On this blog, we have already learned that healthcare-associated infections can be spread through the water and plumbing systems of hospitals. There are many possible reservoirs for the growth and spread of harmful pathogens; including potable water, sinks, faucets, showers, bathtubs, toilets, etc. It is therefore crucial that healthcare facilities develop water-management programs, in order to reduce the risk of infection.
In a recent article from Infection Control Today 2019, it is stated that:
“facilities must develop and adhere to policies and procedures that inhibit microbial growth in building water systems that reduce the risk of growth and the spread of Legionella and other opportunistic pathogens in water.”Kelly M. Pyrek, Infection Control Today, 2019
Infection Control Today (2019) discusses many different policies that should be adopted by healthcare facilities.
In terms of potable tap water and hospital water systems, recommendations include:
- Hot water temperatures at the outlet should be at the highest temperature allowable, preferably >51C.
- In the case of water disruptions, signs should be posted and the drinking of tap water should be prohibited.
- Standards for potable water must be maintained (<1 coliform bacterium/100 mL).
- Equipment should be rinsed first with either sterile water, filtered water or tap water and an alcohol rinse should follow.
- Periodic monitoring of water samples should be done in order to test for Legionella growth.
In terms of sinks in hospitals, recommendations include:
- The use of separate sinks for handwashing and disposal of contaminated fluids.
- The decontamination or elimination of sinks if epidemic spread of gram-negative bacteria via sinks is suspected.
In terms of showers in hospitals, recommendations include:
- Prohibit the use of showers in neutropenic patients.
- Control Legionella colonization of potable water.
The article discusses many more recommendations for other water-related reservoirs that are potential sources of infection. For more information on these other reservoirs, please refer to Infection Control Today’s website.
In addition to this, it is recommended by Tim Keane, a consultant with Philadelphia-based Legionella Risk Management Inc, that healthcare facilities hire engineers that are “building water system expert(s) who specialize in risk management for building water systems” (Infection Control, 2019). This will provide healthcare facilities with the expertise needed to develop a concise water-management program.
Preventing the spread of infection is no easy task, especially when there are constantly new sources of HAIs in healthcare facilities. That being said, with the help of very specific programs and procedures, such as the recommendations described above, it is possible to reduce the risk of infection and the spread of bacteria.
Infection Control Today. Vol. 23. No. 3. March 2019.