%0 Thesis
%9 Master Essay
%A Bhatte, Neeti
%D 2015
%F pittir:26445
%I University of Pittsburgh
%T Water sanitation for the prevention of Legionellosis in a large academic medical center
%U http://d-scholarship-dev.library.pitt.edu/26445/
%X Legionella pneumophila is a bacterium that can cause severe pneumonia by exposure to contaminated water. It is relatively resistant to common water disinfection, so additional prevention measures for healthcare water systems are needed to prevent Legionellosis in severely-ill and immune compromised patients. In the United States, copper silver ionization and chlorine are the most common systems for water disinfection. University of Pittsburgh Medical Center Mercy was the first large medical system in the United States to use monochloramine for Legionella water disinfection for over four years now. This paper is a descriptive and long-term retrospective study of Legionella water disinfection that shows the effectiveness of monochloramine treatment on a large academic medical center water system since its installation in 2011. Legionella water culture data collected by the Mercy Microbiology Laboratory began in March 2011 at UPMC Mercy and is currently an ongoing project. This data is unique as it is the longest follow up data available in the United States. It is collected by the Mercy Microbiology Lab as well as the Special Pathogens Laboratory for UPMC. The paper will include a review of general water treatment methods and the importance of supplementary treatment for Legionella at healthcare facilities. The methods will include the overall plan for Legionella water culture frequency used at UPMC Mercy based on risk assessment, different methodologies of water culture that were studied in the same institution, and the protocols followed for positive cultures and complications that were faced while the treatment was in place at the medical center. The practical lessons learned and the results are of significant importance to public health as well as healthcare precautions. This study also helped address the risk assessment for frequency of Legionella testing and different methods of testing, so it has also been a catalyst for a more controlled and consistent method of treatment in state and county health regulations. Further studies may include eliminating any complications associated with the use of monochloramine and considering a monochloramine treatment system for city-wide or other widespread area usage.