Sammanfattning
Background. Legionella infection was found in Norwegian hospitals for the first time in 2005. We describe the best known methods of controlling Legionella in hospitals.
Material and methods. The article is based on our own experience of measures to prevent Legionnaires’ disease in hospitals and non-systematic searches in PubMed.
Results. There are several methods for combating Legionella in hospitals, such as chlorination, heat treatment and use of filters. However, removal of Legionella is rapidly followed by recontamination. Adding silver and copper ions to water is a well documented method for systemic and lasting removal of Legionella from water. The disadvantage of this measure is high costs, risk of water discolouration and the possible development of resistance by environmental bacterial. This resistance mechanism can theoretically be transmitted to pathogenic bacteria.
Interpretation. We recommend adding silver and copper ions to water as a method of preventing nosocomial Legionnaires’ disease when standard methods fail and there is a high level of Legionella in water. The discolouration of surgical instruments caused by high silver concentrations can be avoided by having a separate water supply for surgical units.