Abstract
BackgroundMicrobial safe tap water is crucial for the safety of immunosuppressed patients.MethodsTo evaluate the suitability of new, reusable point-of-use filters (Germlyser®, Aquafree GmbH, Hamburg, Germany), three variations of a reusable filter with the same filter principle but with different outlets (with and without silver) and inner surface coating of the filter encasements (with and without nano-crystalline silver) were tested. The filter efficacy was monitored over 1, 4 and 8 weeks operating time in a haematological oncology transplantation unit equipped with 18 water outlets (12 taps, 6 showers).ResultsThe filtered water fulfilled the requirements of absence of pathogens over time. From 348 samples, 8 samples (2.3%) exceeded 100 cfu/ml (no sample ≥ 500 cfu/ml). As no reprocessed filter exhibited 100% filter efficacy in the final quality control after each reprocessing, these contaminations could be explained by retrograde contamination during use.ConclusionAs a consequence of the study, the manufacturer recommends changing filters after 4 weeks in high risk areas and after 8 weeks in moderate infectious risk areas, together with routine weekly alcohol-based surface disinfection and additionally in case of visible contamination. The filter efficacy of the 3 filters types did not differ significantly regarding total bacterial counts. Manual reprocessing proved to be insufficient. Using a validated reprocessing in a washer/disinfector with alkaline, acid treatment and thermic disinfection, the filters were effectively reprocessable and now provide tap water meeting the German drinking water regulations as well as the WHO guidelines, including absence of pathogens.
Highlights
Microbial safe tap water is crucial for the safety of immunosuppressed patients
The most common water pathogens are Legionella pneumophila, Pseudomonas aeruginosa and moulds [6]; they are set free as planktonic contaminants from biofilm in the water supply [7]
E.g., after allogeneic stem cell transplantation, as well as intensive care patients are highly susceptible to waterborne nosocomial infections [8,9], and infection of immunocompromised hosts with Pseudomonas spp. or Aspergillus spp. are often fatal
Summary
Microbial safe tap water is crucial for the safety of immunosuppressed patients. Worldwide, nosocomial waterborne pathogens play an important and underestimated role in infection [1,2].Especially in the last decade, water taps as an origin of infection were identified by epidemiological and molecular methods [1,3]. Microbial safe tap water is crucial for the safety of immunosuppressed patients. Nosocomial waterborne pathogens play an important and underestimated role in infection [1,2]. The introduction of a new type of reprocessable POU filter with tubular ceramic filter surfaces (hollow fibre) instead of conventional single-use filters with flat fabric filters offers economical and ecological advantages in the field of water safety and resource management (sustainable development). For the filter types tested here, the manufacturer indicated filter reprocessing after one week's operating time. Based on both hygienic and economical concerns, the purpose of this study was to evaluate the safety of longer operating periods (4 and 8 weeks) in a bone marrow transplantation (BMT) unit
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