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Impact of Electronic Faucets and Water Quality on the Occurrence of Pseudomonas aeruginosa in Water: A Multi-Hospital Study

Published online by Cambridge University Press:  29 December 2014

Dominique Charron ,
Emilie Bédard ,
Cindy Lalancette ,
Céline Laferrière  and
Michèle Prévost
Dominique Charron*
Affiliation:
Department of Civil Engineering, Polytechnique Montreal, Montreal, Quebec, Canada
Emilie Bédard
Affiliation:
Department of Civil Engineering, Polytechnique Montreal, Montreal, Quebec, Canada INRS-Institut Armand-Frappier, Laval, Quebec, Canada
Cindy Lalancette
Affiliation:
INRS-Institut Armand-Frappier, Laval, Quebec, Canada
Céline Laferrière
Affiliation:
Department of Microbiology and Immunology (Infection Control), CHU Ste-Justine, Université de Montréal, Montreal, Quebec, Canada
Michèle Prévost
Affiliation:
Department of Civil Engineering, Polytechnique Montreal, Montreal, Quebec, Canada
*
Address correspondence to Dominique Charron, Polytechnique Montréal, PO Box 6079, Station Centre-ville, Montréal (Qc), Canada H3C 3A7 ([email protected]).
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Abstract

OBJECTIVE

To compare Pseudomonas aeruginosa prevalence in electronic and manual faucets and assess the influence of connecting pipes and water quality.

SETTING

Faucets in 4 healthcare centers in Quebec, Canada.

METHODS

Water samples from 105 electronic, 90 manual, and 14 foot-operated faucets were analyzed for P. aeruginosa by culture and enzymatic detection, and swab samples from drains and aerators were analyzed by culture. Copper and residual chlorine concentrations, temperature, and flow rate were measured. P. aeruginosa concentrations were analyzed in 4 consecutive volumes of cold water and a laboratory study was conducted on copper pipes and flexible hoses.

RESULTS

P. aeruginosa contamination was found in drains more frequently (51%) than in aerators (1%) or water (culture: 4%, enzyme detection: 16%). Prevalence in water samples was comparable between manual (14%) and 2 types of electronic faucets (16%) while higher for foot-operated faucets (29%). However, type 2 electronic faucets were more often contaminated (31%) than type 1 (14%), suggesting that faucet architecture and mitigated volume (30 mL vs 10 mL) influence P. aeruginosa growth. Concentrations were 100 times higher in the first 250 mL than after flushing. Flexible hoses were more favorable to P. aeruginosa growth than copper and a temperature of 40°C led to higher counts.

CONCLUSIONS

The types of faucets and connecting pipes, flow rate, and water quality are important parameters influencing the prevalence and the concentrations of P. aeruginosa in faucets. High concentrations of P. aeruginosa in the first 250 mL suggest increased risk of exposure when using the first flush.

Infect Control Hosp Epidemiol 2014;00(0): 1–9

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 3 , March 2015 , pp. 311 - 319
Copyright
© 2014 by The Society for Healthcare Epidemiology of America. All rights reserved 

