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Bactiquant Water Rapid Onsite Screening for Assessing Legionella Risk

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Presentation on theme: "Bactiquant Water Rapid Onsite Screening for Assessing Legionella Risk"— Presentation transcript:

1 Bactiquant Water Rapid Onsite Screening for Assessing Legionella Risk
Presented by Lisa Rogers

2 “Legionellosis emerged because of human alteration of the environment, since Legionella species are found in aquatic environments, and thrive in warm water and warm, damp places, such as cooling towers” Legionella and the prevention of legionellosis, WHO 2007

3 World Wide Since 1976, 35 outbreaks reported 2-800 cases Sources
11 in NA (US/CA) 14 in AUS/NZ 10 in Europe Sources 13 Cooling towers 5 each, Spas/hot tub, DHW, AC, and 4 unknowns Misc include potting mix, fountain, industrial systems

4 Year City Location Cause Cases Fatality rate 2012 Québec City, Canada Lower Québec City Possibly cooling towers 180 7 % Calp, Spain AR Diamante Beach Hotel Possibly solar water heating system for spa and DHW 18 17% Scotland SW of Edinburgh 99 3% Chicago,Illinois JW Marriott Hotel Decorative Lobby Fountain 10 30% Auckland, NZ Unknown Water Source and/or AC 11 9% Stoke-on-Trent, UK Warehouse, Fenton Hot tub 19 5% Pittsburgh, PA VA Hospital unknown 22 27% 2013 Queensland, AUS Wesley Hospital NYD, probably hot water system. 2 50% Memphis,TN 24-Hour Fitness NYD probably pool or spa. 3 0% Milwaukee,WI Not yet determined Not yet determined, ongoing 20 Reynoldsburg, OH Wesley Ridge Retirement Comm Potable water system, ongoing 44 Warstein,Germany Warsteiner Brewery Air conditioning, ongoing 165 Florence, AL Glenwood Nursing Home Unknown, still under investigation. 13

5 Concerns CDC estimates 8,000 to 18,000 people are hospitalized each year in the U.S. Mortality rate is approximately 15% Legionella bacteria are found naturally in the environment French study found that L. pneumophila can travel airborne at least 6 km from its source Norway study found high velocity, large drift & high humidity in air scrubber… spread probably for >10 km WHO estimates the cost savings to implement preventive plans is $1-3M USD per life saved. (1200 x 1M= $1.2B)

6 Ideal Water Conditions
Temperatures between 20° and 50°C (68° - 122°F) Optimal growth range is stagnant water 35° - 46°C [95° - 115°F] pH between 5.0 and 8.5 Available iron and copper Sediment/scaling promote growth of commensal microflora Other micro-organisms including algae, flavobacteria, and Pseudomonas, which supply essential nutrients for growth of Legionella or harbor the organism (amoebae, protozoa) Low biocide concentrations

7 Water Sampling Guidelines
Table III:7-1. COLONY FORMING UNITS (CFU) OF LEGIONELLA PER MILLILITER Action Cooling Tower Domestic Water Humidifier 1 100 10 2 1,000 Action 1: Prompt cleaning and/or biocide treatment of the system. Action 2: Immediate cleaning and/or biocide treatment. Take prompt steps to prevent employee exposure. Source : OSHA, 1999 CDC recently testified that there is no safe level !

8 Current Sampling Strategy
Culture Plate Analysis 3-5 days for HPC 7-10 days for Legionella Planktonic, highly variable, overloading, background interferences PCR fast but expensive

9 How BQW can help Rapid test can be performed in 15-30 mins
Easy Sampling and Analysis EPA ETV verified methodology

10 + Principle Method Enzyme substrate Fluorescent compound released
Bacteria-enzyme Principle Method

11 Why is Bactiquant Technology interesting ?
Culture-independent technique Quantification of a naturally occuring hydrolase enzyme activity present in bacteria High specificity to bacteria, little background interference Use of fluorescence technology = high sensitivity Concentration Step = increased sensitivity and significant reduction in detection time

