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1

Toplitsch, Daniela, Sabine Platzer, Romana Zehner, Stephanie Maitz, Franz Mascher, and Clemens Kittinger. "Comparison of Updated Methods for Legionella Detection in Environmental Water Samples." International Journal of Environmental Research and Public Health 18, no. 10 (2021): 5436. http://dx.doi.org/10.3390/ijerph18105436.

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The difficulty of cultivation of Legionella spp. from water samples remains a strenuous task even for experienced laboratories. The long incubation periods for Legionellae make isolation difficult. In addition, the water samples themselves are often contaminated with accompanying microbial flora, and therefore require complex cultivation methods from diagnostic laboratories. In addition to the recent update of the standard culture method ISO 11731:2017, new strategies such as quantitative PCR (qPCR) are often discussed as alternatives or additions to conventional Legionella culture approaches.
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2

Thürmer, Alexander, Jürgen Herbert Helbig, Enno Jacobs, and Paul Christian Lück. "PCR-based ‘serotyping’ of Legionella pneumophila." Journal of Medical Microbiology 58, no. 5 (2009): 588–95. http://dx.doi.org/10.1099/jmm.0.008508-0.

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Currently, several PCR assays based on 16S rRNA and virulence-associated genes are available for detection of Legionella pneumophila. So far, no genotyping method has been published that can discriminate between serogroups and monoclonal subgroups of the most common L. pneumophila serogroup 1. Our first approach was to analyse LPS-associated genes of seven L. pneumophila serogroup 1 strains, and we developed two PCR-based methods specific for serogroup 1. Specific DNA fragments could be amplified from all the serogroup 1 strains (n=43) including the strains from the American Type Culture Colle
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3

Ditommaso, Savina, Elisa Ricciardi, Monica Giacomuzzi, Susan R. Arauco Rivera, Adriano Ceccarelli, and Carla M. Zotti. "Overestimation of the Legionella spp. load in environmental samples by quantitative real-time PCR: pretreatment with propidium monoazide as a tool for the assessment of an association between Legionella concentration and sanitary risk." Diagnostic Microbiology and Infectious Disease 80, no. 4 (2014): 260–66. http://dx.doi.org/10.1016/j.diagmicrobio.2014.09.010.

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4

Stuckey, Matthew J., Matthew Arduino, Chris Edens, Margaret Dudeck, Daniel Pollock, and Ryan Fagan. "Water Management and Monitoring Practices in Hospitals—United States, 2018." Infection Control & Hospital Epidemiology 41, S1 (2020): s83—s84. http://dx.doi.org/10.1017/ice.2020.577.

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Background: Water management programs (WMPs) are needed to minimize the growth and transmission of opportunistic pathogens in healthcare facility water systems. In 2017, the Centers for Medicare & Medicaid Service (CMS) began requiring that certified hospitals in the United States have water management policies and procedures; in response, the National Healthcare Safety Network (NHSN) Annual Hospital Survey included new, voluntary questions on practices regarding water management and monitoring. Of 4,929 hospitals surveyed in 2017, 3,821 (77.5%) reported having a WMP. Of these 3,821 facili
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5

Miskowski, Diane. "Legionella: Its Ecology, Risk Assessment and Control." Synergist 19, no. 2 (2008): 42. http://dx.doi.org/10.3320/1.2904767.

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6

Lizana, X., A. López, S. Benito, et al. "Viability qPCR, a new tool for Legionella risk management." International Journal of Hygiene and Environmental Health 220, no. 8 (2017): 1318–24. http://dx.doi.org/10.1016/j.ijheh.2017.08.007.

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7

Cowles, D. "Legionnaires Disease and the Legionella Risk Assessment Process." Museum Management and Curatorship 19, no. 2 (2001): 218–20. http://dx.doi.org/10.1016/s0260-4779(01)00042-5.

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8

Medema, G., B. Wullings, P. Roeleveld, and D. van der Kooij. "Risk assessment of Legionella and enteric pathogens in sewage treatment works." Water Supply 4, no. 2 (2004): 125–32. http://dx.doi.org/10.2166/ws.2004.0037.

