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Major article| Volume 42, ISSUE 11, P1193-1196, November 2014

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Field evaluation of a new point-of-use faucet filter for preventing exposure to Legionella and other waterborne pathogens in health care facilities

Published:September 15, 2014DOI:https://doi.org/10.1016/j.ajic.2014.08.002

      Highlights

      • Newly designed faucet filters eliminate Legionella beyond 62 days of use.
      • Point-of-use faucet filters entirely eliminated heterotrophic plate count bacteria for the first 2 weeks.
      • After week 2, filtered water had an average 1.86 log reduction in heterotrophic plate count bacteria.
      • Point-of-use filters are effective in preventing Legionella exposure in high-risk units.

      Background

      Opportunistic waterborne pathogens (eg, Legionella, Pseudomonas) may persist in water distribution systems despite municipal chlorination and secondary disinfection and can cause health care–acquired infections. Point-of-use (POU) filtration can limit exposure to pathogens; however, their short maximum lifetime and membrane clogging have limited their use.

      Methods

      A new faucet filter rated at 62 days was evaluated at a cancer center in Northwestern Pennsylvania. Five sinks were equipped with filters, and 5 sinks served as controls. Hot water was collected weekly for 17 weeks and cultured for Legionella, Pseudomonas, and total bacteria.

      Results

      Legionella was removed from all filtered samples for 12 weeks. One colony was recovered from 1 site at 13 weeks; however, subsequent tests were negative through 17 weeks of testing. Total bacteria were excluded for the first 2 weeks, followed by an average of 1.86 log reduction in total bacteria compared with controls. No Pseudomonas was recovered from filtered or control faucets.

      Conclusion

      This next generation faucet filter eliminated Legionella beyond the 62 day manufacturers' recommended maximum duration of use. These new POU filters will require fewer change-outs than standard filters and could be a cost-effective method for preventing exposure to Legionella and other opportunistic waterborne pathogens in hospitals with high-risk patients.

      Key Words

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      References

        • Sheffer P.J.
        • Stout J.E.
        • Wagener M.M.
        • Muder R.R.
        Efficacy of new point-of-use water filter for preventing exposure to Legionella and waterborne bacteria.
        Am J Infect Control. 2005; 33: S20-S25
        • Marchesi I.
        • Marchegiano P.
        • Bargellini A.
        • Cencetti S.
        • Frezza G.
        • Miselli M.
        • et al.
        Effectiveness of different methods to control Legionella in the water supply: ten-year experience in an Italian university hospital.
        J Hosp Infect. 2011; 77: 47-51
        • Hosein I.K.
        • Hill D.W.
        • Tan T.Y.
        • Butchart E.G.
        • Wilson K.
        • Finlay G.
        • et al.
        Point-of-care controls for nosocomial legionellosis combined with chlorine dioxide potable water decontamination: a two-year survey at a Welsh teaching hospital.
        J Hosp Infect. 2005; 61: 100-106
        • Trautmann M.
        • Halder S.
        • Hoegel J.
        • Royer H.
        • Haller M.
        Point-of-use water filtration reduces endemic Pseudomonas aeruginosa infections on a surgical intensive care unit.
        Am J Infect Control. 2008; 36: 421-429
        • Cervia J.S.
        • Farber B.
        • Armellino D.
        • Klocke J.
        • Bayer R.L.
        • McAlister M.
        • et al.
        Point-of-use water filtration reduces healthcare-associated infections in bone marrow transplant recipients.
        Transpl Infect Dis. 2010; 12: 238-241
        • Williams M.M.
        • Chen T.H.
        • Keane T.
        • Toney N.
        • Toney S.
        • Armbruster C.R.
        • et al.
        Point-of-use membrane filtration and hyperchlorination to prevent patient exposure to rapidly growing mycobacteria in the potable water supply of a skilled nursing facility.
        Infect Control Hosp Epidemiol. 2011; 32: 837-844
        • Warris A.
        • Onken A.
        • Gaustad P.
        • Janssen W.
        • van der Lee H.
        • Verweij P.E.
        • et al.
        Point-of-use filtration method for the prevention of fungal contamination of hospital water.
        J Hosp Infect. 2010; 76: 56-59
        • Zhou Z.Y.
        • Hu B.J.
        • Qin L.
        • Lin Y.E.
        • Watanabe H.
        • Zhou Q.
        • et al.
        Removal of waterborne pathogens from liver transplant unit water taps in prevention of healthcare-associated infections: a proposal for a cost-effective, proactive infection control strategy.
        Clin Microbiol Infect. 2014; 20: 310-314
      1. International Organization for Standardization. Water quality–Detection and enumeration of Legionella. Switzerland: International Standard ISO 11731; 1998.

      2. International Organization for Standardization. Water quality–Detection and enumeration of Legionella part 2: direct membrane filtration method for waters with low bacterial counts. Switzerland: International Standard ISO 11731-2; 2004.

      3. ASTM. Standard test method for isolation and enumeration of Pseudomonas aeruginosa from water. Pennsylvania: ASTM International Standard Test Method D5246-13; 2013.

      4. Eaton EW, Rice EW, Baird RB, eds. Standard methods for the examination of water and wastewater, 21st ed. online. Washington, DC: American Public Health Association; 2005.

      5. Canning SD. Standard methods for the examination of water and wastewater, 21st ed. Washington, DC: American Public Health Association; 2005.

        • Lee A.
        • McVey J.
        • Faustino P.
        • Lute S.
        • Sweeney N.
        • Pawar V.
        • et al.
        Use of Hydrogenophaga pseudoflava penetration to quantitatively assess the impact of filtration parameters for 0.2-micrometer-pore-size filters.
        Appl Environ Microbiol. 2010; 76: 695-700
        • Sakamoto R.
        • Ohno A.
        • Nakahara T.
        • Satomura K.
        • Iwanaga S.
        • Kouyama Y.
        • et al.
        Legionella pneumophila in rainwater on roads.
        Emerg Infect Dis. 2009; 15: 1295-1297
        • Fisman D.N.
        • Lim S.
        • Wellenius G.A.
        • Johnson C.
        • Britz P.
        • Gaskins M.
        • et al.
        It's not the heat, it's the humidity: wet weather increases legionellosis risk in the greater Philadelphia metropolitan area.
        J Infect Dis. 2005; 192: 2066-2073
        • Hicks L.A.
        • Rose Jr., C.E.
        • Fields B.S.
        • Drees M.L.
        • Engel J.P.
        • Jenkins P.R.
        • et al.
        Increased rainfall is associated with increased risk for legionellosis.
        Epidemiol Infect. 2007; 135: 811-817