title: The high prevalence of Legionella pneumophila contamination in hospital potable water systems in Taiwan: implications for hospital infection control in Asia.
abstract: BACKGROUND
  The major sources of Legionnaires' disease (LD) are the potable water systems of large buildings including hospitals, nursing homes, and hotels. Culturing the hospital water system for Legionella allows a preventive approach for hospital-acquired LD. However, hospital-acquired LD is rarely reported in Taiwan, and environmental cultures of Legionella in hospital water systems in Taiwan have never been systematically performed.
  
  
  OBJECTIVE
  The objective of this study was to determine if Legionella is present in hospital water systems in Taiwan. Water quality analysis was also performed to determine if geographic differences in water quality result in different Legionella positivity rates.
  
  
  METHODS
  The water systems of 16 hospitals throughout Taiwan were tested for Legionella by culture. Standardized culture procedures were followed.
  
  
  RESULTS
  Legionella pneumophila was isolated from 63% (10/16) of the hospital water systems; 19% (3/16) of the hospitals had an L. pneumophila positive rate greater than 30%. L. pneumophila serogroups 1 and 6 (strains that are most responsible for Legionella infections) were isolated from 80% (8/10) and 60% (6/10), respectively, of the hospitals that yielded L. pneumophila in their water distribution systems.
  
  
  CONCLUSIONS
  As was shown in epidemiological studies in the USA and Spain, hospital-acquired legionellosis may be prevalent but underdiagnosed in Taiwan.
authors.affiliation: Center for Environmental Laboratory Services, National Kaohsiung Normal University, 62 Shen-chong Rd, Yanchao, Kaohsiung, 824, Taiwan.
authors.forename: Pei-Yi
authors.initials: PY
authors.lastname: Yu
authors.forename: Yusen Eason
authors.initials: YE
authors.lastname: Lin
authors.forename: Wei-Ru
authors.initials: WR
authors.lastname: Lin
authors.forename: Hsiu-Yun
authors.initials: HY
authors.lastname: Shih
authors.forename: Yin-Ching
authors.initials: YC
authors.lastname: Chuang
authors.forename: Ren-Jy
authors.initials: RJ
authors.lastname: Ben
authors.forename: Wen-Kuei
authors.initials: WK
authors.lastname: Huang
authors.forename: Yao-Shen
authors.initials: YS
authors.lastname: Chen
authors.forename: Yung-Ching
authors.initials: YC
authors.lastname: Liu
authors.forename: Feng-Yee
authors.initials: FY
authors.lastname: Chang
authors.forename: Muh-Yong
authors.initials: MY
authors.lastname: Yen
authors.forename: Ching-Chuan
authors.initials: CC
authors.lastname: Liu
authors.forename: Wen-Chien
authors.initials: WC
authors.lastname: Ko
authors.forename: Hsi-Hsun
authors.initials: HH
authors.lastname: Lin
authors.forename: Zhi-Yuan
authors.initials: ZY
authors.lastname: Shi
mesh_terms: D004865:Equipment and Supplies, Hospital / Q000382:microbiology*; D006801:Humans; D017053:Infection Control; D016952:Legionella pneumophila / Q000302:isolation & purification*; D017751:Safety Management; D013624:Taiwan; D014871:Water Microbiology; D014881:Water Supply / Q000032:analysis*