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Exposure of sewage treatment workers to Legionella pneumophila and enteric pathogens through aerosols at different sewage treatment installations was quantified. The presence of Legionella sp. and L. pneumophila in water and air samples at different sewage installations was determined by cultivation, Direct Fluorescence Assay and PCR. Simultaneously, coliforms, F-RNA phages and spores of sulphite reducing clostridia (SSRC) were enumerated in water and air. For enteric pathogens, the aerosolisation efficiency of coliforms, F-RNA phages and SSRC were combined with published data on the concentra
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9

Armstrong, Thomas W., and Charles N. Haas. "Legionnaires' disease: evaluation of a quantitative microbial risk assessment model." Journal of Water and Health 6, no. 2 (2008): 149–66. http://dx.doi.org/10.2166/wh.2008.026.

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Background: The quantities of Legionella vary considerably from natural waters to water in contaminated domestic hot water supplies, whirlpool spas and cooling towers, with the risk for LD rising as the Legionella counts grow. We currently report the results from our Quantitative Microbial Risk Assessment (QMRA) model evaluation. We developed the LD QMRA model to better understand Legionella exposure risks. Methods: Using an animal data derived model for LD, we calculated risks from estimated exposures for a whirlpool spa outbreak, two hot spring spa outbreaks and compared the results to the r
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10

Gea-Izquierdo, Enrique. "Multiple regression as a preventive tool for determining the risk of Legionella spp." Universitas Scientiarum 17, no. 1 (2012): 64. http://dx.doi.org/10.11144/javeriana.sc17-1.mraa.

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<p><strong>Objective</strong>. To determine the interrelationship between health & hygiene conditions for prevention of legionellosis, the composition of materials used in water distribution systems, the water origin and Legionella pneumophila risk. <strong>Material and methods</strong>. Include a descriptive study and multiple regression analysis on a sample of golf course sprinkler irrigation systems (n=31) pertaining to hotels located on the Costa del Sol (Malaga, Spain). The study was carried out in 2009.<strong> Results</strong>. Presented
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11

Shah, N., C. Knifton, and T. Dowsing. "Delirium Risk Assessment Tool – ACTS Tool." European Geriatric Medicine 4 (September 2013): S200. http://dx.doi.org/10.1016/j.eurger.2013.07.669.

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12

Storey, M. V., N. J. Ashbolt, and T. A. Stenström. "Biofilms, thermophilic amoebae and Legionella pneumophila - a quantitative risk assessment for distributed water." Water Science and Technology 50, no. 1 (2004): 77–82. http://dx.doi.org/10.2166/wst.2004.0023.

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A simplistic quantitative microbial risk assessment (QMRA) based on the maximum risk curve (r = 1) was developed for Legionella within a water distribution system. Both biofilms and a thermophilic isolate of acanthamoebae were shown to increase the resistance of Legionella to conventional thermal disinfection by between one and two logs respectively. The level of risk presented to consumers was shown to exceed the USEPA 10-4 benchmark in many cases tested. This was caused, in part, by the sensitivity of the risk model but also through a lack of reliable dose-response data for Legionella. Notwi
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13

MacAvoy, Suzanne, Teresa Skinner, and Maria Hines. "Fall risk assessment tool." Applied Nursing Research 9, no. 4 (1996): 213–18. http://dx.doi.org/10.1016/s0897-1897(96)80127-3.

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14

Laganà, Pasqualina, Maria Elsa Gambuzza, and Santi Delia. "Legionella risk assessment in cruise ships and ferries." Annals of Agricultural and Environmental Medicine 24, no. 2 (2017): 276–82. http://dx.doi.org/10.26444/aaem/74717.

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15

Sciuto, Emanuele Luigi, Pasqualina Laganà, Simona Filice, et al. "Environmental Management of Legionella in Domestic Water Systems: Consolidated and Innovative Approaches for Disinfection Methods and Risk Assessment." Microorganisms 9, no. 3 (2021): 577. http://dx.doi.org/10.3390/microorganisms9030577.