12 Laboratory Comparison BQW

13 EPA ETV Report Excerpt Table 2: Linearity: BQ Value vs Concentration
Test Organism Concentration Range (CFU/mL) Range of Average BQ values Slope Y-intercept Coefficient of Determination (R2) Lake Water Indigenous Bacteria 3.7 x 102 to 6.0 x 103 1542 to 15607 2.38 2243 0.9138 Lake Water Indigenous Bacteria - without 1:5 dilution 3.7 x 102 to 3.0 x 103 1542 to 11106 3.55 739 0.9689 P. aeruginosa ATCC 27853 8.7 x 102 to 8.0 x 103 868 to 7655 0.95 -136 0.9923 Source Battelle / US EPA -2011

14 Adjusted Fluorescence (fu)
EPA ETV Study Excerpt High reproducibility Test Iteration Adjusted Fluorescence (fu) 8.0 x 103 CFU/mL 4.7 x 103 CFU/mL 2.1 x 103 CFU/mL 8.7 x 102 CFU/mL 1 11392 6128 2799 1249 2 12332 6074 2710 1247 3 11376 6012 2559 1297 4 11513 6508 2768 1437 5 11614 6256 2945 1375 Average 11645 6196 2756 1321 Standard deviation 396 196 140 83 RSD (%) 3.4 3.2 5.1 6.3 Source Battelle / US EPA -2011

15 EPA ETV Report Excerpt Table 3. Bactiquant®-test Repeatability and Inter-Assay Reproducibility Test Iteration BQV Fluorescence (flu) Indigenous Bacteria from Lake Water (3.7 x 102 CFU/mL) P. aeruginosa ATCC 27853 (4.7 x 103 CFU/mL) Analyst 1 Analyst 2 Average 2363 2225 6888 6691 Standard deviation 152 57 333 93 RSD (%) 6.4 2.6 4.8 1.4 RPD (%) 6.0 2.9 Table 3 summarizes the repeatability and inter-assay reproducibility results for Bactiquant®-test using two bacterial cultures in water. Two different people analyzed 4 samples of each culture, using different fluorometers.

16 Case Studies

17 BQ value 1000 BQ value 100 BQ value 10
Critical care facility, Courtesy of Clinical Microbiology Institute, Viborg Hospital, Denmark 2006. X-axis Sample No. (1-70) Y-axis Log10(adjusted fluorescence) and Log10(cfu) Legionella pneumophila serotype 2-14

18 Australia Case Study Wesley Hospital, Queensland: 2 cases, 1 death
5 Building, 560 bed facility Heat Treatment for 2 70C ( 158F) Over 3000 samples collected BQ, Legionella, HPC 13 days to reopen, 29 days fully operational BQ used to screen, verify cleaning efficacy and validate post treatment



21 Excerpt from: The Australian Hospital Engineer, September 2013
“CETEC made use of the Bactiquant® water technology for the rapid screening of total bacterial loading within the potable water network. This technology allowed CETEC in under an hour to obtain results superior to plate count for the network. The ability to obtain rapid results as compared to 4 to 10 day timeframe for conventional methods presented significant time, logistical and financial savings.” Excerpt from: The Australian Hospital Engineer, September 2013

22 New Studies The Danish Health Institute has started a two year project now with multiple sites looking at pre-screening as well as post treatment efficacy. Hopefully, some results from that study will be forthcoming later this year.

23 Pros and Cons Rapid onsite testing aids in identifying hotspots
Validate the efficacy of cleaning methods Monitor for changes in system quickly HPC nor BQW a perfect predictor of Legionella Not a substitute for direct Legionella analysis

24 Thank you for listening!
Do you have any questions? Thank you for listening!

25 Booth on Aisle 3000 Lisa Rogers 813-831-6511
Booth on Aisle 3000

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