Effect of monochloramine disinfection of municipal drinking water on risk of nosocomial Legionnaires'disease.
Background Many Legionella infections are acquired through inhalation or aspiration of drinking water.
Although about 25% of municipalities in the USA use monochloramine for disinfection of drinking water, the effect of monochloramine on the occurrence of Legionnaires'disease has never been studied.
Methods We used a case-control study to compare disinfection methods for drinking water supplied to 32 hospitals that had had outbreaks of Legionnaires'disease with the disinfection method for water supplied to 48 control-hospitals, with control for selected hospital characteristics and water treatment factors.
Findings Hospitals supplied with drinking water containing free chlorine as a residual disinfectant were more likely to have a reported outbreak of Legionnaires'disease than those that used water with monochloramine as a residual disinfectant (odds ratio 10.2 [95% Cl 1.4-460]). This result suggests that 90% of outbreaks associated with drinking water might not have occurred if monochloramine had been used instead of free chlorine for residual disinfection (attributable proportion 0.90 [0.29-1.00]). Interpretation The protective effect of monochloramine against legionella should be confirmed by other studies.
Chloramination of drinking water may be a cost-effective method for control of Legionnaires'disease at the municipal level or in individual hospitals, and widespread implementation could prevent thousands of cases.
Mots-clés Pascal : Eau potable, Infection nosocomiale, Désinfection, Légionellose, Bactériose, Infection, Legionella, Legionellaceae, Bactérie, Prévention, Hôpital, Tosylchloramide sodique, Homme
Mots-clés Pascal anglais : Drinking water, Nosocomial infection, Disinfection, Legionellosis, Bacteriosis, Infection, Legionella, Legionellaceae, Bacteria, Prevention, Hospital, Tosylchloramide sodium, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0109505
Code Inist : 002B30A01C. Création : 16/11/1999.