A Review of Guidelines for the Primary Prevention of Legionellosis in Long-Term Care Facilities.

Abstract	Legionellosis is an important public health problem in the United States and other countries, and residents of long-term care facilities (LTCFs) are at higher risk for Legionnaires' disease than the general population. In this study, we reviewed published US and international guidelines for the primary prevention of legionellosis in LTCFs, including nursing homes, skilled nursing facilities, assisted living facilities, and aged care facilities. The results of this review indicate that most guidelines emphasize adequate design and maintenance of water systems and water temperatures; however, guidance regarding routine preventative environmental testing for Legionella bacteria is not uniform among various jurisdictions, and facilities are generally left without clear guidance on this issue. In the United States, the Centers for Disease Control and Prevention does not recommend such testing in LTCFs, in contrast to the Veterans Health Administration and Environmental Protection Agency. Internationally, the World Health Organization recommends routine environmental testing, as do Ireland; France; The Netherlands; South Africa; Vienna, Austria; and Queensland, Australia. Among domestic and international guidelines in favor of environmental testing, recommendations on the frequency of testing for Legionella in water systems vary. Further research to inform recommendations on the usefulness of routine environmental testing and other measures for the primary prevention of legionellosis in this setting is needed.
Authors	Kimberly A Barker, Ellen A Whitney, Sarah Blake, Ruth L Berkelman
Journal	Journal of the American Medical Directors Association (J Am Med Dir Assoc) Vol. 16 Issue 10 Pg. 832-6 (Oct 01 2015) ISSN: 1538-9375 [Electronic] United States
PMID	26155722 (Publication Type: Journal Article, Review)
Copyright	Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
Topics	Disinfection Environmental Monitoring Humans Legionellosis (prevention & control) Practice Guidelines as Topic Primary Prevention Residential Facilities Temperature Water Supply

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