WATER QUALITY


MUHAMMAD ATIF NISAR, KIRSTIN ROSS, MELISSA BROWN, RICHARD BENTHAM, GILES BEST – COLLEGE OF SCIENCE AND ENGINEERING, FLINDERS UNIVERSITY; JAMES XI – NWARE AUSTRALIA PTY LTD; JASON HINDS, HARRIET WHILEY – ARC TRAINING CENTRE FOR BIOFILM RESEARCH AND INNOVATION, AUSTRALIA


Monitoring waterquality in healthcare systems


Muhammad Atif Nisar, Kirstin Ross, Melissa Brown, Richard Bentham, Giles Best, James Xi, Jason Hinds, and Harriet Whiley investigate the water stagnation/flow and temperature profiles at thermostatic mixing values (TMVs) and hand basin outlets on VBNC and culturable Legionella.


Hospital and healthcare building water systems have been identified as a major source of Legionnaires disease – a potentially fatal pneumonia-like infection caused by the Legionella bacteria. Legionella is ubiquitous in natural and


engineered water systems and is transmitted through aspiration or inhalation of Legionella-contaminated water or aerosols. Those at greatest risk of infection are the elderly and immuno- compromised individuals, and, as such,


healthcare outbreaks associated with hospital engineered water systems are of significant concern.1 Globally, the incidence of Legionnaires disease has been increasing.2–4


As such,


Muhammad Atif Nisar


Kirstin Ross


Melissa Brown


Richard Bentham


•Dr Muhammad Atif Nisar recently completed a PhD in Environmental Microbiology at Flinders University. His research focused on the interaction between amoeba and Legionella and the role of VBNC Legionella in the management of this pathogen in high-risk settings.


•Dr Kirstin Ross is a professor in environmental health at Flinders University. Her research is focused on anything in the environment that affects human health. She is interested in engaging with communities in environmental health issues, particularly with remote First Nations communities.


•Dr Melissa Brown is a professor of microbiology at Flinders University and a fellow of both the American Academy of Microbiology and of the Australian Society of Microbiology. She is a molecular microbiologist whose research focuses on strategies used by pathogenic bacteria to resist and persist in diverse environments.


•Dr Richard Bentham is an adjunct associate professor in Environmental Health at Flinders University and Associate Director Consultancy at Built


•Dr Giles Best is a research fellow and the manager of the Flow Cytometry facility within the College of Medicine and Public Health, Flinders University. In this role, Dr Best assists with the design and execution of a wide range of assays involving flow cytometry and analysis of the resulting data.


•James Xi is an electronics engineer at Enware Pty Ltd and a PhD candidate with Environmental Health at Flinders University. His research supports Enware’s commitment as an industry leader and is focused on the use of sensor data and predictive modelling to control Legionella in premise plumbing systems.


•Jason Hinds is the senior manager of research and development, design and engineering at Enware Pty Ltd, an 85-year-old manufacturer and distributor of high quality specialist plumbing and water delivery and management solutions. Jason is responsible for leading Enware’s research and innovation strategies, managing their product portfolio and new product development initiatives.


•Dr Harriet Whiley is an associate professor in environmental health at Flinders University and deputy director of the ARC Training Centre for Biofilm Research and Innovation. Her research is aimed at informing best practice control of pathogens in the environment to protect human health.


Giles Best James Xi Jason Hinds Harriet Whiley


TMV & shower monitoring


Figure 1. Enware Smart® Flow System


for a patient ensuite with thermostatic mixing valve (TMV) and basin monitoring devices.


40 IFHE DIGEST 2024


there is a need for improved monitoring and management strategies to control Legionella within hospitals and healthcare facilities. One of the biggest challenges for Legionella management within these systems is that, under unfavourable conditions (e.g. disinfectants, low nutrients and heat stress), Legionella transforms itself into a viable but non culturable (VBNC) state that cannot be detected using the standard methods. Concerningly, VBNC Legionella are still alive and infectious and can transform back into a culturable form under favourable conditions.1 A range of factors influence the


survival and persistence of Legionella in hospital water systems. This includes biofilms, nutrients, protozoan hosts, water


monitoring Basin


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