Study finds environmental tests help predict hospital-acquired Legionnaires' di...(on in Pittsburgh said study first author...)

For this investigation, Drs. Yu, Stout and colleagues evaluated samples of hospital system water at 20 facilities across the country from 2000 to 2002. Water samples were retrieved from at least 10 separate sites at each hospital on multiple occasions over the two-year period. When cases of Legionnaires were identified, patient urine and sputum samples from 12 of the hospitals were tested to determine classification of Legionella, which has at least 48 strains.

The researchers found that 14 (70 percent) of hospital water systems tested positive for Legionella species, and that six (43 percent) positive hospitals had high-level colonization. Legionnaires cases were among the 633 patients with hospital-acquired pneumonia whose urine or sputum samples were tested for Legionella bacteria. All were traced to hospitals with high-level colonization.

Our study provides much-needed evidence to support a national policy change to include routine environmental surveillance of health care facility water systems along with stringent clinical monitoring of patients, said Dr. Stout, who estimates that 39,000 people have died of Legionnaires since 1982. We think this long overdue approach should be adopted by infection control and infectious disease practitioners nationwide.

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