投稿分類 感控監測

主委發表種類: 口頭

投稿標題(中): 以二氧化氯消毒供水系統對非發酵性細菌及其他分枝桿菌之影響

投稿標題(英): Efficacy of chlorine dioxide in water distribution system to control non-fermenting gram-negative bacteria and non-tuberculous mycobacterium spp.

投稿摘要: Introduction
Some non-fermentive gram negative bacilli (NFGNB) the nontuberculous mycobacteria (NTM), distributed widely in the environment, have resulted in nosocomial bacteremia occasionally in immunocompromised patients in our hospital. Chlorine dioxide (ClO2) is a promising alternative disinfectant for hospital water systems to control Legionella in European hostpitals and is also effective against viruses, bacteria, protozoan cyst, biofilms, and waterborne pathogens in public drinking water systems. This study, we try to evaluate the efficacy of ClO2 for controlling NFGNB and the NTM in our hospital water system.
Materials and Methods
Far Eastern Memorial Hospital is a 1000-bed medical center in north Taiwan. The whole hospital water is supplied by the city water department. After one probable health care-associated Legionellosis was diagnosed, steps were taken to control Legionella in the water system, and ClO2 was chosen to treat the hospital water system.
Result
14 water samples were collected before, 2 weeks, 4 weeks for 3 times and then every 3 months after ClO2 installation. The results revealed that the most two common NFGNB are Sphingomonas paucimobilis and Pseudomona spp. With more than 300 CFU/mL; the most common NTM are M. abscessus, followed by M. lentiflacum and M. avium.
After 2 weeks of chlorine dioxide disinfection, Sphingomonas paucimobilis was still the most common NFGNB in water system, however, the colony has been decreased to only 5~100 CFU/mL. After one year of follow up, the colony counts of all NFGNB are lesser than 5
In aspect of NTM, after 2 weeks of chlorine dioxide disinfection, only one unidentified NTM species is noted. Four weeks later, no more NTM was isolated in water.
Conclusion
Chlorine dioxide disinfection shows a good efficacy in NFGNB and NTM decolonization in water system after one year of observation.

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