WATER SYSTEM SAFETY
not release final results until they are confirmed, according to ISO 11731, and although some labs will give preliminary results, these can be misleading, as colonies may appear on plates later in the incubation. Legiolert provides confirmed results within seven days, so offers much greater certainty of knowing if the samples you had taken were negative for the bacterium, or at least having a clearer understanding of what the problem might be.”
Ongoing testing to ensure patient safety As well as the ongoing in-house testing using Pseudalert, the Trust’s use of Legiolert as a monitoring tool continues. Louise Clark explained: “Having long- term experience with Pseudalert, and the positive trials with Legiolert, the upshot is that we have reviewed our internal arrangements and procedures, and recognised that there is a requirement for continual monitoring and testing. We will continue using the IDEXX rapid testing systems in supporting and understanding the extent and impact of any contamination and remedial actions. “The design of the building, and the difficulty in accessing all of the water services within it, means that we have occasional unpredictable flare-ups, so we use the IDEXX methods to support the remedial actions taken. Again, some of my colleagues were initially quite sceptical, but are now more readily accepting of the Legiolert process and the results that it delivers. “We use Legiolert to support the testing
for Legionella that is also undertaken for us by UKAS-accredited laboratories, as advised in guidance,” Louise Clark explained. “This is not currently the case for Pseudomonas aeruginosa, where guidance does not specify testing by a UKAS-accredited laboratory. While the Trust’s use of Legiolert is not UKAS- accredited, IDEXX provides us with external quality assessment samples, which gives us the assurance that our in- house testing is accurate.
The people and the whole system “We appreciate that UKAS accreditation covers more than simply the test. It is also about the laboratory, the people – the whole system. However, we believe that the system we have adopted, which uses testing conducted in UKAS-accredited labs supported by our own in-house testing, gives us real advantages in the way we test for the bacteria, and what we do when we find them.” Louise Clark’s team includes Water manager, Jonathan Danso, and Engineering team leader, Daryl Merrylees, Both use the IDEXX methods routinely, and see the benefits of in-house testing to patient safety. Jonathan Danso explained: “If we have an area of low usage, we can use Legiolert to monitor the outlets and keep costs down. Where the count is high, it gives an early indication, enabling us to take remedial action quicker. The IDEXX process gives reassurance to clinical staff that there is not an issue.”
Faster identification and money saved For Daryl Merrylees, the rapid results show the benefits of the tests. He said: “If we have suspected Legionella contamination, to remove point-of-use-filters we have to get three clear results. The UKAS- accredited tests need 14 days to get results, so the three tests required take at least six weeks. With Legiolert we can get an early indication at seven days of any bacterial growth. The IDEXX methods speed everything up and save money, as we take the samples and process them in-house.” Louise Clark concluded: “Hospitals are
there to make people better, rather than to give them another infection. Therefore, should there be a risk of Pseudomonas aeruginosa or Legionella pneumophila, the way we monitor and test our systems in-house with the support of IDEXX methodology is really useful. Using this testing technology allows us to implement and confirm remedial actions in the shortest possible timeframe, minimising any impact on patient care.”
Nigel Otter
Nigel Otter graduated from the University of Newcastle upon Tyne with a Life Sciences degree, and has spent the majority of his career working in the pharmaceutical, biotechnology, and diagnostics industries. He has worked in a variety of senior executive roles both in the UK and internationally, predominantly in marketing, managing brands and teams, and pioneering new life- sciences technologies in established markets.
He joined IDEXX Water, a specialist company dedicated to water microbiology, in 2013, as Marketing manager EMEA. In this role, he has been involved in the launch of innovative rapid microbiology diagnostic methods for the detection of Pseudomonas aeruginosa, Legionella pneumophila, SARS-Cov-2, and heterotrophic bacteria in water. In addition, as part of the IDEXX EMEA team, he manages the company’s core product lines for the detection of coliforms and
E.coli in drinking water, used to monitor and protect water quality for 2.5 billion people globally. Today he is focused on the adoption of in-house water microbiology testing by hospitals on behalf of IDEXX Water.
January 2023 Health Estate Journal 45
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