[Sanitizing a hospital hot water system contaminated with Legionella pneumophila]

A number of measures were taken to control Legionella pneumophila in a hospital hot water system over a period of 18 months, including (i) raising the temperature of the water leaving the central storage tanks from initially 55-60 degrees C to approximately 73 degrees C, (ii) heat shock treatment of the whole system with water temperatures above 70 degrees C and (iii) increasing the daily return flow from the hospital circulation system from initially 30 m3 to 120 m3. In addition, (iv) three UV irradiation devices were installed on the inlet and outlets of the storage tanks and (v) an attempt was made to decontaminate the water system by means of CO2. Measures (i) and (iii) were demonstrated to be effective for permanent control of Legionellae in the system. Measures (ii) and (v) proved to have only a short term effect of several days and measure (iv) did not show any effect on the presence of Legionellae at all. The extent of Legionella contamination of the water samples correlated negatively with water temperature and depended on the position of the outlets within the hospital. Different pipe materials (copper, plastics) could not be shown to have any influence on the extent of water contamination with Legionella. The findings of the survey indicate that especially the peripheral areas of the hot water system were colonized by Legionellae.