RAPID MICROBIOLOGY
Detecting P. aeruginosa faster and more easily
Andrew Headland, senior business manager for IDEXX Water, reports on the recent successful adoption of the company’s Pseudalert rapid microbiology water testing technology – which was launched in 2014 into the UK healthcare sector to provide accurate and easy identification of Pseudomonas aeruginosa in hospital water systems in 24 hours – by the Oxford University Hospitals NHS Foundation Trust. The Trust’s key goals were to further enhance patient safety, and to reduce its costs for testing for Pseudomonas by as much as 45%.
Waterborne bacterial contamination poses a threat in hospitals, as it has the potential to lead to serious infections, especially among immunocompromised patients, such as the elderly, people undergoing treatment for cancer, burns patients, or premature infants. For estates and facilities managers, Pseudomonas aeruginosa is one such bacterium which needs to be monitored and controlled within a hospital. This can be challenging, as P. aeruginosa is widespread, and is both difficult to prevent and difficult to eradicate. It forms biofilms within pipes and water outlets, and is likely to be spread by direct contact with a tap or sink. The dangers of P. aeruginosa were strongly brought to light after the bacterium was identified as the pathogen responsible for a serious disease outbreak in neonatal units in Northern Ireland in 2012, and, following the incident, new guidelines for testing for it, detailed in the Health Technical Memorandum 04-01 (HTM 04-01) Addendum: Pseudomonas aeruginosa – advice for augmented care units, were brought in. Although these are guidelines only, there is a responsibility and onus on estates and facilities managers to implement the required testing. Following a successful trial, Oxford University Hospitals NHS Foundation Trust has adopted the IDEXX Pseudalert test for the identification of Pseudomonas aeruginosa. Its selection of the system was based on the speed of results gained using Pseudalert, which gives definitive answers in 24 hours, with no additional confirmation steps.1 Additionally, the simple-to-use system also showed a dramatic 45% cost saving over standard laboratory processing, while enhancing patient safety.
Prime movers
The prime movers behind the implementation are Phil Mitchell, the Trust’s Environmental Estates officer, and Dan Samworth, Environmental Estates supervisor. Phil Mitchell explained: “In
‘Many deadlegs’
P. aeruginosa is widespread, and is both difficult to prevent and difficult to eradicate. It forms biofilms within pipes and water outlets.
common with other hospitals, as part of the quality testing regime set out in HTM 04-01 Part C for augmented care areas, we used to take water samples and send them all to a UKAS-accredited laboratory. The laboratory has the interim results of the presumptive test in three days. It tells us if there’s an indication of a positive, but the full certificate, which gives the quantifiable result, takes seven days. An interim report on the presumptive test might lead us to close the specific outlet. It’s a time-consuming and expensive procedure, during which potential problems might go undetected and potentially increase.”
The way the water distribution system is configured across much of the Trust’s ageing estate does not help. There are many deadlegs, and limited access to pipework. Such challenges make the identification of biofilm ‘hotspots’ and remediation work very difficult. “IDEXX approached us and sent information about its Pseudalert system,” Phil Mitchell explained. “We found it very interesting, and arranged a presentation. It gave us the background information on the company, details of the work it has done, and confirmation that Pseudalert is HTM 04-01-compliant.” Pseudalert is specified as a
recommended method in the Standard Committee of Analysts’ Blue Book, The Microbiology of Drinking Water Part 8 – Methods for the isolation and enumeration of Aeromonas and Pseudomonas aeruginosa, which is a HTM 04-01 requirement. The Pseudalert method was also published as ISO standard 16266-2 in July this year.
Safeguarding water quality ‘for two billion per day’ A global provider of water testing solutions, IDEXX delivers easy, rapid, accurate, and cost-effective information on water quality. It helps protect water quality for an estimated two billion people every day, with tests accepted and
The equipment used by the hospital to undertake its IDEXX Pseudalert testing. October 2018 Health Estate Journal 103
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