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Legionella is able to remain in water as free-living planktonic bacteria or to grow within biofilms that adhere to the pipes. It is also able to enter amoebas or to switch into a viable but not culturable (VBNC) state, which contributes to its resistance to harsh conditions and hinders its detection in water. Factors regulating Legionella growth, such as environmental conditions, type and concentration of available organic and inorganic nutrients, presence of protozoa, spatial location of microorganisms, metal plumbing components, and associated corrosion products are important for Legionella
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16

Papadakis, Antonios, Dimosthenis Chochlakis, Vassilios Sandalakis, Maria Keramarou, Yannis Tselentis, and Anna Psaroulaki. "Legionella spp. Risk Assessment in Recreational and Garden Areas of Hotels." International Journal of Environmental Research and Public Health 15, no. 4 (2018): 598. http://dx.doi.org/10.3390/ijerph15040598.

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17

Blanky, Marina, Yehonatan Sharaby, Sara Rodríguez-Martínez, Malka Halpern, and Eran Friedler. "Greywater reuse - Assessment of the health risk induced by Legionella pneumophila." Water Research 125 (November 2017): 410–17. http://dx.doi.org/10.1016/j.watres.2017.08.068.

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18

Lauritano, D. "RISK ASSESSMENT OF COLONIZATION OF LEGIONELLA SPP. IN DENTAL UNIT WATERLINES." Oral & Implantology 10, no. 3 (2017): 283. http://dx.doi.org/10.11138/orl/2017.10.3.283.

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19

Pankhurst, Caroline L. "Risk Assessment of Dental Unit Waterline Contamination." Primary Dental Care os10, no. 1 (2003): 5–10. http://dx.doi.org/10.1308/135576103322504030.

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Biofilms form rapidly on dental unit waterlines. The majority of the organisms in the biofilm are harmless environmental species, but some dental units may harbour opportunistic respiratory pathogens. This paper describes a risk assessment approach to analysing the hazard from biofilm organisms contaminating dental unit waterlines on the respiratory health of both the dental team and patients. The health risk from the respiratory pathogens Legionella spp, Mycobacterium spp and Pseudomonads was found to be low. Nevertheless, in order to satisfy water regulations and comply with health and safet
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20

Ortegon, Nina. "Ground Risk Assessment Tool: Our Journey." Pediatrics 137, Supplement 3 (2016): 639A. http://dx.doi.org/10.1542/peds.137.supplement_3.639a.

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21

Forteza, Francisco J., Albert Sesé, and José M. Carretero-Gómez. "CONSRAT. Construction sites risk assessment tool." Safety Science 89 (November 2016): 338–54. http://dx.doi.org/10.1016/j.ssci.2016.07.012.

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22

ANDERSON, JANE. "Tool Refines Risk Assessment of Hospitals." Rheumatology News 10, no. 3 (2011): 78. http://dx.doi.org/10.1016/s1541-9800(11)70226-5.

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23

Brown, Stephen L. "Risk Assessment as a Predictive Tool." Risk Analysis 7, no. 3 (1987): 285. http://dx.doi.org/10.1111/j.1539-6924.1987.tb00463.x.

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24

BOSCHERT, SHERRY. "Osteoporosis Guidelines Add Risk Assessment Tool." Internal Medicine News 41, no. 10 (2008): 1–4. http://dx.doi.org/10.1016/s1097-8690(08)70549-3.

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25

Tiwana, Amrit, and Mark Keil. "The one-minute risk assessment tool." Communications of the ACM 47, no. 11 (2004): 73–77. http://dx.doi.org/10.1145/1029496.1029497.

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26

Thummathai, Kwaunpanomporn, Hunsa Sethabouppha, Chawapornpan Chanprasit, and Duangrudee Lasuka. "Depression Risk Assessment Tool for Adolescents." Archives of Psychiatric Nursing 32, no. 3 (2018): 343–47. http://dx.doi.org/10.1016/j.apnu.2017.11.023.

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27

Cherubin, Paolo, Stefano Pellino, and Annamaria Petrone. "Baseline risk assessment tool: A comprehensive risk management tool for process safety." Process Safety Progress 30, no. 3 (2011): 251–60. http://dx.doi.org/10.1002/prs.10464.

