Preprint Article Version 1 This version not peer reviewed

The Effect of Hydrogen Peroxide on Reducing the Colonization of Legionella spp. in a Hospital Water Network

Version 1 : Received: 16 February 2017 / Approved: 16 February 2017 / Online: 16 February 2017 (18:48:27 CET)

A peer-reviewed article of this Preprint also exists.

Casini, B.; Aquino, F.; Totaro, M.; Miccoli, M.; Galli, I.; Manfredini, L.; Giustarini, C.; Costa, A.L.; Tuvo, B.; Valentini, P.; Privitera, G.; Baggiani, A. Application of Hydrogen Peroxide as an Innovative Method of Treatment for Legionella Control in a Hospital Water Network. Pathogens 2017, 6, 15. Casini, B.; Aquino, F.; Totaro, M.; Miccoli, M.; Galli, I.; Manfredini, L.; Giustarini, C.; Costa, A.L.; Tuvo, B.; Valentini, P.; Privitera, G.; Baggiani, A. Application of Hydrogen Peroxide as an Innovative Method of Treatment for Legionella Control in a Hospital Water Network. Pathogens 2017, 6, 15.

Journal reference: Pathogens 2017, 6, 15
DOI: 10.3390/pathogens6020015

Abstract

Objectives: To evaluate the effectiveness of hydrogen peroxide (HP) use in the hospital water network disinfection to control Legionella spp. colonization.
Methods: Following the detection of high levels of Legionella contamination in a 136-bed general hospital water network, an HP treatment of the hot water (25 mg/L) was adopted. During a period of 34 months, the effectiveness of HP on Legionella colonization was assessed. Legionella was isolated in accordance with ISO-11731 and identification was carried out by sequencing of the mip gene.
Results: Before HP treatment L.pneumophila sg 2-15 was isolated in all sites with a mean count of 9950±8279 CFU/L. After one month of HP-treatment, we observed the disappearance of L. pneumophila 2-15, however other Legionella species never cultured before appeared; Legionella pneumophila 1 was isolated in 1 out of 4 sampling sites (2,000 CFU/L) and other non-pneumophila species in all sites (mean load 3,000 ±2887 CFU/L). Starting from September 2013, HP-treatment was modified adding food-grade polyphosphates and in the following months we observed a progressive reduction of the mean load of all species (p<0.05), until to a substantial disappearing of Legionella colonization.
Conclusion: Hydrogen peroxide demonstrated a good efficacy in controlling Legionella. Although in the initial phases of treatment it seemed unable to eliminate all the species, by keeping HP levels to 25 mg/L and adding food-grade polyphosphates, a progressive and complete control of colonisation was obtained.

Subject Areas

Hydrogen Peroxide; Legionella; Hospital; Disinfection

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