投稿分類 防護措施

主委發表種類: 口頭

投稿標題(中): 使用末端水龍頭過濾器以降低加護病房中環境退伍軍人菌傳播的風險

投稿標題(英): Use of point of use faucet filtration unit to prevent potential nosocomial transmission of Legionella in ICUs

投稿摘要: Background: Legionnaires’ disease is a major cause of hospital and community acquired pneumonia which is acquired from the environment, and therefore amenable to prevention. Taiwan CDC has issued guideline in 2010 for control of Legionella in healthcare facilities. Disinfection may be inevitable if the hospital water system is colonized Legionella to a certain degree which the risk of nosocomial infections arises. Among all disinfection modalities (ionization, chlorine, superheat-and-flush, chlorine dioxide), point of use filtration is the most environmental friendly and safe technology (unlike chemical disinfectants). Its physical barrier remove waterborne pathogens from the water supply and provide “pathogen free” water to patients and healthcare workers. Objective: In this study, we investigate the effectiveness of a point of use filtration unit to remove Legionella in an ICU room. Method: The study hospital is a medical center in Kaohsiung. Legionella culture was consistently positive in one EMCU distal site (Sep culture: Lp7 at 100 cfu/L). A faucet filtration unit using capillary microfiltration membrane (TMI Protector, Future Innovations, Ltd) was installed at the outlet. Monthly cultures were withdrawn for evaluation of filter’s effectiveness in an environmental laboratory with ISO 17025 accreditation. Results: the water samples from test site (with filter) remained negative for Legionella for two months (Oct and Nov cultures) while the water sample from control sites (without filters) were positive for Legionella (ranged from 100 ~ 30,000 cfu/L). During the two months period, the decrease of water flow rate from the test site (due to clogging) was not noticeable - a major cost concern for point of use filtration. Discussion: Point of use filtration has been a robust technology to control waterborne pathogens in healthcare facilities. However, new generation of capillary filtration units deliver longer life (up to 2 months with no clogging) and lower cost (with replaceable filter membrane) make nosocomial infection control more economically applauded. The use of the point of use filtration units provide hospital management flexibility to protect high risk area (ICUs, BMT, SOT, etc..) without disinfecting the entire water system. The feature of filtration by physical removal of all pathogens can provide patient protection against Legionella and other waterborne pathogens.

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