Sit bath systems: A new source of Legionella infection

PLoS One. 2020 Nov 4;15(11):e0241756. doi: 10.1371/journal.pone.0241756. eCollection 2020.

Abstract

Sit Bath Systems (SBSs) are the most common hygiene method for patients who are not self-sufficient. Therefore, the water quality of SBSs in the nosocomial environment plays a fundamental role in controlling infections for both patients and health-care workers. A long-term study on Legionella and Pseudomonas aeruginosa (P. aeruginosa) contamination was performed in SBSs (n = 20) of six Health Care Facilities (HCFs). A total of 254 water samples were analyzed following ISO procedures. The samples were positive for P. aeruginosa (46.85%) and Legionella (53.54%), respectively, both over the directive limits. Legionella isolates were identified as: Legionella pneumophila (L. pneumophila) serogroups 1, 3, and 6 and Legionella non-pneumophila species (L. anisa, L. londiniensis, L. rubrilucens, and L. nagelii). Moreover, the contamination found was studied with respect to median temperature measured (42 °C), from which two groups (A and B) could be distinguished. P. aeruginosa was found in both groups (100% of SBSs), while a higher percentage of Legionella positive samples was found in group A (75% of SBSs), compared to group B (50% of SBSs), showing how Legionella control could be carried out by using temperatures above 42 °C. An analysis of SBS water pipelines, maintenance, and disinfection treatments indicates SBSs as a new source of infection risk for both patients and health-care workers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacterial Proteins / genetics
  • Cross Infection / microbiology
  • Cross Infection / pathology
  • DNA, Bacterial / chemistry
  • DNA, Bacterial / metabolism
  • Health Facilities*
  • Humans
  • Legionella / genetics
  • Legionella / isolation & purification*
  • Legionella pneumophila / genetics
  • Legionella pneumophila / isolation & purification
  • Legionellosis / microbiology
  • Legionellosis / pathology
  • Legionnaires' Disease / microbiology
  • Legionnaires' Disease / pathology
  • Pseudomonas aeruginosa / genetics
  • Pseudomonas aeruginosa / isolation & purification
  • Risk Factors
  • Serogroup
  • Temperature
  • Water Microbiology*

Substances

  • Bacterial Proteins
  • DNA, Bacterial

Grants and funding

This work was supported by a research grant RFO 2018 from University of Bologna, Italy.