ArticleWater research2021
A comprehensive evaluation of monochloramine disinfection on water quality, Legionella and other important microorganisms in a hospital.
Article in Water research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 36 citations in OpenAlex.
- Exploring the efficacy of combination of point-of-use filters and peracetic acid disinfection in reducing total viable counts in final rinse water of endoscopes.Scientific reports · 2025Article
- Infection by Clonally RelatedAmerican journal of respiratory and critical care medicine · 2025Article
- Foresight 2035: a perspective on the next decade of research on the management of Legionella spp. in engineered aquatic environments.FEMS microbiology reviews · 2025Review
- Effect of pipe material and disinfectant on active bacterial communities in drinking water and biofilms.Journal of applied microbiology · 2025Article
- Water Safety Plan, Monochloramine Disinfection and Extensive Environmental Sampling Effectively ControlMicroorganisms · 2023Article
- Tenets of a holistic approach to drinking water-associated pathogen research, management, and communication.Water research · 2022Review
- A review on disinfection methods for inactivation of waterborne viruses.Frontiers in microbiology · 2022Review
- Metagenomic analysis of MWWTP effluent treated via solar photo-Fenton at neutral pH: Effects upon microbial community, priority pathogens, and antibiotic resistance genes.The Science of the total environment · 2021Article
- Legionella and other opportunistic pathogens in full-scale chloraminated municipal drinking water distribution systems.Water research · 2021Article
- Legionella contamination of a cold-water supplying system in a German university hospital - assessment of the superheat and flush method for disinfection.Journal of preventive medicine and hygiene · 2021Article
- Review
- Optimizing disinfectant residual dosage in engineered water systems to minimize the overall health risks of opportunistic pathogens and disinfection by-products.The Science of the total environment · 2021Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
Abstract
Opportunistic pathogens such as Legionella are of significant public health concern in hospitals. Microbiological and water chemistry parameters in hot water throughout an Ohio hospital were monitored monthly before and after the installation of a monochloramine disinfection system over 16 months. Water samples from fifteen hot water sampling sites as well as the municipal water supply entering the hospital were analyzed using both culture and qPCR assays for specific microbial pathogens including Legionella, Pseudomonas spp., nontuberculous Mycobacteria [NTM], as well as for heterotrophic bacteria. Legionella culture assays decreased from 68% of all sites being positive prior to monochloramine addition to 6% positive after monochloramine addition, and these trends were parallel to qPCR results. Considering all samples, NTMs by culture were significantly reduced from 61% to 14% positivity (p<0.001) after monochloramine treatment. Mycobacterium genus-specific qPCR positivity was reduced from 92% to 65%, but the change was not significant. Heterotrophic bacteria (heterotrophic bacteria plate counts [HPCs]) exhibited large variability which skewed statistical results on a per room basis. However, when all samples were considered, a significant decrease in HPCs was observed after monochloramine addition. Lastly, Pseudomonas aeruginosa and Vermamoeba vermiformis demonstrated large and significant decrease of qPCR signals post-chloramination. General water chemistry parameters including monochloramine residual, nitrate, nitrite, pH, temperature, metals and total trihalomethanes (TTHMs) were also measured. Significant monochloramine residuals were consistently observed at all sampling sites with very little free ammonia present and no water quality indications of nitrification (e.g., pH decrease, elevated nitrite or nitrate). The addition of monochloramine had no obvious impact on metals (lead, copper and iron) and disinfection by-products.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.