Abbreviated duration of superheat-and-flush and disinfection of taps for Legionella disinfection: Lessons learned from failure

Yao Shen Chen, Yung Ching Liu, Susan Shin Jung Lee, Hung Chin Tsai, Shue Ren Wann, Chih Hsiang Kao, Chiao Lin Chang, Wen Kuei Huang, Tsi Shu Huang, Hsueh Lan Chao, Ching Hsien Li, Chin Mei Ke, Yu Sen Eason Lin

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

One medical center in southern Taiwan faced an outbreak of nosocomial Legionnaires' disease; a total of 81 suspected cases were detected during an 8-month period. Baseline environmental surveillance showed that 80% of the distal sites in intensive care units (ICUs) were positive for Legionella pneumophila. Superheat-and-flush was selected for hospital water supply disinfection because it required no special equipment, and it can be initiated expeditiously. We conducted 2 episodes of superheat-and-flush based on the published recommendations from the Department of Health, Taiwan; US Centers for Disease Control and Prevention; and American Society of Heating, Refrigerating, and Air-Conditioning Engineers. Both flushes failed to control colonization of Legionella in the hospital water supply. The rate of distal sites positive for Legionella in wards and ICUs was 14% and 66%, respectively, 10 days after the second flush. The effect of replacement of faucets and showerheads in ICUs appeared to be insignificant in colonization of Legionella. The application of superheat-and-flush for flush duration of 5 minutes was ineffective. Superheat-and-flush may not be economic for a large medical center because it could be costly and labor intensive.

Original languageEnglish
Pages (from-to)606-610
Number of pages5
JournalAmerican Journal of Infection Control
Volume33
Issue number10
DOIs
Publication statusPublished - Dec 2005
Externally publishedYes

ASJC Scopus subject areas

  • Microbiology
  • Infectious Diseases

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    Chen, Y. S., Liu, Y. C., Lee, S. S. J., Tsai, H. C., Wann, S. R., Kao, C. H., Chang, C. L., Huang, W. K., Huang, T. S., Chao, H. L., Li, C. H., Ke, C. M., & Lin, Y. S. E. (2005). Abbreviated duration of superheat-and-flush and disinfection of taps for Legionella disinfection: Lessons learned from failure. American Journal of Infection Control, 33(10), 606-610. https://doi.org/10.1016/j.ajic.2004.12.008