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Experiences of the First 16 Hospitals Using Copper-Silver Ionization for Legionella Control: Implications for the Evaluation of Other Disinfection Modalities

Published online by Cambridge University Press:  02 January 2015

Janet E. Stout  and
Victor L. Yu
Janet E. Stout
Affiliation:
Special Pathogens Laboratory of the Veterans Affairs Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
Victor L. Yu*
Affiliation:
Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
*
Veterans Affairs Medical Center, Infectious Disease Section, University Drive C, Pittsburgh, PA 15240
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Abstract

Background and Objectives:

Hospital-acquired legionnaires' disease can be prevented by disinfection of hospital water systems. This study assessed the long-term efficacy of copper-silver ionization as a disinfection method in controlling Legionella in hospital water systems and reducing the incidence of hospital-acquired legionnaires' disease. A standardized, evidence-based approach to assist hospitals with decision making concerning the possible purchase of a disinfection system is presented.

Design:

The first 16 hospitals to install copper-silver ionization systems for Legionella disinfection were surveyed. Surveys conducted in 1995 and 2000 documented the experiences of the hospitals with maintenance of the system, contamination of water with Legionella, and occurrence of hospital-acquired legionnaires' disease. All were acute care hospitals with a mean of 435 beds.

Results:

All 16 hospitals reported cases of hospital-acquired legionnaires' disease prior to installing the copper-silver ionization system. Seventy-five percent had previously attempted other disinfection methods including superheat and flush, ultraviolet light, and hyperchlorination. By 2000, the ionization systems had been operational from 5 to 11 years. Prior to installation, 47% of the hospitals reported that more than 30% of distal water sites yielded Legionella. In 1995, after installation, 50% of the hospitals reported 0% positivity, and 43% still reported 0% in 2000. Moreover, no cases of hospital-acquired legionnaires' disease have occurred in any hospital since 1995.

Conclusions:

This study represents the final step in a proposed 4-step evaluation process of disinfection systems that includes (1) demonstrated efficacy of Legionella eradication in vitro using laboratory assays, (2) anecdotal experiences in preventing legionnaires' disease in individual hospitals, (3) controlled studies in individual hospitals, and (4) validation in confirmatory reports from multiple hospitals during a prolonged time (5 to 11 years in this study). Copper-silver ionization is now the only disinfection modality to have fulfilled all four evaluation criteria.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 8 , August 2003 , pp. 563 - 568
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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