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FACILITIES MANAGEMENT


Conclusion RC compromises POU filtration significantly. Various design and material features in the filter itself as well as in other water outlet equipment – taps, sinks, showers and patient rooms – are necessary to mitigate the risk of RC. While there is awareness of water


outlet-directed RC and water supply- directed RC with some well-established measures such as check valves, other measures known for several decades – e.g. proper cleaning, the sole use of sinks for handwashing or the removal of aerators - still lack proper and complete implementation in many healthcare facilities. For drain-directed RC, awareness began only recently and measures will hopefully be implemented soon, as RC prevention can make a significant difference in preventing waterborne secondary infections in COVID-19 and other immunosuppressed patients. IFHE


*References* 1 Zhou Q. et al. Nosocomial Infections Among Patients with COVID-19, SARS and MERS: A Rapid Review and Meta-Analysis. Annals of Translational Medicine 2020; 8 (10): 629.


2 Jeldrik M. Effect of Retrograde Microbial Contamination on Mobile Drinking Water Systems. Ph.D. Thesis, University of Hamburg, Hamburg, Germany, 2013.


3 Grabowski M, Lobo JM, Gunnel B, Enfield K, Carpenter R, Barnes L et al. Characterizations of handwashing sink activities in a single hospital medical intensive care unit. Journal of Hospital Infection 2018; 100 (3): e115-e122.


4 World Health Organization. Legionella and the prevention of legionellosis, 2007.


5 UK Department of Health and Social Care. Health Technical Memorandum 04-01: Safe water in healthcare premises Part B: Operational management, 2016.


6 UK Department of Health and Social Care. Health Technical Memorandum 01-05: Decontamination in primary care dental practices, 2013.


7 Robert Koch Institute. Infektionsprävention in der Zahnheilkunde - Anforderungen an die Hygiene, 2004.


8 Rogues A.M, Boulestreau H, Lashéras A, Boyer A, Gruson D, Merle C et al. Contribution of tap water to patient colonisation with Pseudomonas aeruginosa in a medical intensive care unit. Journal of Hospital Infection 2007; 67 (1): 72-8.


9 Reuters S, Sigge A, Wiedeck H, Trautmann M. Analysis of transmission pathways of Pseudomonas aeruginosa between patients and tap water outlets. Critical Care Medicine 2002; 30 (10): 2222-8.


10 World Health Organization. Implementation manual to prevent and control the spread of carbapenem-resistant organisms at the


national and health care facility level, 2019.


11 Breathnach AS, Cubbon MD, Karunaharan RN, Pope CF, Plance TD. Multidrug-resistant Pseudomonas aeruginosa outbreaks in two hospitals: association with contaminated hospital waste-water systems. Journal of Hospital Infection 2012; 82 (1): 19-24.


12 Sydnor ERM, Bova G, Gimburg A, Cosgrove SE, Perl TM, Maragakis LL. Electronic-Eye Taps: Legionella Species Contamination in Healthcare. Infection Control & Hospital Epidemiology 2012; 33 (3): 235-40.


13 Hopman J, Tostmann A, Wertheim H, Bos M, Kolwijck E, Akkermans R et al. Reduced rate of intensive care unit acquired gram- negative bacilli after removal of sinks and introduction of water-free patient care. Antimicrobial Resistance & Infection Control 2017; 6: 59.


14 Hopman J, Meijer C, Kenters N, Coolen JP, Ghamati MR, Mehtar S et al. Risk assessment after a severe hospital-acquired infection associated with carbapenemase-producing Pseudomonas aeruginosa. JAMA Network Open 2019; 2 (2): e187665.


15 Proctor CR, Reimann M, Vriens B, Hammes F. Biofilms in shower hoses. Water Research 2018; 131: 274-86.


16 Habel JO. Antibacterial efficacy of silver in hoses proven in study. Health Estate Journal 2020; 74 (7): 54-6.


IFHEDigest Providing insights into the vast field of healthcare engineering and facility management IFHE DIGEST 2021 89


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