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Factors That Affect Legionella Positivity in Healthcare Building Water Systems from a Large, National Environmental Surveillance Initiative
Environmental Science & Technology ( IF 10.8 ) Pub Date : 2022-08-05 , DOI: 10.1021/acs.est.2c02194 Shantini D Gamage 1, 2 , Chetan Jinadatha 3, 4 , John D Coppin 5 , Stephen M Kralovic 1, 2, 6 , Alan Bender 7 , Meredith Ambrose 1 , Brooke K Decker 8 , Aaron S DeVries 9 , Michihiko Goto 10, 11 , Oleh Kowalskyj 12 , Angela L Maistros 13 , Vincent Rizzo 12 , Loretta A Simbartl 1 , Richard J Watson 14 , Gary A Roselle 1, 2, 6
Environmental Science & Technology ( IF 10.8 ) Pub Date : 2022-08-05 , DOI: 10.1021/acs.est.2c02194 Shantini D Gamage 1, 2 , Chetan Jinadatha 3, 4 , John D Coppin 5 , Stephen M Kralovic 1, 2, 6 , Alan Bender 7 , Meredith Ambrose 1 , Brooke K Decker 8 , Aaron S DeVries 9 , Michihiko Goto 10, 11 , Oleh Kowalskyj 12 , Angela L Maistros 13 , Vincent Rizzo 12 , Loretta A Simbartl 1 , Richard J Watson 14 , Gary A Roselle 1, 2, 6
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Legionella growth in healthcare building water systems can result in legionellosis, making water management programs (WMPs) important for patient safety. However, knowledge is limited on Legionella prevalence in healthcare buildings. A dataset of quarterly water testing in Veterans Health Administration (VHA) healthcare buildings was used to examine national environmental Legionella prevalence from 2015 to 2018. Bayesian hierarchical logistic regression modeling assessed factors influencing Legionella positivity. The master dataset included 201,146 water samples from 814 buildings at 168 VHA campuses. Overall Legionella positivity over the 4 years decreased from 7.2 to 5.1%, with the odds of a Legionella-positive sample being 0.94 (0.90–0.97) times the odds of a positive sample in the previous quarter for the 16 quarters of the 4 year period. Positivity varied considerably more at the medical center campus level compared to regional levels or to the building level where controls are typically applied. We found higher odds of Legionella detection in older buildings (OR 0.92 [0.86–0.98] for each more recent decade of construction), in taller buildings (OR 1.20 [1.13–1.27] for each additional floor), in hot water samples (O.R. 1.21 [1.16–1.27]), and in samples with lower residual biocide concentrations. This comprehensive healthcare building review showed reduced Legionella detection in the VHA healthcare system over time. Insights into factors associated with Legionella positivity provide information for healthcare systems implementing WMPs and for organizations setting standards and regulations.
中文翻译：
从大型国家环境监测计划影响医疗保健建筑供水系统中军团菌阳性的因素
医疗保健建筑供水系统中的军团菌生长可导致军团菌病，从而使水管理计划 (WMP) 对患者安全很重要。然而，关于医疗保健建筑中军团菌流行率的知识有限。退伍军人健康管理局 (VHA) 医疗保健大楼的季度水质检测数据集用于检查2015 年至 2018 年全国环境军团菌流行率。贝叶斯分层逻辑回归模型评估了影响军团菌阳性的因素。主数据集包括来自 168 个 VHA 校园的 814 座建筑物的 201,146 个水样。4 年内总军团菌阳性率从 7.2% 下降到 5.1%，军团菌感染的几率- 正样本为 0.94 (0.90–0.97) 乘以 4 年期间 16 个季度中上一季度正样本的几率。与区域级别或通常应用控制的建筑级别相比，医疗中心校园级别的积极性差异更大。我们发现，在较旧的建筑物（或每近十年的建设为 0.92 [0.86-0.98]）、较高的建筑物（或每增加一层楼为 1.20 [ 1.13-1.27 ]）、热水样本（或1.21 [1.16–1.27]），以及残留杀菌剂浓度较低的样品中。这项全面的医疗保健建筑审查表明，随着时间的推移，VHA 医疗保健系统中的军团菌检测减少。深入了解与军团菌相关的因素积极性为实施 WMP 的医疗保健系统和制定标准和法规的组织提供信息。
更新日期：2022-08-05
中文翻译：
从大型国家环境监测计划影响医疗保健建筑供水系统中军团菌阳性的因素
医疗保健建筑供水系统中的军团菌生长可导致军团菌病，从而使水管理计划 (WMP) 对患者安全很重要。然而，关于医疗保健建筑中军团菌流行率的知识有限。退伍军人健康管理局 (VHA) 医疗保健大楼的季度水质检测数据集用于检查2015 年至 2018 年全国环境军团菌流行率。贝叶斯分层逻辑回归模型评估了影响军团菌阳性的因素。主数据集包括来自 168 个 VHA 校园的 814 座建筑物的 201,146 个水样。4 年内总军团菌阳性率从 7.2% 下降到 5.1%，军团菌感染的几率- 正样本为 0.94 (0.90–0.97) 乘以 4 年期间 16 个季度中上一季度正样本的几率。与区域级别或通常应用控制的建筑级别相比，医疗中心校园级别的积极性差异更大。我们发现，在较旧的建筑物（或每近十年的建设为 0.92 [0.86-0.98]）、较高的建筑物（或每增加一层楼为 1.20 [ 1.13-1.27 ]）、热水样本（或1.21 [1.16–1.27]），以及残留杀菌剂浓度较低的样品中。这项全面的医疗保健建筑审查表明，随着时间的推移，VHA 医疗保健系统中的军团菌检测减少。深入了解与军团菌相关的因素积极性为实施 WMP 的医疗保健系统和制定标准和法规的组织提供信息。
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