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- W2049402002 abstract "Deux patients hospitalisés dans le service d'infectiologie en 1997 et 1998 ont contracté une légionellose nosocomiale. Ce service disposait d'un humidificateur d'air et l'eau chaude était produite dans des ballons. Des échantillons d'eau des douches, lavabos, ballons de chauffage, humidificateurs d'air, tour aéroréfrigérante ont été étudiés. Des souches de Legionella pneumophila sérotype 6 ayant des pulsotypes identiques ont été isolées chez les cas. L'humidificateur d'air, la tour aéroréfrigérante et l'ensemble du réseau d'eau chaude étaient contaminés. Dans les chambres des cas, l'eau des douches contenait jusqu'à 105 ufc/L de L. pneumophila de mêmes sérotype et pulsotype que les souches cliniques. Les ballons de chauffage de l'eau, non entretenus, et les nombreux bras morts étaient sans doute à l'origine de la contamination du réseau. Le remplacement des ballons par une production instantanée d'eau chaude, la désinfection par choc thermique, la chloration préventive à 2 mg/L, l'audit des réseaux hydriques et les travaux correctifs ont sécurisé l'usage de l'eau chaude. En 1999, 83 % des échantillons d'eau analysés étaient conformes à notre référentiel sécurité (< 50 ufc/L dans les secteurs dits protégés, < 1 000 ufc/L ailleurs). A nosocomial legionnaire's disease was diagnosed in two patients hospitalized in the infectious diseases unit in 1997 and 1998. This unit was equipped with an air humidifier and hot water was produced in heating tanks. Water samples from showers, washbasins, water heating tanks, air humidifiers, and the cooling tower were studied. The patients were infected with Legionella pneumophila serogroup 6 strains with similar typing patterns under pulsed-field gel electrophoresis (PFGE). The air humidifier, the cooling tower, and all the hot water systems were contaminated. In the two patients' rooms, L. pneumophila was detected in shower water samples up to 105 colonyforming units/L: the serogroup and PFGE patterns of this isolate were similar to those isolated in the two patients. The contamination of the hot water system probably resulted from the water heating tanks of the hospita1, which had never be cleaned, and from the numerous ‘dead-end tubes’. Replacement of water heating tanks with instantaneous water heaters, heat treatment of the water distribution system, preventive chlorination up to 2 mg/L, study and improvement of the water distribution systems made hot water use safer. In 1999, 83% of the water samples analysed complied with our security guideline (< 50 cfu/L in protected areas for highly susceptible patients, < 1000 cfu/L elsewhere)." @default.
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- W2049402002 date "2000-05-01" @default.
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- W2049402002 title "Légionelloses nosocomiales: investigation d'une épidémie de deux cas et mesures de prévention" @default.
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- W2049402002 doi "https://doi.org/10.1016/s0399-077x(00)89142-8" @default.
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