title: [Superheat-and-flush effect on the control of hospital-acquired Legionella infection].
abstract: OBJECTIVE
  Superheat-and-flush is one of the methods of disinfection used against Legionella in hospital water distribution systems. An outbreak of nosocomial legionellosis (NL) was detected in the hospital Germans Trias i Pujol in January 1996. The aim of this study was to evaluate the impact of this disinfection technique at an environmental and clinical level.
  
  
  METHODS
  Water samples were collected daily from central and tap water points 3 days prior to 15 days after superheating and flushing. Clinical surveillance of NL was performed 30 consecutive days following disinfection.
  
  
  RESULTS
  After superheat-and-flush, the inoculum of Legionella pneumophila decreased in the central points but increased after day 11, achieving maximum values at 15 days. On the other hand, L. pneumophila was not detected in tap water points after 4 days but recolonization was observed after day 7, achieving 66% at day 9. No clinical cases of NL were detected during the study period.
  
  
  CONCLUSIONS
  Superheat-and-flush is an effective albeit transitory method of rapid disinfection in outbreaks of NL.
authors.affiliation: Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona.
authors.forename: Sonia
authors.initials: S
authors.lastname: Ragull
authors.forename: María
authors.initials: M
authors.lastname: Luisa Pedro-Botet
authors.forename: Marian
authors.initials: M
authors.lastname: García-Núñez
authors.forename: María
authors.initials: M
authors.lastname: Esteve
authors.forename: Nieves
authors.initials: N
authors.lastname: Sopena
authors.forename: Celestino
authors.initials: C
authors.lastname: Rey Joly
authors.forename: Miquel
authors.initials: M
authors.lastname: Sabrià
mesh_terms: D003428:Cross Infection / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D016952:Legionella pneumophila / Q000302:isolation & purification; D007877:Legionnaires' Disease / Q000209:etiology / Q000517:prevention & control*; D014871:Water Microbiology; D018508:Water Purification