Verification of the efficiency of chemical disinfection and sanitation measures in in-building distribution systems

Long-Term Bacterial Dynamics in a Full-Scale Drinking Water Distribution System

Large seasonal variations in microbial drinking water quality can occur in distribution networks, but are often not taken into account when evaluating results from short-term water sampling campaigns. Temporal dynamics in bacterial community characteristics were investigated during a two-year drinking water monitoring campaign in a full-scale distribution system operating without detectable disinfectant residual. A total of 368 water samples were collected on a biweekly basis at the water treatment plant (WTP) effluent and at one fixed location in the drinking water distribution network (NET). The samples were analysed for heterotrophic plate counts (HPC), Aeromonas plate counts, adenosine-tri-phosphate (ATP) concentrations, and flow cytometric (FCM) total and intact cell counts (TCC, ICC), water temperature, pH, conductivity, total organic carbon (TOC) and assimilable organic carbon (AOC). Multivariate analysis of the large dataset was performed to explore correlative trends between microbial and environmental parameters. The WTP effluent displayed considerable seasonal variations in TCC (from 90 × 103 cells mL-1 in winter time up to 455 × 103 cells mL-1 in summer time) and in bacterial ATP concentrations (<1-3.6 ng L-1), which were congruent with water temperature variations. These fluctuations were not detected with HPC and Aeromonas counts. The water in the network was predominantly influenced by the characteristics of the WTP effluent. The increase in ICC between the WTP effluent and the network sampling location was small (34 × 103 cells mL-1 on average) compared to seasonal fluctuations in ICC in the WTP effluent. Interestingly, the extent of bacterial growth in the NET was inversely correlated to AOC concentrations in the WTP effluent (Pearson's correlation factor r = -0.35), and positively correlated with water temperature (r = 0.49). Collecting a large dataset at high frequency over a two year period enabled the characterization of previously undocumented seasonal dynamics in the distribution network. Moreover, high-resolution FCM data enabled prediction of bacterial cell concentrations at specific water temperatures and time of year. The study highlights the need to systematically assess temporal fluctuations in parallel to spatial dynamics for individual drinking water distribution systems.

Plan for the control of Legionella infections in long-term care facilities: role of environmental monitoring

In accordance with the international and national guidelines, the Emilia-Romagna Region (Italy) has established regional guidelines for the surveillance and prevention of legionellosis based on the concept of risk assessment, with particular attention to environmental monitoring. The aim of this study was to verify how environmental surveillance in the context of risk assessment plans could help to guide decisions about preventive strategies against Legionella infections in Long Term Care Facilities (LTCF). In six LTCFs in the city of Bologna (Emilia-Romagna Region) a self-control plan was implemented that included the environmental monitoring of Legionella spp. and the surveillance of hospital-acquired Legionnaires' Disease. At baseline, four hot water systems were colonized by Legionella pneumophila (3 LCTFs) and Legionella londiniensis (1 LCTF). In each establishment specific control measures were adopted based on the characteristics of the system, the virulence of the strain and the level of the contamination. The monitoring, carried out for around two years, was also extended to the ways in which the system and the distal water distribution points were used and maintained with respect to the good practices in operation and management. The adopted actions (shock and/or continuous disinfection treatments) and the implementation of the good practice measures reduced the contamination to acceptable and stable levels. No cases of hospital-acquired legionellosis occurred during the period of study. The environmental surveillance was successful in evaluating the risk and identifying the most suitable preventive strategies.