Treatment of a Legionella pneumophila-Colonized Water Distribution System Using Copper-Silver Ionization and Continuous Chlorination

  title={Treatment of a Legionella pneumophila-Colonized Water Distribution System Using Copper-Silver Ionization and Continuous Chlorination},
  author={Amaya Biurrun and Luis Caballero and Carmen Pelaz and Elena Le{\'o}n and Alberto Gago},
  journal={Infection Control \&\#x0026; Hospital Epidemiology},
  pages={426 - 428}
Abstract The detection in April 1997 of a case of nosocomial legionellosis in our hospital led to the discovery that both our hot- and cold-water circuits were heavily colonized with Legionella pneumophila. Conventional methods for eradication of the organisms were unsuccessful, so a copper-silver (Cu-Ag) ionization system and a continuous chlorination system were installed. Five months later, the number of colonized sites decreased from an initial 58.3% to 16.7%. 
Persistence of chlorine‐sensitive Legionella pneumophila in hyperchlorinated installations
Aims:  To study the persistence of Legionella over time in different disinfected facilities and analysing whether failures in bacterial eradication could be the result of a decrease in the
Efficacy of Copper-Silver Ionization in Controlling Biofilm- and Plankton-Associated Waterborne Pathogens
At concentrations below the EPA limits, ionization has potential to control the three waterborne pathogens, in addition to Legionella, in hospital water systems for nosocomial infection control.
Controlling Legionella in Hospital Drinking Water: An Evidence-Based Review of Disinfection Methods
This review evaluates systemic disinfection methods (copper-silver ionization, chlorine dioxide, monochloramine, ultraviolet light, and hyperchlorination), a focal disinfection method (point-of-use filtration), and short-term disinfections methods in outbreak situations (superheat-and-flush with or without hyperchlorinated).
The long-term efficacy of copper-silver ionization as a disinfection method in controlling Legionella in hospital water systems and reducing the incidence of hospital-acquired legionnaires' disease is assessed.
Legionella pneumophila in ospedale, un pr o blema superabile.
Chlorination with sodium hypochlorite or other chlorine compounds, superheathing, copper/silver ionization, UV radiation, ozone and other treatments of drinking and hot waters, if rationally used, may contribute substantially to avoiding this preventable pneumonia.
Métodos de desinfección del agua y su implicación en la legionelosis
Legionellosis is a respiratory disease caused by the bacterium Legionella spp., which is primarily found in water distribution systems. The objective was to describe whether water disinfection
Nosocomial legionellosis: prevention and management
  • A. Levin
  • Biology
    Expert review of anti-infective therapy
  • 2009
No randomized controlled trials have been performed to study the treatment of legionellosis but comparative observational studies have been published, mostly involving community-acquired cases and presented similar results when comparing important outcomes, such as mortality and complications.
Effectiveness of Disinfectants Used in Cooling Towers against Legionella pneumophila
All disinfectants have bactericidal activity against L. pneumophila sg 1 at concentrations used in cooling tower treatments, and bacteria are less susceptible to disinfectants F, B, D and A than to H, E, C and G.
Multiple disinfection processes of Legionella pneumophila positive in hotels’ water distribution systems in Jordan
The MDP application seems to be efficient enough to eliminate legionellae when repeatedly applied twice within 21 d, and negative Legionella pneumophila prevalence was observed in the three hotels.


Legionella Disinfection of Water Distribution Systems: Principles, Problems, and Practice
Progress in the field of disinfection directed at hospital water systems has been necessarily slow, and cases of nosocomial legionellosis continue to appear, increasing pressures for hospitals to find solutions.
Controlled evaluation of copper-silver ionization in eradicating Legionella pneumophila from a hospital water distribution system.
Copper-silver ionization can eradicate L. pneumophila in a water distribution system because of its relatively low cost, straightforward installation, easy maintenance, nontoxic by-products and the presence of a disinfecting residual.
Controlling Legionella in Hospital Water Systems: Experience With the Superheat-and-Flush Method and Copper-Silver Ionization
It is concluded that a properly maintained and monitored copper-silver ionization system was more effective than the superheat-and-flush method for reducing the recovery of Legionella from the hospital water distribution system.
Disinfection of water distribution systems for legionella: a review of application procedures and methodologies.
Hospital-acquired legionella pneumonia is emerging as a major problem; potable water distribution systems have been shown to be the primary reservoirs for the legionella organisms. As a result,
Legionnaires' disease associated with a hospital water system. A five-year progress report on continuous hyperchlorination.
Continuous hyperchlorination of the hot and cold water began in January 1982, and chlorine levels of 3 to 5 mg/L have been maintained most recently, and water samples have been consistently negative for Legionella for more than five years.
Efficacy of copper and silver ions and reduced levels of free chlorine in inactivation of Legionella pneumophila
All disinfection systems, regardless of temperature or free chlorine concentration, showed increase inactivation rates when 400 and 40 micrograms of copper and silver per liter was added; however, this trend was significant only at 0.4 mg of free chlorine per liter.
[Guidelines for the prevention of nosocomial pneumonia].
This revised guideline is designed to reduce the incidence of nosocomial pneumonia and is intended for use by personnel who are responsible for surveillance and control of infections in acute-care hospitals; the information may not be applicable in long-term-care facilities because of the unique characteristics of such settings.
Effect of Zidovudine Postexposure Prophylaxis on the Development of HIV-Specific Cytotoxic T-Lymphocyte Responses in HIV-Exposed Healthcare Workers
HIV-specific cytotoxic T-lymphocyte responses may be useful as a surrogate marker of HIV replication in the evaluation of new regimens for PEP of occupational HIV exposures in healthcare workers with occupational exposures to HIV.