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References

REFERENCES

1.Exner, M. Wasser als Infektionsquelle: Leitungswasser: Klar und sauber? Heilberufe 2012;64:24–27.Google Scholar
2.Blanc, DS, Nahimana, I, Petignat, C, Wenger, A, Bille, J, Francioli, P. Faucets as a reservoir of endemic Pseudomonas aeruginosa colonization/infections in intensive care units. Intensive Care Med 2004;30:1964–1968.Google Scholar
3.Moore, G, Walker, J. Presence and control of Legionella pneumophila and Pseudomonas aeruginosa biofilms in hospital water systems. In: Percival SL, Williams DW, Randle J, Cooper T, eds. Biofilms in Infection Prevention and Control. Boston: Academic Press, 2014:311–337.Google Scholar
4.Walker, JT, Jhutty, A, Parks, S, et al. Investigation of healthcare-acquired infections associated with Pseudomonas aeruginosa biofilms in taps in neonatal units in Northern Ireland. J Hosp Infect 2014;86:16–23.Google Scholar
5.Durojaiye, OC, Carbarns, N, Murray, S, Majumdar, S. Outbreak of multidrug-resistant Pseudomonas aeruginosa in an intensive care unit. J Hosp Infect 2011;78:154–155.Google Scholar
6.Ehrhardt, D, Terashita, D, English, T. An outbreak of Pseudomonas aeruginosa in neonatal intensive care unit, Los Angeles County, 2006. Acute Communicable Disease Control Program; December 6, 2006. http://publichealth.lacounty.gov/wwwfiles/ph/dcp/acd/2006SpecialStudies.pdf.Google Scholar
7.Yapicioglu, H, Gokmen, TG, Yildizdas, D, et al. Pseudomonas aeruginosa infections due to electronic faucets in a neonatal intensive care unit. J Paediatr Child Health 2011;48:430–434.Google Scholar
8.Assadian, O, El‐Madani, N, Seper, E, et al. Sensor-operated faucets: a possible source of nosocomial infection? Infect Control Hosp Epidemiol 2002;23:44–46.Google Scholar
9.Berthelot, P, Chord, F, Mallaval, F, Grattard, F, Brajon, D, Pozzetto, B. Magnetic valves as a source of faucet contamination with Pseudomonas aeruginosa? Intensive Care Med 2006;32:1271.Google Scholar
10.Halabi, M, Wiesholzer-Pittl, M, Schöberl, J, Mittermayer, H. Non-touch fittings in hospitals: a possible source of Pseudomonas aeruginosa and Legionella spp. J Hosp Infect 2001;49:117–121.Google Scholar
11.Leprat, R, Denizot, V, Bertr, X, Talon, D.Non-touch fittings in hospitals: a possible source of Pseudomonas aeruginosa and Legionella spp. J Hosp Infect 2003;53:77.Google Scholar
12.Merrer, J, Girou, E, Ducellier, D, et al. Should electronic faucets be used in intensive care and hematology units? Intensive Care Med 2005;31:1715–1718.Google Scholar
13.Van der Mee-Marquet, N, Bloc, D, Briand, L, Besnier, JM, Quentin, R. Non-touch fittings in hospitals: a procedure to eradicate Pseudomonas aeruginosa contamination. J Hosp Infect 2005;60:235–239.Google Scholar
14.Chaberny, IF, Gastmeier, P. Should electronic faucets be recommended in hospitals? Infect Control Hosp Epidemiol 2004;25:997–1000.Google Scholar
15.Health and Safety Executive (HSE). Legionnaires' Disease: Technical Guidance. Part 2: The Control of Legionella Bacteria in Hot and Cold Water Systems. United Kingdom: HSE Books; 2013.Google Scholar
16.Comité sur les infections nosocomiales du Québec. Position du Comité sur les infections nosocomiales du Québec sur les risques associés à l'utilisation des robinets électroniques en milieux de soins. Québec: Institut national de santé publique du Québec; 2009:24.Google Scholar
17.Sydnor, ER, Bova, G, Gimburg, A, Cosgrove, SE, Perl, TM, Maragakis, LL. Electronic-eye faucets: Legionella species contamination in healthcare settings. Infect Control Hosp Epidemiol 2012;33:235–240.Google Scholar
18.Serrano-Suarez, A, Dellunde, J, Salvado, H, et al. Microbial and physicochemical parameters associated with Legionella contamination in hot water recirculation systems. Environ Sci Pollut Res Int 2013;20:5534–5544.CrossRefGoogle ScholarPubMed
19.Cristina, ML, Spagnolo, AM, Casini, B, et al. The impact of aerators on water contamination by emerging gram-negative opportunists in at-risk hospital departments. Infect Control Hosp Epidemiol 2014;35:122–129.CrossRefGoogle ScholarPubMed
20.Department of Health (DH), Estates & Facilities. Water Systems: HTM 04-01: Addendum. Pseudomonas aeruginosa—Advice for Augmented Care Units. Government of Great Britain: Department of Health (DH), Estates & Facilities; 2013.Google Scholar
21.Flemming, HC, Bendinger, B. The last meters before the tap: where drinking water quality is at risk. In: van der Kooij D, van der Wielen PW, eds. Microbial Growth in Drinking-Water Distribution Systems: Problems, Causes, Prevention and Research Needs. London, UK: IWA, 2014:207–238.Google Scholar
