title: Prevention and control of health care-associated waterborne infections in health care facilities.
abstract: The current article is a review of the public health risks attributable to waterborne pathogens in health care. The consequences of health care-associated infections (HAIs) are discussed. Not only are Legionella spp involved in HAIs, but also Pseudomonas aeruginosa, other gram-negative microorganisms, fungi, and amoeba-associated bacteria. This is particularly noteworthy among immunocompromised patients. New prevention strategies and control measures brought about through advanced planning, facility remodelling and reconstruction, disinfection, and filtration have resulted in a significant reduction of the incidence of waterborne HAIs. The positive consequences of a comprehensive multibarrier approach including prevention and control programs in health care facilities are discussed. Environmental cultures are now integrated within the infection control program of some European countries. In high-risk areas, the application of disposable sterile point-of-use filters for faucets and shower heads appears to be the practice of choice to efficiently control waterborne pathogens and to prevent infections.
authors.affiliation: Institute for Hygiene and Public Health, University of Bonn, Bonn, Germany. martin.exner@ukb.unl-bonn.de
authors.forename: M
authors.initials: M
authors.lastname: Exner
authors.forename: A
authors.initials: A
authors.lastname: Kramer
authors.forename: L
authors.initials: L
authors.lastname: Lajoie
authors.forename: J
authors.initials: J
authors.lastname: Gebel
authors.forename: S
authors.initials: S
authors.lastname: Engelhart
authors.forename: P
authors.initials: P
authors.lastname: Hartemann
mesh_terms: D018441:Biofilms; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control*; D005618:Fresh Water / Q000382:microbiology; D006801:Humans; D017053:Infection Control / Q000379:methods*; D018570:Risk Assessment; D014871:Water Microbiology; D014881:Water Supply / Q000592:standards