Evidence map›Paper›PMID 34909504›Full record

ArticleJournal of preventive medicine and hygiene2021

Legionella contamination of a cold-water supplying system in a German university hospital - assessment of the superheat and flush method for disinfection.

Matthias Unterberg, Tim Rahmel, Thomas Kissinger, Christian Petermichl, Michael Bosmanns, Martin Niebius, Christina Schulze, Hans-Peter Jochum, Nina Parohl, Michael Adamzik and 1 more

Open access · greenAbstract read
In one paragraph

Article in Journal of preventive medicine and hygiene, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Matthias UnterbergDepartment of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.
Tim RahmelDepartment of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.
Thomas KissingerNursing Service Management, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.
Christian PetermichlDepartment of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.
Michael BosmannsDepartment of Hygiene, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.
Martin NiebiusDepartment of Hygiene, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.
Christina SchulzeDepartment of Hygiene, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.
Hans-Peter JochumManagement, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.
Nina ParohlHyKoMed GmbH, Lünen, Germany.
Michael AdamzikDepartment of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.
Hartmuth NowakDepartment of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.
Universitätsklinikum Knappschaftskrankenhaus Bochum · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIn case of a contamination of water-supplying systems in hospitals with legionella, usually chemical disinfection measures are used for remediation. Unfortunately, it is reported, that these methods may not be sustainable, have an impact on water quality, and can even fail. As an alternative, the superheat and flush method does not need any special equipment, can be initiated in a short lead of time and does not affect the water quality. However, evidence on this disinfection measurement against legionella is lacking. We therefore investigated and report on the effectiveness and long-term results of the superheat and flush disinfection method.

methodsDuring routine periodical examinations, a rising count of legionella was detected in the cold-water supplying system at a German university hospital. Adapted to an analysis of risks, effort and benefit, the superheat and flush procedure was applied twice within 6 months.

resultsWhile 33 out of 70 samples had a higher legionella count than the legal threshold of 100 CFU/100 mL (CFU - Colony Forming Units) before the first disinfection was carried out, this number could be reduced to 1 out of 202 samples after the first intervention. Additionally, in contrast to previously published studies, the effect was long-lasting, as no relevant limit exceedance occurred during the following observation period of more than two years.

conclusionThe superheat and flush disinfection can provide an economic and highly effective measure in case of legionella contamination and should be shortlisted for an eradication attempt of affected water-supplying systems in hospitals.

Indexed as

Cross InfectionLegionellaLegionella pneumophilaLegionnaires' DiseaseDisinfectionHospitals, UniversityHumansWater MicrobiologyWater SupplydiseaseHospital-acquired Legionnaires’LegionellaSuperheat and flushWater-supplying system

Identifiers

PMID34909504
PMCPMC8639127
OpenAlexW4200599844

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.