Filter Provides Legionella Barrier for Hospitals

Oct. 31, 2003
Legionella bacteria and other pathogens blocked for high-purity water

About the author: Contributed by Pall Corp.

Presence of the bacteria Legionella pneumophilia in hospitals and nursing homes in the U.S. and Europe has been detected at an alarming rate. Contaminated water has frequently been found to be the source. Legionella is found naturally in water but multiplies in heating systems.

The growing problem of hospital water contaminated with bacteria, fungi and protozoa can be harmful to patients, especially those with compromised immune systems. These include surgical, cancer, burn, transplant, chronic lung disease and HIV-infected patients as well as the elderly and newborns. Contaminated water has been found in a wide number of places throughout hospitals from patient rooms to intensive care units and from showers to humidifiers appearing most commonly in the cooling towers and hot/warm water storage and systems. This has resulted in an increase in nosocomial (hospital-acquired) infections, some of which are resistant to antibiotics.

Infection control experts in hospitals and medical institutions are increasingly turning to point-of-use filtration as a preventive measure to alleviate the problem of contaminated water systems.

Disinfecting water at a treatment plant or even at the point of entry into a hospital does not solve the problem. Bacteria and other microorganisms create biofilms (when they attach themselves to a surface as a colony) in piping systems, faucets and showerheads. When the water meets the air, these biofilms also can create an aerosolized germ that can be inhaled. Water treatment methods including heat, chemical disinfection and ultraviolet radiation do not reliably remove the biofilms that form.

Patient exposure to these potentially lethal microorganisms in the hospital occurs while showering, bathing, drinking and ingesting ice as well as from inhaling aerosols of contaminated water. Exposure also can occur through contact with medical equipment such as tube feed bags, endoscopes and bronchoscopes, which can become contaminated when rinsed with tap water, or from the hands of healthcare personnel who have washed using tap water.

Although Legionella is the most recognized of all the waterborne pathogens, there are many other microbes that are just as dangerous.

In an analysis conducted by Elias J. Anaissie, M.D., et.al., of the Myeloma and Transplantation Research Center, University of Arkansas for Medical Sciences, the waterborne bacteria Pseudomonas aeruginosa is estimated to cause about 1,400 pneumonia deaths in U.S. hospitals each year (Archives of Internal Medicine, July 2002). Most recently, the medical community raised new concern about the toxic mold Aspergillus found in hospital water systems. In a newly reported study, this waterborne fungus was found to cause illness in about 15 percent of immune compromised patients with a 50 percent fatality rate, despite the use of traditional preventative measures.

In response to the increasing number of outbreaks in U.S. hospitals, various hospitals turned to Pall Corp. to utilize its expertise in biological processes often used in developing solutions for ultrapure water used in pharmaceutical manufacturing.

Pall was asked to provide filtration treatment and the AquaSafe Water Filter was selected. The point-of-use filter was installed in various hospitals to precent the spread of Legionella and other potentially lethal pathogens found in the water systems of hospitals as well as other health care provider sites. The filter provided an effective barrier from waterborne microbial contamination ensuring the availability of high-purity water for bathing, showering, food preparation, drinking, rinsing of medical instruments and other hygiene measures in hospitals and medical institutions.

The disposable, sterilizing grade filter (0.2 mm membrane) for faucets and showerheads reduces microbial contamination and is a barrier against common contaminants such as Legionella, Pseudomonas, Aspergillus and Cryptosporidium, found in hospital water supplies. It served as an easy-to-use solution for both large and small volumes of point-of-use water.

These various hospitals all found the filter to be an effective solution to the threat of Legionella. The filter continues to be used as part of the routine standard of care in these hospitals wherever immune-compromised patients are located.

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