionella species in hotel water systems in Turkey. J Travel Med. 2007; 14(6): 369–373.
 
6.
Mekkour M, Driss KB, Cohen N. Prevalence of Legionella pneumophila in production networks and distribution of domestic hot water in Marocco. World Environment. 2012, 2(2): 11–15.
 
7.
Poupard M, Campèse C, Bernillon P, Che D. Factors associated with mortality Legionnaires’ disease, France, 2002–2004. Med Mal Infect. 2007; 37(6): 325–330.
 
8.
Kusnetsov J, Neuvonen LK, Korpio T, Uldum SA, Mentula S, Putus T, et al. Two Legionnaires’ disease cases associated with industrial waste water treatment plants: a case report. BMC Infect Dis. 2010; 10: 343–350.
 
9.
Lock K, Millett C, Heathcock R, Joseph CA, Harrison TG, Lee JV, et al. Public health and economic costs of investigating a suspected outbreak of Legionnaires’ disease. 2008; 136(10): 1304–1314.
 
10.
Borella P, Montagana MT, Romano-Spica V, Stampi S, Stancanelly G, Triassii M, et al. Legionella infection risk from domestic hot water. Emerg Infect Dis. 2004, 10(4): 457–464.
 
11.
Erdogan H, Erdogan A, Lakamdayali H, Yilmaz A, Arslan H. Travel-associated Legionnaires’ disease: clinical features of 17 cases and a review of the literature. Diagn Microbiol Infect Dis. 2010; 68(3): 297–303.
 
12.
www.ecdc.europa.eu (access: 2013.02.09).
 
13.
www.pzh.gov.pl (access: 2013.02.09).
 
14.
Rozporządzenie Ministra Zdrowia z dnia 29 marca 2007 r. w sprawie jakości wody przeznaczonej do spożycia przez ludzi. Ministerstwo Zdrowia (Dz. U. Nr. 61 poz. 417) (in Polish).
 
15.
PN-EN ISO 19458: 2007 „Jakość wody – Pobieranie próbek do analiz mikrobiologicznych”. PKN, 2007 (in Polish).
 
16.
PN-ISO 11731: 2002 „Jakość wody. Wykrywanie i oznaczanie bakterii z rodzaju Legionella”. PKN, 2002 (in Polish).
 
17.
PN-EN ISO 11731–2:2008 „Jakość wody – Wykrywanie i oznaczanie ilościowe bakterii z rodzaju Legionella – Część 2: Metodyka filtracji membranowej dla wód o małej liczbie bakterii”. PKN, 2008 (in Polish).
 
18.
Guidelines for drinking-water quality. World Health Organization Recommendations – 3 rd ed. Vol. 1.
 
19.
Allen JG, Myatt TA, Macintosh DL, Ludwig JF, Minegishi T, Stewart JH, et al. Assessing risk of health care-acquired Legionnaires’ disease from environmental sampling: The limits of using a strict percent positivity approach. Am J Infect Control. 2012; 40(10): 917–921.
 
20.
Rakić A, Perić J, Foglar L. Influence of temperature, chlorine residual and heavy metals on the presence of Legionella pneumophila in hot water distribution systems. Ann Agric Environ Med. 2012; 19(3): 431–436.
 
21.
Tesauro M, Bianchi A, Consonni M, Pregliasco F, Galli MG. Environmental surveillance of Legionella pneumophila in two Italian hospitals. Ann Ist Super Sanità 2010, 46(3): 274–278.
 
22.
Matuszewska R, Krogulska B. Występowanie bakterii z rodzaju Legionella w systemach wody chłodniczej. Roczn PZH. 2008; 59 (4): 445–454 (in Polish).
 
23.
Diederen BM. Legionella spp. and legionnaires’disease. J Infect. 2008; 56(1): 1–12.
 
24.
Lin YS, Stout JE, Yu VL, Vidic RD. Disinfection of water distridution systems for Legionella. Semin Respir Infect. 1998, 13(2): 147–59.
 
25.
Krogulska B, Matuszewska R. „Bakterie z rodzaju Legionella – obowiązujące w Polsce regulacje prawne”, „Bezpieczna woda w szpitalu” warsztaty na temat zakażeń szpitalnych wywoływanych przez pałeczki Legionella spp. Instytut Gruźlicy i Chorób Płuc w Warszawie, Narodowy Instytut Zdrowia Publicznego; 24 Oct 2008 (in Polish).
 
26.
Napoli C, Itta R, Fasano F, Marsico T, Montagana MT. Vairable bacterial lowad of Legionella spp. in hospital water system. Sci Total Environ. 2009; 408(2): 242–244.
 
27.
YuVL. Nosocomial legionellosis. Curr Opin Infect Dis. 2000; 13: 385–388.
 
28.
Yu PY, Lin YE, Lin WR, Shih HY, Chuang YC, Ben RJ, et al. The high prevalence of Legionella pneumophila contamination in hospital potable water systems in Taiwan: implications for hospital infection control in Asia. Int J Infect Dis. 2008; 12(4): 416–420.
 
29.
Stout JE, Yu VL. Legionella in the hospital water supply: A plea for decision making based on evidence-based medicine. Infect Control Hosp Epidemiol. 2001; 22(11): 670–672.
 
30.
Kool JL, Bergmire-Sweat D, Butler JC, Brown EW, Peabody DJ, Massi DS, 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): 798–805.
 
31.
Sabrià M, Mòdol JM, Garcia-Nuñez M, Reynaga E, Pedro-Botet ML, Sopena N, et al. Environmental cultures and hospital-acquired Legionnaires’ disease: a 5-year prospective study in 20 hospitals in Catalonia, Spain. Infect Control Hosp Epidemiol. 2004; 25(12): 1072–1076.
 
32.
Borella P, Montagna MT, Stampi S, Stancanelli G, Romano-Spica V, Triassi M, et al. Legionella contamination in hot water of Italian hotels. Appl Environ Microbiol. 2005 71(10): 5805–5813.
 
33.
Morton S, Barlett CL, Bibby LF, Hutchinson DN, Dyer JV, Dennis PJ. Outbreak of Legionnaires’ disease from a cooling water system in a power station. Br J Ind Med. 1986; 43(9): 630–635.
 
34.
Bellido-Blasco JB, Pelaz-Antolín C, Delas-González MA, Sarrión-Martínez J, Moreno-Muñoz MR, Herrero-Carot C. Aggregation of cases of Legionella pneumonia in workers related to the ceramic industry in Castellon, Spain, 2006. Rev Esp Salud Publica. 2008, 82(1): 111–116.
 
35.
Muraca PW, Stout JE, Yu VL, Yee YC. Legionnaires’ disease in the work environment: implications for environmental health. Am Ind Hyg Assoc J. 1988; 49(11): 584–590.
 
36.
Hrubá L. The colonization of hot water systems by Legionella. Ann Agric Environ Med. 2009, 16: 115–119.
 
37.
Leoni E, de Luca G, Legnani R, Sacchetti R, Stampi S, Zanetti F. Legionella waterlinie colonization: detection of Legionella species in domestic, hotel and hospital hot water systems. J Appl Microbiol. 2005, 98: 373–379.
 
38.
Legnani PP, Leoni E, Corradini N. Legionella contamination of hospital water supplies: monitoring of private healthcare facilities in Bologna, Italy. J Hosp Infect. 2002, 50: 220–223.
 
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