title: Control of Legionella Contamination and Risk of Corrosion in Hospital Water Networks following Various Disinfection Procedures.
abstract: Physical and chemical disinfection methods have been proposed with the aim of controlling Legionella water contamination. To date, the most effective procedures for reducing bacterial contamination have not yet been defined. The aim of this study was to assess the long-term effectiveness of various disinfection procedures in order to reduce both culturable and nonculturable (NC) legionellae in different hospital water networks treated with heat, chlorine dioxide, monochloramine, and hydrogen peroxide. The temperature levels and biocide concentrations that proved to give reliable results were analyzed. In order to study the possible effects on the water pipes, we verified the extent of corrosion on experimental coupons after applying each method for 6 months. The percentage of positive points was at its lowest after treatment with monochloramine, followed by chlorine dioxide, hydrogen peroxide, and hyperthermia. Different selections of Legionella spp. were observed, as networks treated with chlorine-based disinfectants were contaminated mainly by Legionella pneumophila serogroup 1, hyperthermia was associated with serogroups 2 to 14, and hydrogen peroxide treatment was associated mainly with non-pneumophila species. NC cells were detected only in heat-treated waters, and also when the temperature was approximately 60°C. The corrosion rates of the coupons were within a satisfactory limit for water networks, but the morphologies differed. We confirm here that chemical disinfection controls Legionella colonization more effectively than hyperthermia does. Monochloramine was the most effective treatment, while hydrogen peroxide may be a promising alternative to chlorine-based disinfectants due to its ability to select for other, less virulent or nonpathogenic species.
authors.affiliation: University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neurosciences, Section of Public Health, Modena, Italy isabella.marchesi@unimore.it.
authors.forename: Isabella
authors.initials: I
authors.lastname: Marchesi
authors.affiliation: University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neurosciences, Section of Public Health, Modena, Italy.
authors.forename: Greta
authors.initials: G
authors.lastname: Ferranti
authors.affiliation: INAIL Research Area, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Monte Porzio Catone, Rome, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Mansi
authors.affiliation: INAIL Research Area, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Monte Porzio Catone, Rome, Italy.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Marcelloni
authors.affiliation: INAIL Research Area, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Monte Porzio Catone, Rome, Italy.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Proietto
authors.affiliation: University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neurosciences, Section of Public Health, Modena, Italy.
authors.forename: Navneet
authors.initials: N
authors.lastname: Saini
authors.affiliation: University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neurosciences, Section of Public Health, Modena, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Borella
authors.affiliation: University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neurosciences, Section of Public Health, Modena, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Bargellini
mesh_terms: D003343:Corrosion; D004202:Disinfectants / Q000494:pharmacology*; D004203:Disinfection / Q000379:methods*; D006761:Hospitals; D006358:Hot Temperature; D016952:Legionella pneumophila / Q000187:drug effects / Q000254:growth & development* / Q000302:isolation & purification* / Q000528:radiation effects; D014871:Water Microbiology
chemical_list: D004202:Disinfectants