Prevalence of Legionella spp. in hot water samples from Polish hospitals in 2009-2013

Background: Microbiological threat from Legionella spp. is associated with the current widespread use of air-condition systems and frequent colonization of hot water distribution systems in public facilities (hospitals, hotels, nursing homes). This poses a particularly high risk in hospitalized patients, as many of them are immunocompromised. More than 50 species and 72 serogroups of Legionella spp. have been described thus far, including more than 20 species being pathogenic to humans. Material/Methods: Microbiological threat posed by Legionella spp. was assessed based on a retrospective analysis of microbiological quality of water from hot water distribution systems in Polish hospitals, determined in 2009-2013 at certified laboratories of the Sanitary-Epidemiological Surveillance. The results were kindly provided by the hospitals’ administration upon request, for which the authors would like to express their deepest gratitude. The study material included samples of hot water from internal distribution systems in 379 Polish hospitals, collected by the State Sanitary Inspectorate. Results: Based on the results of microbiological analyses, we were able to estimate Legionella spp. colonization rates in hospital water distribution systems and to assess the activities undertaken by the State Sanitary Inspectorate to reduce excessive bacterial counts in this reservoir. Microbiological analyses conducted in 2009-2013, i.e. after implementing a statutory obligation to monitor Legionella spp. in hospital hot water distribution systems, showed elevated bacterial counts in 3.92% to 12.7% of the samples. These findings justify further microbiological monitoring of hospital water distribution systems. Discussion: The prevalence of the most pathogenic serotype SG1 in hot water distribution systems of Polish hospitals is relatively low compared to other European countries. To maintain this favorable status, hospital water systems should be monitored not only for the presence of Legionella pneumophila, but also for the prevalence of serogroup 1 L. pneumophila.