22.Dwidjosiswojo, Z, Richard, J, Moritz, MM, Dopp, E, Flemming, H-C, Wingender, J. Influence of copper ions on the viability and cytotoxicity of Pseudomonas aeruginosa under conditions relevant to drinking water environments. Int J Hyg Environ Health 2011;214:485–492.Google Scholar
23.Bédard, E, Charron, D, Lalancette, C, Déziel, E, Prévost, M. Recovery of Pseudomonas aeruginosa culturability following copper- and chlorine-induced stress. FEMS Microbiol Lett 2014;356:226–234.Google Scholar
24.Xue, Z, Hessler, CM, Panmanee, W, Hassett, DJ, Seo, Y. Pseudomonas aeruginosa inactivation mechanism is affected by capsular extracellular polymeric substances reactivity with chlorine and monochloramine. FEMS Microbiol Ecol 2013;83:101–111.Google Scholar
25.International Organization for Standardization (ISO). Water quality—detection and enumeration of Pseudomonas aeruginosa—method by membrane filtration. 16266:2006.Google Scholar
26.United States Environmental Protection Agency (USEPA). Method 200.8—Determination of trace elements in waters and wastes by inductively coupled plasma-mass spectrometry (revision 5.4–EMMC version). Cincinnati, OH: Office of Research and Development; 1994.Google Scholar
27.Lee, DG, Urbach, JM, Wu, G, et al. Genomic analysis reveals that Pseudomonas aeruginosa virulence is combinatorial. Genome Biol 2006;7:R90.Google Scholar
28.Ferroni, A, Nguyen, L, Pron, B, Quesne, G, Brusset, M-C, Berche, P. Outbreak of nosocomial urinary tract infections due to Pseudomonas aeruginosa in a paediatric surgical unit associated with tap-water contamination. J Hosp Infect 1998;39:301–307.Google Scholar
29.Rogues, AM, Boulestreau, H, Lashéras, A, et al. Contribution of tap water to patient colonisation with Pseudomonas aeruginosa in a medical intensive care unit. J Hosp Infect 2007;67:72–78.Google Scholar
30.Cholley, P, Thouverez, M, Floret, N, Bertrand, X, Talon, D. The role of water fittings in intensive care rooms as reservoirs for the colonization of patients with Pseudomonas aeruginosa. Intensive Care Med 2008;34:1428–1433.Google Scholar
31.Hota, S, Hirji, Z, Stockton, K, et al. Outbreak of multidrug-resistant Pseudomonas aeruginosa colonization and infection secondary to imperfect intensive care unit room design. Infect Control Hosp Epidemiol 2009;30:25–33.Google Scholar
32.Vianelli, N, Giannini, MB, Quarti, C, et al. Resolution of a Pseudomonas aeruginosa outbreak in a hematology unit with the use of disposable sterile water filters. Haematologica 2006;91:983–985.Google Scholar
33.Bressler, D, Balzer, M, Dannehl, A, Flemming, H-C, Wingender, J. Persistence of Pseudomonas aeruginosa in drinking-water biofilms on elastomeric material. Water Sci Technol Water Supply 2009;9:81–87.Google Scholar
34.Moritz, MM, Flemming, HC, Wingender, J. Integration of Pseudomonas aeruginosa and Legionella pneumophila in drinking water biofilms grown on domestic plumbing materials. Int J Hyg Environ Health 2010;213:190–197.CrossRefGoogle ScholarPubMed
35.Rogers, J, Dowsett, AB, Dennis, PJ, Lee, JV, Keevil, CW. Influence of temperature and plumbing materials selection on biofilm formation and growth of Legionella pneumophila in model potable water systems contamining complex microbial flora. Appl Environ Microbiol 1994;60:1585–1592.Google Scholar
36.Brown, AD. Some general properties of a psychrophilic pseudomonad: the effects of temperature on some of these properties and the utilization of glucose by this organism and Pseudomonas aeruginosa. J Gen Microbiol 1957;17:640–648.Google Scholar
37.Spinks, AT, Dunstan, RH, Harrison, T, Coombes, P, Kuczera, G. Thermal inactivation of water-borne pathogenic and indicator bacteria at sub-boiling temperatures. Water Research 2006;40:1326–1332.Google Scholar
38.Petignat, C, Francioli, P, Nahimana, I, et al. Exogenous sources of Pseudomonas aeruginosa in intensive care unit patients: implementation of infection control measures and follow-up with molecular typing. Infect Control Hosp Epidemiol 2006;27:953–957.Google Scholar
39.Shrivastava, R, Upreti, RK, Jain, SR, Prasad, KN, Seth, PK, Chaturvedi, UC. Suboptimal chlorine treatment of drinking water leads to selection of multidrug-resistant Pseudomonas aeruginosa. Ecotoxicol Environ Saf 2004;58:277–283.Google Scholar
40.Lalancette, C, Bédard, E, Laferrière, C, Déziel, E, Prévost, M. Do drinking water system biofilms act as reservoirs for hospital-acquired Pseudomonas aeruginosa infections? Paper presented at: American Water Works Association–Water Quality Technology Conference and Exposition (WQTC); November 3--7, 2013; Long Beach, CA.Google Scholar