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Churchill Hospital Controlling Legionella Risk in a Oxford Hospital Building Using Copper and Silver Ionisation Churchill Hospital Case Study

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Churchill Hospital Controlling Legionella Risk in a Oxford Hospital Building Using Copper and Silver Ionisation Churchill Hospital Case Study Case Study Churchill Hospital Controlling Legionella risk in a Oxford hospital building using copper and silver ionisation Churchill Hospital Case Study Background with counts of 100 (2), 200, 300, 600 (2), 1300, 1400 and 5200 cfu/L. One outlet had flexible hoses and a large deadleg, which The Churchill Hospital (part of the John Radcliffe, Oxfordshire) caused Legionella to persist there for longer than in other outlets. is a teaching hospital in Oxford, England. The hospital was The number of outlets sampled was then reduced to 11 outlets, established in 1942 and is primarily a centre for the treatment of after ProEconomy was satisfied thatLegionella was being cancer patients, with research and teaching facilities. It has 180 controlled, and for the past year, six outlets are sampled monthly. in-patient and 100 day care beds. The Orca Copper and Silver Legionella at counts above 100 cfu/L persisted in some outlets Ionisation system (CSI) system was installed at the Churchill until April 2015 (Figure 1), due to flexible hoses and deadlegs. Hospital in November 2014. Since June 2015 (6 months after commissioning) Legionella has been controlled, with only three outlets showing low counts (100 Sampling cfu/L of mainly non-pneumophila). No Legionella has occurred in any of the tested outlets at Churchill Hospital after July 2016 Before the CSI system was activated, pre-commissioning samples (Figures 1 and 2). were taken from 16 outlets identified as being at risk of Legionella contamination. After activation of the CSI system, samples were taken every month from 9 to 20 outlets that showed risk of Conclusion Legionella contamination and were analysed for Legionella by the culture method and for copper and silver by Inductively Coupled There was enough evidence to show Legionella posed a real Plasma-Optical Emission Spectroscopy/Mass Spectrometry threat to the hospital. Legionella control using a CSI system was (ICP-OES/MS), by UKAS accredited laboratories (ALcontrol and achieved from May 2015 and total Legionella eradication was ALS Laboratories, UK). The number of outlets sampled was achieved from August 2016 onwards. The system, like any other then reduced to 11 outlets, after ProEconomy was satisfied that Legionella control system, must be monitored regularly so that Legionella was being controlled, and it was reduced to six outlets any problem outlet is quickly detected and dealt with. Legionella sampled monthly in the past year. has been totally eradicated from the Churchill Hospital for about a year now and as a result, ProEconomy is now providing Legionella Results control to the whole of the John Radcliffe Hospital. The results of the pre-commissioning samples (November 2014) are shown in Figures 1 and 2. A total of nine of the 16 outlets tested showed the presence of Legionella pneumophilla SG2-14 5500 5000 Outlet 1 4500 Outlet 2 Outlet 3 4000 Outlet 4 3500 Outlet 5 Outlet 6 3000 Outlet 7 2500 Outlet 8 Outlet 9 2000 Outlet 10 Outlet 11 Legionella counts (cfu/L) counts Legionella 1500 1000 500 0 20/11/2014 20/12/2014 20/01/2015 20/02/2015 20/03/2015 20/04/2015 20/05/2015 20/06/2015 20/0/2015 20/08/2015 20/09/2015 20/10/2015 20/11/2015 20/12/2015 20/01/2016 20/02/2016 20/03/2016 20/04/2016 20/05/2016 20/06/2016 20/0/2016 20/08/2016 20/09/2016 20/10/2016 20/11/2016 Sample Date Figure 1 Legionella counts at eleven outlets Figure 1. Legionella counts at eleven outlets 25 100 90 20 80 0 15 60 50 10 40 Positives Total Number of Samples of Samples Number Total 30 5 20 10 0 0 v - 16 v - eb - 16 eb Jul - 15 Jul - Jul - 16 Jul Oct - 16 Oct - Apr - 16 Apr - Apr - 15 - Apr Oct - 15 - Oct Apr - 16 - Apr Jan - 15 Jan - 15 Feb Jan - 16 Jan - F Jan - 16 Jan 16 - Feb Jun - 16 Jun Jun - 15 Jun Jun - 16 Jun Dec - 14 Dec Dec - 16 Dec Dec - 15 Dec Sep - 15 Sep - 16 Mar - 16 Mar Mar - 15 Mar - Mar - 16 Mar - No Nov - 14 - Nov Nov - 15 Nov Aug - 15 Aug - 16 Aug - May - 16 May May - 15 - May May - 16 May Total Number of Samples Total Positives Positive Figure 2 Total number of samples taken per month, number of positives and percentage of Legionella positives. 5500 5000 Outlet 1 4500 Outlet 2 Outlet 3 4000 Outlet 4 3500 Outlet 5 Outlet 6 3000 Outlet 7 2500 Outlet 8 Outlet 9 2000 Outlet 10 Outlet 11 Legionella counts (cfu/L) counts Legionella 1500 1000 500 0 20/11/2014 20/12/2014 20/01/2015 20/02/2015 20/03/2015 20/04/2015 20/05/2015 20/06/2015 20/0/2015 20/08/2015 20/09/2015 20/10/2015 20/11/2015 20/12/2015 20/01/2016 20/02/2016 20/03/2016 20/04/2016 20/05/2016 20/06/2016 20/0/2016 20/08/2016 20/09/2016 20/10/2016 20/11/2016 Sample Date Churchill Hospital Case Study Figure 1 Legionella counts at eleven outlets 25 100 90 20 80 0 15 60 50 10 40 Positives Total Number of Samples Number Total 30 5 20 10 0 0 v - 16 v - eb - 16 eb - Jul - 15 Jul - Jul - 16 Jul - Oct - 16 - Oct Apr - 16 - Apr Apr - 15 Apr Oct - 15 - Oct Apr - 16 Apr - Jan - 15 Jan 15 - Feb Jan - 16 Jan - F Jan - 16 16 - Feb Jun - 16 Jun Jun - 15 Jun Jun - 16 Jun Dec - 14 Dec - Dec - 16 Dec Dec - 15 Dec Sep - 15 Sep Sep - 16 Sep Mar - 16 Mar Mar - 15 Mar - Mar - 16 - Mar No Nov - 14 Nov Nov - 15 - Nov Aug - 15 Aug - 16 Aug May - 16 May May - 15 May May - 16 May Total Number of Samples Total Positives Positive Figure 2 Total number of samples taken per month, number of positives and percentage of Legionella positives.Figure 2. Total number of samples taken per month, number of positives and percentage of Legionella positives. Testimonial In an interview with Hospital Times magazine, Claire Hennessey, Head of Operational Estates for Oxford University Hospitals NHS Foundation Trust, had the following to say about their experience with the Orca system: “We started with an installation at the head and neck ward at the Churchill Hospital, where we had the showers out of use and where calorifiers giving us temperature control issues. Depending on how the system worked, it would be a showcase of what we could introduce to the bigger site at John Radcliffe. The result was amazing. In the pre-sample, before the ProEconomy system went in, we had nine positives out of 16 sites sampled. In the first month sampling, after the installation, we were down to just one positive. That one positive stayed for a while. The system allowed us to see that and we evidenced that the outlet concerned was used very infrequently.” .
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