[Aspects of hospital hygiene in Legionella infections]

Legionella inevitably are imported from natural reservoirs into drinking-water supplies. Bacterial growth predominantly occurs at water temperatures between 40 degrees C und 50 degrees C (104 degrees F and 122 degrees F). Heat conduction to insufficiently insulated cold water tubes implies the possibility of increased contamination also there. Problems with contamination arise in parts of the water supplies with stagnant warm water. Therefore, reservoirs should be descaled regularly. In general, for prophylaxis are recommended raising the temperature of warm water to 60 degrees C (140 degrees F), regular microbiological control of water quality and regular technical maintenance of waterworks where warm water stagnates for some time. Patients bearing a higher risk of Legionella-infections require intensified precautionary measures. The diagnosis of legionellosis should be based on the direct evidence of immunofluorescence-stained microorganisms. Finding increased antibody titers alone is not always correlated with the response to Legionella-specific therapy.