Summary: The efficacy of any disinfection measures should be validated in a stepwise fashion from laboratory assessment to a controlled multiple-hospital evaluation over a prolonged period of time. In this review, we evaluate systemic disinfection methods (copper-silver ionization, chlorine dioxide, monochloramine, ultraviolet light, and hyperchlorination), a focal disinfection method (point-of-use filtration), and short-term disinfection methods in outbreak situations (superheat-and-flush with or without hyperchlorination.)The infection control practitioner should take the lead in selection of the disinfection system and the vendor. Formal appraisals by other hospitals with experience of the system under consideration is indicated. Routine performance of surveillance cultures of drinking water to detect Legionella and monitoring of disinfectant concentrations are necessary to ensure long-term efficacy.
This report discusses best practices for Legionella detection in water systems and reviews guidelines for Legionella prevention. The direct link between drinking water colonization by Legionella and hospital-acquired legionellosis has prompted healthcare organizations to recommend proactive culturing for Legionella as a preventative measure (see guideline table).
Summary: The first field evaluation of chlorine dioxide disinfection of a hospital campus water system to control Legionella pneumophila.
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