Protect Immunocompromised Patients from Waterborne Infections
Maintaining the quality of water in a hospital or healthcare environment through water management programs is critical to protect patients from waterborne healthcare-associated infections (HAI). 9 in 10 CDC investigations show outbreaks of Legionella ‘were caused by problems which were preventable with more effective water management1.
In a healthcare environment, patients and staff are exposed to water from many sources, from drinking and food preparation, to personal hygiene (washing and teeth cleaning) or through equipment cleaning.
As a result of this exposure, patients may be particularly vulnerable to waterborne HAI infections and additional control measures are important in the areas where immunocompromised patients may come into contact with water. In medical facilities, locations for additional control measures include: bone marrow transplant units, hematology units, oncology units, intensive care units, transplantation units, burns units, neonatology unit, endoscope reprocessing departments, and geriatric departments. Water risk management is also increasingly used in nursing homes or home care settings.
The Centers for Medicare & Medicaid Services have issued policy on the requirement to Reduce Legionella Risk in Healthcare Facility Water Systems in both hospitals and long-term care facilities: “Facilities must develop and adhere to policies and procedures that inhibit microbial growth in building water systems that reduce the risk of growth and spread of Legionella and other opportunistic pathogens in water.”2
Manage Risks by Understanding Transmission Pathways
Understanding the reservoirs and transmission pathways of waterborne pathogens is essential for developing prevention strategies and control measures for healthcare-associated infections. Centers for Disease Control and Prevention (CDC) guidance3 identifies three key areas for risk management for patient safety in relation to water quality, namely assuring that:
- Healthcare premise plumbing, the building’s hot and cold water distribution system, is designed and maintained in a way that minimizes growth and spread of waterborne pathogens in both supply and waste. Learn more about design and maintenance of hospital water systems for infection control.
Point of Use (POU) Water Filtration for Infection Control
Applying a combination of engineering and hygiene measures, as well as surveillance and clinical management to hospital water quality can reduce the risk of waterborne healthcare-associated infections.4 Point-of-use water filtration can provide a reliable and effective solution for microorganism retention as part of a water management program.
Borella et al.5 described their 15 years of experience in the control of Legionella contamination within healthcare buildings, concluding that systemic water disinfection is not sufficient to control the risk of infection as a single measure. Borella’s group found the control measure with the highest effectivity ranking was point-of-use water filters, followed by constant maintenance of circulating hot water temperatures above 136 °F (> 58 °C). Similar conclusions on the effectiveness of point-of-use water filtration were also reported by Loveday et al. in a systematic review of the association between healthcare water systems and Pseudomonas aeruginosa infections.6
Pall POU Water Filters are FDA 510(k) Cleared Class II Medical Devices for faucets, showers and ice machines. They are validated to act as a barrier to Legionella spp., Pseudomonas spp., non-tuberculous mycobacteria and other opportunistic waterborne pathogens which may lead to patient infections.
- Centers for Disease Control and Prevention, “Legionnaires’ Disease: Use water management programs in buildings to help prevent outbreaks.” Vital Signs June 2016. Available at: https://www.cdc.gov/vitalsigns/pdf/2016-06-vitalsigns.pdf [Accessed 2 June 2020]
- Centers for Medicare and Medicaid Services, “Requirement to Reduce Legionella Risk in Healthcare Facility Water Systems to Prevent Cases and Outbreaks of Legionnaires’ Disease (LD)”, Ref: S&C 17-30-Hospitals/CAHs/NHs REVISED 06.09.2017. Available at: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-17-30.pdf [Accessed 2 June 2020]
- Centers for Disease Control and Prevention, “Healthcare Environmental Infection Prevention: Reduce the Risk from Water.” Available at: https://www.cdc.gov/hai/prevent/environment/water.html [Accessed 2 June 2020]
- Hajime, K., Weber, D. J., & Rutala, W. A., “Healthcare Outbreaks Associated With a Water Reservoir and Infection Prevention Strategies.“ Clinical Infectious Diseases, 1-13 2016
- Borella et al., “Hospital-Acquired Legionella Infections: an Update on the Procedures for Controlling Environmental Contamination.” Ann Ig, 5.28: 98-108. 2016
- Loveday et al., “Association between Healthcare Water Systems and Pseudomonas aeruginosa Infections: A Rapid Systematic Review.” J Hosp Infect, 86: 7-15. 2014