Načrt preprečevanja razmnoževanja bakterije Legionella pneumophila v vodovodnem sistemu večje zdravstvene ustanove v Sloveniji : ocena stanja in obvladovanje tveganj

Česnik, Helena (author), Poljšak, Borut (mentor), Oder, Martina (comentor)

Uvod: Bakterije iz rodu Legionella so prisotne v vseh naravnih vodnih virih, vendar se zaradi nizkih koncentracij človek ne more okužiti. Ko je človek poskrbel za svoje ugodje, je poskrbel za ugodje nekaterih mikroorganizmov, kar lahko rečemo tudi za bakterije Legionella, saj temperatura vode v vodovodnih sistemih med 25 °C in 45 °C predstavlja idealne pogoje za njihovo razmnoževanje. Namen: Namen magistrskega dela je bil pripraviti Načrt za preprečevanje razmnoževanja bakterij iz rodu Legionella v vodovodnem sistemu v večji zdravstveni ustanovi v Sloveniji. Metode dela: Izdelava magistrskega dela je potekala v več korakih. Po pregledu strokovne in znanstvene literature ter na podlagi priporočil različnih institucij, smo izdelali načrt za preprečevanje razmnoževanja bakterij iz rodu Legionella v večji zdravstveni ustanovi. Načrt je bil preizkušen v praksi in po treh mesecih uporabe ustrezno dopolnjen in nadgrajen. Jedro: Ustanova, za katero smo pripravili načrt, je zdravstveni objekt v javni rabi, v kateri se uporablja pitna voda za neposredno uporabo za pitje in izvajanje osebne higiene. Le-to uporabljajo zdrava populacija (zaposleni) in osebe z oslabljenim imunskim odzivom (bolniki). Načrt zajema natančen opis del in nalog, ki jih izvajajo zaposleni v tej ustanovi. Natančno so opisani preventivni in korektivni ukrepi, ki so potrebni, da preprečimo razmnoževanje bakterij Legionella v vodovodnem sistemu. Razprava in sklep: Varstvo oseb pred nalezljivimi boleznimi zajema splošne kot posebne ukrepe za njihovo preprečevanje in obvladovanje. Po navedbah strokovnjakov je okužba z bakterijami Legionella v bolnišničnem okolju izredno nevarna (smrtnost 28 %), zato je pomembno, da preprečimo stik bakterije z bolniki. Najučinkovitejši ukrep za znižanje števila bakterij in s tem infektivne doze je preprečevanje njihovega razmnoževanja v vodovodnih sistemih v teh ustanovah. Za doseganje dobrih rezultatov je načrt preprečevanja razmnoževanja bakterij Legionella v internih vodovodnih sistemih zdravstvenih ustanov ključnega pomena. Predvsem je zelo pomembno, da so ukrepi učinkoviti v boju proti bakterijam Legionella in da je dokument razumljiv ter enostaven za njegove uporabnike.

• Language: Slovenian
• Keywords: bakterije Legionella, legioneloze, bolnišnično okolje, toplotni šok, klorni šok, preventiva
• Work type: Master's thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2017
• PID: 20.500.12556/RUL-91413
• COBISS.SI-ID: 5250667
• Publication date in RUL: 05.04.2017

Secondary language

• Language: English
• Title: Multiplication prevention plan of Legionella pneumophila bacterium in the water network of a larger Slovenian healthcare institution : risk assessment and management

Abstract

Introduction: Although Legionella genus bacteria are present in all natural water resources, their concentration levels are insufficient for human infection. When man created a pleasant environment for himself, he also created a pleasant environment for certain microorganisms. An example of this are Legionella bacteria which find perfect conditions for multiplication in the water network systems where the water temperature ranges from 25 °C to 45 °C. Purpose: The purpose of the master’s thesis was to develop a multiplication prevention plan of Legionella genus bacteria in the water network system of a larger Slovenian healthcare institution. Work methods: The master’s thesis was compiled in several stages. After examining expert and scientific literature as well as recommendations issued by several institutions, the author developed a plan for prevention of multiplication of Legionella genus bacteria in a larger healthcare institution. The plan was then put into practice and, after three months of use, duly completed and upgraded. Main part: The institution for which the plan was drafted is a healthcare facility in public use where drinking water is used directly for drinking and personal hygiene purposes. The water is used both by the healthy population (staff) as well as people with a weakened immune response (patients). The plan includes a detailed description of the work and tasks carried out by the staff. It offers a comprehensive overview of the precautionary and correctional measures needed to prevent Legionella bacteria from multiplying in the water network system. Discussion and Conclusion: The protection of people against contagious diseases consists of general and special measures for disease prevention and control. According to experts, infection with Legionella bacteria in hospitals is extremely dangerous (28 per cent mortality rate), which is why it is important to prevent patients from contacting the bacteria. The most effective way for reducing the number of bacteria and, in consequence, the infective dose, is by preventing their multiplication in the water network systems of such institutions. To achieve good results, it is essential to have multiplication prevention plans of Legionella bacteria in internal water network systems of healthcare institutions. This entails, in particular, having efficient measures in the fight against Legionella bacteria as well as documents that are clear and user friendly.

• Keywords: Legionella bacteria, legionellosis, hospital environment, heat shock, chlorine shock, prevention