title: [Prevention and control of Legionella infection in the hospital environment].
abstract: An outbreak of nosocomial legionnaires' disease in a hospital of Northern Italy is described, together with the epidemiological survey and the control measures adopted. Two patients developed Legionella pneumophila (serogroup 1) pneumonia, one (immunodepressed) died. The Task Group organised by the Health Service excluded other previous nosocomial infections, and made controls on patients and personnel of at risk units (all negative). An intensive programme of environmental sampling and educational activities on personnel have been carried out. The environmental surveillance revealed that the centralised hot water distribution system of the hospital was colonised with Legionella. Shock heating and hyperchlorination of water were applied, which reduced the number of contaminated sites short term, but recolonisation took place two months later. We underline the difficulties encountered to control Legionella by active surveillance of water quality; once the system is contamined, Legionella eradication may be difficult and expensive, and cases of hospital-acquired legionnaieres' disease are likely to occur.
authors.affiliation: Dip. di Scienze Igienistiche, Microbiologiche e Biostatistiche, Università di Modena e Reggio Emilia.
authors.forename: P
authors.initials: P
authors.lastname: Borella
authors.forename: A
authors.initials: A
authors.lastname: Bargellini
authors.forename: S
authors.initials: S
authors.lastname: Pergolizzi
authors.forename: G
authors.initials: G
authors.lastname: Aggazzotti
authors.forename: C
authors.initials: C
authors.lastname: Curti
authors.forename: P
authors.initials: P
authors.lastname: Nizzero
authors.forename: G
authors.initials: G
authors.lastname: Stancanelli
authors.forename: R
authors.initials: R
authors.lastname: Vaiani
authors.forename: G
authors.initials: G
authors.lastname: Gesù
authors.forename: R
authors.initials: R
authors.lastname: Mazzuconi
mesh_terms: D000328:Adult; D002713:Chlorine; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D004196:Disease Outbreaks; D004203:Disinfection / Q000379:methods; D004783:Environmental Microbiology; D004866:Equipment Contamination; D017809:Fatal Outcome; D005260:Female; D006282:Health Personnel / Q000193:education; D006361:Heating; D006748:Hospital Departments; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007877:Legionnaires' Disease / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D008284:Maintenance and Engineering, Hospital; D008297:Male; D008875:Middle Aged; D012306:Risk; D014871:Water Microbiology; D014876:Water Pollution; D018508:Water Purification / Q000379:methods*; D014881:Water Supply
chemical_list: D002713:Chlorine