Jimmy Walker PhD, BSc, a microbiologist with over 30 years’ experience in water microbiology and decontamination, discusses the important aspects of Legionnaires’ disease for those with responsibility for hospital water systems, and what we need to understand about the presence of this waterborne pathogen in such systems to safeguard patients.
Do Water Safety Groups (WSG) need to eliminate all species of Legionella from their water systems? The public health data indicates that focusing on Legionella pneumophila is the most effective way to reduce risks to patient safety. Data from Denmark demonstrate that the urinary antigen test is not a source of bias in public health figures, and that efforts to eliminate non-pneumophila species can be a red herring for WSGs, who should focus their efforts on managing the water system and on testing for L. pneumophila to minimise the risk to vulnerable patients.
Background
Reducing Legionella risk to prevent Legionnaires’ disease is a key concern for Estates Departments and infection control specialists. WSGs must consider the risk posed by different Legionella species. The family Legionellaceae (commonly known as Legionella) comprises over 60 species, and more than 70 serogroups. Most healthcare and community-acquired Legionnaires’ disease cases (>95%) are caused by L. pneumophila, even though laboratories have consistently recovered nonpneumophila species from water systems, including healthcare settings.1,2
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