医院水系统现场单氯胺消毒减少机会性饮用水病原体

IF 11.4 1区环境科学与生态学 Q1 ENGINEERING, ENVIRONMENTAL

Water Research Pub Date : 2025-06-25 DOI:10.1016/j.watres.2025.124107

Marianne Grimard-Conea , Xavier Marchand-Senécal , Sébastien P. Faucher , Michèle Prévost

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引用次数: 0

摘要

在急症护理医院，易感患者和大型遗留水系统会增加与饮用水病原体相关的医院感染风险。本研究旨在评估现场单氯胺处理对医院热水系统中嗜肺军团菌（Lp）、非结核分枝杆菌（NTMs）、蠕形线虫（Vv）和理化水质的长期（>；1年）影响。采用创新的采样方法，在22个远端站点（水龙头、淋浴头、洗手站）评估了处理效果，并与代表主要流动分配系统的10个控制点（回水回路、加热器、远端站点）进行了比较。单氯胺几乎消除了Lp，培养率（24小时）和基因拷贝数（4周）降低了3倍。平均Vv浓度在24小时内下降了2-log，没有证据表明ntm增加。在单氯胺浓度为2-3 mg/L且温度超过55°C的条件下，所有生物的最佳还原量均被观察到。然而，这些条件只在控制点持续维持，治疗后的平均浓度比远端部位低1个对数。中断给药（5天和4周）也显示军团菌、ntm和Vv （>1-2-log）的显著快速反弹，突出了它们在生物膜中的持久性。观察到金属释放的短期增加，铜和铅的平均浓度分别上升1.8倍和4.6倍。总体而言，结果证实了现场单氯胺对Lp和其他生物的高效快速控制效果。对水质、温度分布和使用模式的分析强调了保持优化的水力和热制度的重要性，以确保在暴露点有效地控制病原体。本研究提供了可操作的见解和实际证据，以支持医疗机构实施稳健的长期监测和控制策略。

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Mitigation of opportunistic drinking water pathogens by onsite monochloramine disinfection in a hospital water system

In acute care hospitals, susceptible patients and large, legacy water systems contribute to increased risk of nosocomial infections associated with drinking water pathogens. This study aimed to evaluate the long-term (>1-year) impact of onsite monochloramine treatment on Legionella pneumophila (Lp), nontuberculous mycobacteria (NTMs), Vermamoeba vermiformis (Vv), and physico-chemical water quality in a hospital hot water system. Using an innovative sampling approach, the efficacy of treatment was assessed at 22 distal sites (faucets, showerheads, handwashing stations) and compared to 10 control points representing the main flowing distribution system (return loops, heaters, remote sites). Monochloramine nearly eliminated Lp, achieving up to 3-log reductions in culturability (<24 h) and gene copies (4-week). Mean Vv concentrations decreased by 2-log within 24 h, with no evidence of a shift towards increased NTMs. Optimal reductions in all organisms were observed at monochloramine concentrations of 2–3 mg/L combined with temperatures exceeding 55 °C. However, these conditions were only consistently maintained at control points, where post-treatment mean concentrations were systematically 1-log lower than those at distal sites. The interruption of dosage (5-day and 4-week) also revealed significant and rapid rebounds of Legionella, NTMs, and Vv (>1–2-log), highlighting their persistence in biofilms. Short-term increases in metal release were observed, with mean copper and lead concentrations rising 1.8- and 4.6-fold, respectively. Overall, results confirmed the high and rapid efficacy of onsite monochloramine to control Lp and other organisms. Analysis of water quality, temperature distribution, and usage patterns emphasize the importance of maintaining optimized hydraulic and thermal regimes to ensure effective pathogen control at points of exposure. This study provides actionable insights and practical evidence to support healthcare facilities in implementing robust long-term monitoring and control strategies.

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来源期刊

Water Research 环境科学-工程：环境

CiteScore

20.80

自引率

9.40%

发文量

1307

审稿时长

38 days

期刊介绍： Water Research, along with its open access companion journal Water Research X, serves as a platform for publishing original research papers covering various aspects of the science and technology related to the anthropogenic water cycle, water quality, and its management worldwide. The audience targeted by the journal comprises biologists, chemical engineers, chemists, civil engineers, environmental engineers, limnologists, and microbiologists. The scope of the journal include: •Treatment processes for water and wastewaters (municipal, agricultural, industrial, and on-site treatment), including resource recovery and residuals management; •Urban hydrology including sewer systems, stormwater management, and green infrastructure; •Drinking water treatment and distribution; •Potable and non-potable water reuse; •Sanitation, public health, and risk assessment; •Anaerobic digestion, solid and hazardous waste management, including source characterization and the effects and control of leachates and gaseous emissions; •Contaminants (chemical, microbial, anthropogenic particles such as nanoparticles or microplastics) and related water quality sensing, monitoring, fate, and assessment; •Anthropogenic impacts on inland, tidal, coastal and urban waters, focusing on surface and ground waters, and point and non-point sources of pollution; •Environmental restoration, linked to surface water, groundwater and groundwater remediation; •Analysis of the interfaces between sediments and water, and between water and atmosphere, focusing specifically on anthropogenic impacts; •Mathematical modelling, systems analysis, machine learning, and beneficial use of big data related to the anthropogenic water cycle; •Socio-economic, policy, and regulations studies.