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Open AccessArticle

The Role of Sensor-Activated Faucets in Surgical Handwashing Environment as a Reservoir of Legionella

1
Department of Biological, Geological, and Environmental Sciences, University of Bologna, via San Giacomo 12, 40126 Bologna, Italy
2
Department of Medical and Surgical Science, University of Bologna, via San Giacomo 12, 40126 Bologna, Italy
*
Author to whom correspondence should be addressed.
Pathogens 2020, 9(6), 446; https://doi.org/10.3390/pathogens9060446
Received: 3 May 2020 / Revised: 21 May 2020 / Accepted: 3 June 2020 / Published: 5 June 2020
(This article belongs to the Special Issue Legionella Contamination in Water Environment)
Surgical handwashing is a mandatory practice to protect both surgeons and patients in order to control Healthcare-Associated Infections (HAIs). The study is focused on Legionella and Pseudomonas aeruginosa contamination in Surgical Handwashing Outlets (SHWOs) provided by sensor-activated faucets with Thermostatic Mixer Valves (TMVs), as correlated to temperature, technologies, and disinfection used. Samples were analyzed by standard culture techniques, comparing hot- and cold-water samples. Legionella isolates were typed by an agglutination test and by mip sequencing. Legionella contamination showed the same distribution between hot and cold samples concerning positive samples and mean concentration: 44.5% and 1.94 Log10 cfu/L vs. 42.6% and 1.81 Log10 cfu/L, respectively. Regarding the distribution of isolates (Legionella pneumophila vs. Legionella non-pneumophila species), significant differences were found between hot- and cold-positive samples. The contamination found in relation to ranges of temperature showed the main positive samples (47.1%) between 45.1–49.6 °C, corresponding to high Legionella concentrations (2.17 Log10 cfu/L). In contrast, an increase of temperature (>49.6 °C) led to a decrease in positive samples (23.2%) and mean concentration (1.64 Log10 cfu/L). A low level of Pseudomonas aeruginosa was found. For SHWOs located in critical areas, lack of consideration of technologies used and uncorrected disinfection protocols may lead to the development of a high-risk environment for both patients and surgeons. View Full-Text
Keywords: Healthcare-Associated Infections (HAIs); Surgical Handwashing Outlets (SHWOs); sensor-activated faucets; Legionella spp.; risk assessment plan Healthcare-Associated Infections (HAIs); Surgical Handwashing Outlets (SHWOs); sensor-activated faucets; Legionella spp.; risk assessment plan
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MDPI and ACS Style

Mazzotta, M.; Girolamini, L.; Pascale, M.R.; Lizzadro, J.; Salaris, S.; Dormi, A.; Cristino, S. The Role of Sensor-Activated Faucets in Surgical Handwashing Environment as a Reservoir of Legionella. Pathogens 2020, 9, 446.

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