PDF(Pubmed)
Abstract：
BACKGROUND: Infection by Legionella bacteria is a risk to elderly individuals in health care facilities and should be managed by preventing bacterial proliferation in internal water systems. Norwegian legislation calls for a mandatory Legionella-specific risk assessment with the subsequent introduction of an adapted water management programme. The present study investigates adherence to legislation and guidelines on Legionella control and prevention in Norwegian nursing homes.
METHODS: A cross-sectional survey was distributed to Norwegian municipalities to investigate the status of Legionella specific risk assessments of internal water distribution systems and the introduction of water management programmes in nursing homes.
RESULTS: A total of 55.1% (n = 228) of the participating nursing homes had performed Legionella-specific risk assessments, of which 55.3% (n = 126) stated that they had updated the risk assessment within the last year. 96.5% introduced a water management programme following a risk assessment, whereas 59.6% of the ones without a risk assessment did the same. Nursing homes with risk assessments were more likely to monitor Legionella levels than those without (61.2% vs 38.8%), to remove dead legs (44.7% vs 16.5%), and to select biocidal preventive treatment over hot water flushing (35.5% vs 4.6%).
CONCLUSIONS: This study presents novel insight into Legionella control in Norway, suggesting that adherence to mandatory risk assessment in nursing homes is moderate-low. Once performed, the risk assessment seems to be advantageous as an introduction to future Legionella prevention in terms of the scope and contents of the water management programme.
METHODS: A cross-sectional survey was distributed to Norwegian municipalities to investigate the status of Legionella specific risk assessments of internal water distribution systems and the introduction of water management programmes in nursing homes.
RESULTS: A total of 55.1% (n = 228) of the participating nursing homes had performed Legionella-specific risk assessments, of which 55.3% (n = 126) stated that they had updated the risk assessment within the last year. 96.5% introduced a water management programme following a risk assessment, whereas 59.6% of the ones without a risk assessment did the same. Nursing homes with risk assessments were more likely to monitor Legionella levels than those without (61.2% vs 38.8%), to remove dead legs (44.7% vs 16.5%), and to select biocidal preventive treatment over hot water flushing (35.5% vs 4.6%).
CONCLUSIONS: This study presents novel insight into Legionella control in Norway, suggesting that adherence to mandatory risk assessment in nursing homes is moderate-low. Once performed, the risk assessment seems to be advantageous as an introduction to future Legionella prevention in terms of the scope and contents of the water management programme.
摘要：
背景：军团菌感染对医疗机构中的老年人是一种风险，应通过防止内部水系统中的细菌增殖来管理。挪威立法要求进行针对军团菌的强制性风险评估，随后引入适应性水管理方案。本研究调查了挪威疗养院对军团菌控制和预防立法和指南的遵守情况。
方法：向挪威各市进行了一项横断面调查，以调查内部供水系统的军团菌特定风险评估状况，并在疗养院中引入水管理计划。
结果：共有55.1%(n=228)的参与疗养院进行了军团菌特异性风险评估，其中55.3%(n=126)表示他们在去年更新了风险评估。96.5％的人在进行风险评估后引入了水管理计划，而59.6%的没有风险评估的人做了同样的事情.有风险评估的疗养院比没有风险评估的疗养院更有可能监测军团菌水平（61.2％vs38.8％）。去除死腿(44.7%对16.5%)，并选择杀菌预防性处理而不是热水冲洗(35.5%vs4.6%)。
结论：这项研究为挪威军团菌控制提供了新的见解，这表明养老院对强制性风险评估的依从性是中低的。一旦表演，就水管理计划的范围和内容而言，作为对未来军团菌预防的介绍，风险评估似乎是有利的。
方法：向挪威各市进行了一项横断面调查，以调查内部供水系统的军团菌特定风险评估状况，并在疗养院中引入水管理计划。
结果：共有55.1%(n=228)的参与疗养院进行了军团菌特异性风险评估，其中55.3%(n=126)表示他们在去年更新了风险评估。96.5％的人在进行风险评估后引入了水管理计划，而59.6%的没有风险评估的人做了同样的事情.有风险评估的疗养院比没有风险评估的疗养院更有可能监测军团菌水平（61.2％vs38.8％）。去除死腿(44.7%对16.5%)，并选择杀菌预防性处理而不是热水冲洗(35.5%vs4.6%)。
结论：这项研究为挪威军团菌控制提供了新的见解，这表明养老院对强制性风险评估的依从性是中低的。一旦表演，就水管理计划的范围和内容而言，作为对未来军团菌预防的介绍，风险评估似乎是有利的。
