Responding to Morbidity and Mortality

摘要

In 2013, hospital-acquired Legionella pneumophila (L. pneumophila) led to illness and death inrnQueensland, Australia, prompting unprecedented State-wide healthcare potable water microbial sampling.rnResults revealed pockets of high HPC bacteria and L. pneumophila serogroup (SG) 1 counts state-wide,rnshedding new light on a previously unrecognized risk. These bacteriological results were part of a programrnwhich identified gaps in Queensland healthcare infrastructure water quality management which requiredrnattention in order to properly protect public health. These gaps furthermore included potential for thernimplementation of change in Australian municipal water management as Australian Drinking WaterrnGuidelines (ADWG) do not require, but only recommend quality practices (such as for disinfectionrneffectiveness, turbidity, and secondary disinfectant residual). Key challenges in Queensland water qualityrnwhich were seen to feed into the problems identified in healthcare infrastructure potable water qualityrninclude dissolved organic carbon which can exceed 5 mg/L; yearly average water temperatures whichrnexceed 20 ℃ (exceeding 30 ℃ in most locations during the summer; 45℃ in some locations); nornrequirement to maintain secondary disinfectant residual; and, a lack of required water quality monitoringrnand reporting. As a result of the above, a technical advisory panel was commissioned by QueenslandrnHealth which developed Guidelines for Managing Microbial Water Quality in Healthcare Facilities. ThesernGuidelines encourage healthcare facilities to develop Water Quality Risk Management Plans for theirrnpotable water infrastructure in order to prevent microbial regrowth which can lead to illness.