WATER SYSTEM SAFETY
Complying with the new BS standard on P. aeruginosa
Writing on behalf of IHEEM’s Water Technical Platform, IHEEM-registered AE (Water), Steve Mount, reviews the recently produced British Standard for risk assessment of Pseudomonas aeruginosa and other waterborne pathogens in healthcare premises, BS 8580-2:2022: Water quality Part 2: Risk assessments for Pseudomonas aeruginosa and other waterborne pathogens – Code of practice, and discusses the challenges facing healthcare organisations in complying with it.
Looking back at the ‘history’ of Pseudomonas aeruginosa, and the microorganism’s relevance to healthcare, and in 1872 Schroeter reported the production of a water-soluble, blue-green pigment on sliced boiled potato and in pus. He named it Bacterium aeruginosum. The name Pseudomonas was proposed by Migula in 1894, and in 1900, after further work, he named the organism Pseudomonas aeruginosa. Pseudomonas aeruginosa (PA) is
a Gram-negative bacterium often found in soil and ground water. An opportunistic pathogen, it rarely affects healthy individuals, but can cause a wide range of infections, particularly in the immunocompromised – for example cancer patients, new-borns, and people with severe burns, diabetes mellitus, or cystic fibrosis. PA infections are sometimes associated
with contact with contaminated water. In hospitals, the organism can contaminate devices left inside the body, such as respiratory equipment and catheters. PA is resistant to many commonly-used antibiotics. The Pseudomonas outbreak in the neonatal unit of the Royal Jubilee Maternity Hospital in Belfast in 2012, in which three babies died, highlighted the problems associated with the organism.
Key British Standards The British Standard, BS8580-1: Water quality – Risk assessments for Legionella control – Code of practice, was released on 31 January 2019, and replaced BS 8580: 2010. The name was changed from ‘BS 8580’ to ‘BS 8580-1’ because the drafting panel felt it was going to be necessary to develop a similar risk assessment standard for Pseudomonas and other waterborne pathogens which can cause infections in humans. This led to the development and production of BS 8580-2: 2022: Water quality Part 2: Risk assessments for Pseudomonas aeruginosa and other waterborne pathogens — Code of practice, released on 24 January this year.
24 Health Estate Journal June 2022
Pseudomonas aeruginosa is a Gram-negative bacterium often found in soil and ground water.
BS 8580-2 is especially applicable to all types of healthcare premises, including hospitals, care, nursing, and residential homes. It is intended for use in the healthcare sector by Water Safety Groups (WSGs), Authorising Engineers / independent advisors, Responsible Person(s), infection prevention and control professionals, microbiologists, contractors, and service-providers. On non-healthcare sites – such as
educational, travel, leisure, commercial, and industrial settings – where there
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The outbreak in the neonatal unit of the Royal Jubilee Maternity Hospital, Belfast, highlighted the problems associated with the organism
are additional systems or equipment which could pose a risk from waterborne pathogens, it should be used by WSGs, Responsible Person(s), and all relevant advisors, contractors, service-providers, and suppliers. For this review, I will focus on its relevance to healthcare. Pseudomonas aeruginosa is a major cause of nosocomial infections in augmented care patients – particularly in burns and cystic fibrosis patients and neonates. Successful treatment is becoming more difficult, as PA is inherently resistant to many antibiotics, and can acquire antibiotic resistance due to the production of carbapenamase.
The need for competence BS 8580-2 rightly states the need for competence in undertaking the assessment of PA from all involved, and reminds us that while assessors competent to carry out Legionella risk assessments will have an understanding of water system engineering, one should
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