Greater Hospital Vigilance Urged Over Water Systems in Summer

Patients who are vulnerable to infection run a greater risk of contracting Legionnaires’ disease, a severe form of pneumonia, during warm, humid weather, according to a study published in the Journal of Infectious Diseases. The infection is caused by Legionella bacteria that can live in hospital water systems and throughout the environment.

Legionella bacteria, while usually not a problem for healthy adults, can be most serious and even fatal for patients who are immune compromised, including those in Intensive Care Units, the very young and the very old, the chronically ill, and post-surgical, cancer and transplant patients. These patients risk becoming infected through a buildup of microbes that can inhabit a hospital’s water system, where they have oftentimes become resistant to traditional methods of cleaning and disinfection.

At-risk patients can become ill through any exposure to hospital water, whether through ingestion, comforting mouth sores with ice cubes, bathing, inhalation of shower mist or being treated with equipment washed in hospital water.

“Many healthcare professionals aren’t aware of what’s lurking in their water in the summer or any season, especially the water used with critically ill and at-risk patients. As a result, countless Legionella and other harmful microorganisms that can cause serious infections go undetected,” says Janet Stout, an international expert on Legionella and other microbes in hospital water.

Stout, director of the Special Pathogens Laboratory and a microbiologist at the University of Pittsburgh, is a strong advocate for reducing the risk of waterborne infection in hospitals, nursing homes and other healthcare facilities. She is on a mission to get these institutions to test their water and then do something about it.

Speaking at the annual conference of the Association for Professionals in Infection Control and Epidemiology (APIC) in San Jose, California, Stout shared stories that vividly illustrated the problem:

• A hospital’s Burn Unit treated its badly burned patients with a cooling water spray to ease their pain…until it was discovered that the water was loaded with dangerous, infection-causing microbes.
• Another hospital, attempting to prevent the spread of infection, installed non-touch faucets. But a study found that every faucet tested positive for Legionella bacteria, and that 74 percent were also contaminated with Pseudomonas aeruginosa, another bacterium associated with serious, often fatal, pneumonia.

Patients, their families and caregivers need to be aware of the potential for waterborne infection any time they are hospitalized, particularly if they are seriously ill or undergoing treatment that affects their immune systems, according to Stout.

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New Research Spares Children the Needle Pain

Children suffering from pneumonia could be spared the pain of the doctor's needle, thanks to new research funded by the British Lung Foundation.

The study, a world-first carried out by researchers at The University of Nottingham, discovered that children given oral treatment recovered as quickly, suffered less pain, required less oxygen therapy in hospital and were able to go home sooner than those given injections.

Two-and-a-half million children are affected by pneumonia each year in Europe. Until now, most children have been admitted to hospital and treated with injected antibiotics.

The findings suggest that these injections — endured by generations of children — may be unnecessary and could be replaced with oral doses of the medicine in the majority of cases. The study has been published online in the medical journal Thorax.

The research involved 243 children in hospitals throughout the UK. It was led by Terence Stephenson, professor of Child Health, and Dr Maria Atkinson, both of The University of Nottingham's Medical School.

The study is the first in the developed world to compare oral treatment versus intravenous treatment for children with community-acquired pneumonia, who are unwell enough to need admission to hospital.

Stephenson says: “This is good news for children who hate injections; good news for parents whose children will spend less time in hospital; good news for paediatricians who hate sticking needles in children and good news for the NHS, as fewer beds will be occupied and the treatment is cheaper.”

Dame Helena Shovelton, chief executive of the British Lung Foundation, says: “Treating childhood pneumonia will be less painful and distressing for parents, for children and for the health professionals caring for them, thanks to this research. We are very proud to have made this breakthrough possible.”

The research project involved 243 children, enrolled over a 21-month period at eight UK hospitals. Half were randomly assigned to receive a week of oral antibiotic treatment and half to receive antibiotics intravenously.

Follow-up over subsequent weeks showed that both types of treatment are effective in tackling the illness — and the former actually had a number of advantages over the latter. Oral antibiotics are also cheaper than those given via the IV route.

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