Aspects and problems associated with the water services to be considered in intensive care units.

Background: Water is a product taken for granted and assumed to be a safe commodity in intensive care units (ICU). Biofilm readily becomes established in complex water services presenting a risk to vulnerable patients. Harboured within biofilms are opportunistic pathogens which can be transmitted via hand contact, splashing, aerosol and indirect contact through medical equipment.

Implementing changes to reduce infections in ICU patients. Water services and waste systems.

Background: Evidence linking the role of water services in transmission of infection to patients in ICUs has increased in recent years.

Aims: This research based commentary set out to identify potential solutions for water and wastewater systems in ICU settings.

Methods: Databases and open source information was used to obtain data on approaches to water and wastewater-related issues in ICU settings.

Factors to consider in the safe design of intensive care units - Part 1: historical aspects and ventilation systems.

Background: Evidence linking the role of ventilation systems in transmission of infection to patients in intensive care units has increased in recent years.

Aims: This research-based commentary set out to identify the historical aspect of intensive care unit design, current problems and some potential solutions with respect to ventilation systems.

Methods: Databases and open source information was used to obtain data on the historical aspects and current guidance in ICU, and the authors experiences have been used to suggest potential solutions to ventilation problems in ICU.

Growth of Legionella anisa in a model drinking water system to evaluate different shower outlets and the impact of cast iron rust.

Legionella continues to be a problem in water systems. This study investigated the influence of different shower mixer faucets, and the influence of the presence of cast iron rust from a drinking water system on the growth of Legionella. The research is conducted using a model of a household containing four drinking water systems.

A Year in the Life of a Contaminated Heater-Cooler Unit With Mycobacterium chimaera?

OBJECTIVE Heater-cooler units (HCUs) have been shown to be a source of Mycobacterium chimaera infections. For the past year, weekly water samples have been taken from HCUs used at University Hospitals Birmingham (UHB) NHS Foundation Trust. We report the microbial contamination of the HCUs over a year detailing the decontamination regimes applied at UHB to reduce the microbial load.

Comments on Whiley Legionella Risk Management and Control in Potable Water Systems: Argument for the Abolishment of Routine Testing. Int. J. Environ. Res. Public Health 2017, 14, 12.

In their recent article, Whiley makes an interesting case for the abolishment of routine testing in risk management and control plans. Here, we present our views regarding this suggestion, drawing upon our own experiences in the UK. We urge caution against the removal of routine monitoring from guidelines due to the impending public health risks that would result.

Occurrence of Legionella in UK household showers.

Household water systems have been proposed as a source of sporadic, community acquired Legionnaires' disease. Showers represent a frequently used aerosol generating device in the domestic setting yet little is known about the occurrence of Legionella spp. in these systems.

Rapid investigation of cases and clusters of Legionnaires' disease in England and Wales using direct molecular typing.

Legionella pneumophila is the leading cause of Legionnaires' disease, a severe pneumonia that can occur as sporadic cases or point-source outbreaks affecting multiple patients. The infection is acquired by inhalation of aerosols from contaminated water systems. In order to identify the probable source and prevent further cases, clinical and environmental isolates are compared using phenotypic and genotypic methods.

Biofilm formation in an experimental water distribution system: the contamination of non-touch sensor taps and the implication for healthcare.

Hospital tap water is a recognised source of Pseudomonas aeruginosa. U.K.

Detection of Waterborne Viruses Using High Affinity Molecularly Imprinted Polymers.

Molecularly imprinted polymers (MIPs) are artificial receptor ligands which can recognize and specifically bind to a target molecule. They are more resistant to chemical and biological damage and inactivation than antibodies. Therefore, target specific-MIP nanoparticles are aimed to develop and implemented to biosensors for the detection of biological toxic agents such as viruses, bacteria, and fungi toxins that cause many diseases and death due to the environmental contamination.

Aerosolization of respirable droplets from a domestic spa pool and the use of MS-2 coliphage and Pseudomonas aeruginosa as markers for Legionella pneumophila.

Legionnaires' disease can result when droplets or aerosols containing legionella bacteria are inhaled and deposited in the lungs. A number of outbreaks have been associated with the use of a spa pool where aeration, a high water temperature, and a large and variable organic load make disinfectant levels difficult to maintain. Spa pool ownership is increasing, and the aim of this study, using two surrogate organisms (MS-2 coliphage and Pseudomonas aeruginosa [a natural contaminant]), was to assess the potential risk to domestic users when disinfection fails.

Testing the efficacy of homemade masks: would they protect in an influenza pandemic?

Objective: This study examined homemade masks as an alternative to commercial face masks.

Methods: Several household materials were evaluated for the capacity to block bacterial and viral aerosols. Twenty-one healthy volunteers made their own face masks from cotton t-shirts; the masks were then tested for fit.

A pragmatic approach to Pseudomonas.

Last month's HEJ featured an article based on a presentation at a recent IHEEM seminar given by Dr Jimmy Walker, principal investigator, Decontamination, Biosafety Unit, Microbiology Services, at the Health Protection Agency, who provided valuable advice on detecting and dealing with Pseudomonas in hospital water supplies. Here Dr Walker, and HPA colleague, Peter Hoffman, consultant clinical scientist at the Agency's Laboratory of Healthcare-associated Infection, Microbiology Services, give a detailed overview of the key characteristics of Pseudomonas aeruginosa biofilms, and describe some of the most effective ways for controlling their spread in hospital water systems.

The effectiveness of sodium dichloroisocyanurate treatments against Clostridium difficile spores contaminating stainless steel.

Background: Clostridium difficile is a major cause of hospital-associated infective diarrhea, and its spore form can persist for months in the hospital environment. Chlorine-based cleaning agents are recommended for eliminating this reservoir of potential infection.

Objectives: To investigate the individual contributions of active chlorine, detergent and mechanical action on decontamination of a C difficile contaminated surface.