Reducing the risk of waterborne infection

Concerns have been raised about the threat posed to patients from tap contamination in healthcare facilities. However, a new protocol is boosting decontamination options for thermostatic mixing taps, which could help improve infection prevention. Susan Pearson reports.

According to recent stories in The Guardian and Sun (January 30, 2016), injured military personnel at the Ministry of Defence’s rehabilitation centre Headley Court have unknowingly been bathing for months in tap water contaminated with the potentially pathogenic bacterium Pseudomonas aeruginosa. Many of the patients at the centre, which is reported to have had numerous maintenance problems, have open wounds that would be particularly susceptible to dangerous pseudomonas infections.

Yet there are very comprehensive guidelines on how to prevent such issues. Although the recognition of water as a source of pseudomonas infections has historically been slow, the Department of Health’s landmark  2013 document,  the Addendum to Health Memorandum  04-01 on the control of Legionella:  ‘Pseudomonas aeruginosa – advice for augmented care units’,  has established best practice, including risk assessments that consider water quality in relation to high risk patients.1 Since the trigger for these guidelines came from the much publicised 2011/12 Belfast neonatal incident, in which the P. aeruginosa infections from which three Northern Irish babies died were traced back to contaminated taps, one of the HTM 04-01 Addendum main areas of focus has been to look at what aspects of taps might promote pseudomonas growth and how to prevent this happening. Because the Addendum acknowledges that its recommendations can only be based on the scientific knowledge available at the time of publication, the design of taps has been evolving alongside growing understanding of how pseudomonas is transmitted via water.