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28

Hamilton, Melissa. "Evaluating Algorithmic Risk Assessment." New Criminal Law Review 24, no. 2 (2021): 156–211. http://dx.doi.org/10.1525/nclr.2021.24.2.156.

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Algorithmic risk assessment is hailed as offering criminal justice officials a science-led system to triage offender populations to better manage low- versus high-risk individuals. Risk algorithms have reached the pretrial world as a best practices method to aid in reforms to reduce reliance upon money bail and to moderate pretrial detention’s material contribution to mass incarceration. Still, these promises are elusive if algorithmic tools are unable to achieve sufficient accurate rates in predicting criminal justice failure. This article presents an empirical study of the most popular pretr
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29

Scaturro, Maria, Elisa Poznanski, Mariarosaria Mupo, et al. "Evaluation of GVPC and BCYE Media for Legionella Detection and Enumeration in Water Samples by ISO 11731: Does Plating on BCYE Medium Really Improve Yield?" Pathogens 9, no. 9 (2020): 757. http://dx.doi.org/10.3390/pathogens9090757.

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Legionella spp are the causative agents of Legionnaires’ diseases, which is a pneumonia of important public health concern. Ubiquitous freshwater and soil inhabitants can reach man-made water systems and cause illness. Legionella enumeration and quantification in water systems is crucial for risk assessment and culture examination is the gold standard method. In this study, Legionella recovery from potable water samples, at presumably a low concentration of interfering microorganisms, was compared by plating on buffered charcoal yeast extract (BCYE) and glycine, vancomycin, polymyxin B, cycloh
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30

Ronco, Deb A., Kelly J. Manahan, and John P. Geisler. "Ovarian cancer risk assessment: a tool for preoperative assessment." European Journal of Obstetrics & Gynecology and Reproductive Biology 158, no. 2 (2011): 325–29. http://dx.doi.org/10.1016/j.ejogrb.2011.05.018.

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31

Santos, Susan L. "ES Views: Risk assessment: A tool for risk management." Environmental Science & Technology 21, no. 3 (1987): 239–40. http://dx.doi.org/10.1021/es00157a602.

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32

Whitehouse, R. J. "Planning application tool—a risk assessment tool for non-specialists." Journal of Hazardous Materials 61, no. 1-3 (1998): 375–80. http://dx.doi.org/10.1016/s0304-3894(98)00146-0.

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33

Cole, Christy L., and Alvaro I. Martinez. "Risk-based EHS audit finding assessment tool." International Journal of Environment and Waste Management 3, no. 3/4 (2009): 366. http://dx.doi.org/10.1504/ijewm.2009.026352.

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34

van der Put, Claudia E. "Youth Actuarial Risk Assessment Tool (Y-ARAT)." Assessment 21, no. 3 (2013): 340–51. http://dx.doi.org/10.1177/1073191113495710.

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35

Poe, Stephanie S., Patricia B. Dawson, Maria Cvach, et al. "The Johns Hopkins Fall Risk Assessment Tool." Journal of Nursing Care Quality 33, no. 1 (2018): 10–19. http://dx.doi.org/10.1097/ncq.0000000000000301.

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36

Xiuting, Sun, Xiaodong Zhuang, Huimin Zhou, and Xinxue Liao. "A17325 Risk Assessment Tool in Cardiovascular Disease." Journal of Hypertension 36 (October 2018): e116. http://dx.doi.org/10.1097/01.hjh.0000548463.10806.9e.

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37

Brown, Anthony Scott. "Clinical trials risk: a new assessment tool." Clinical Governance: An International Journal 16, no. 2 (2011): 103–10. http://dx.doi.org/10.1108/14777271111124455.

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38

Callahan, Barbara G. "The Fox River Risk Assessment Teaching Tool." Human and Ecological Risk Assessment: An International Journal 10, no. 3 (2004): 605–7. http://dx.doi.org/10.1080/10807030490452223.

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39

Hamdy, Ronald C. "FRAX®: a fracture risk-assessment tool." Aging Health 5, no. 4 (2009): 489–94. http://dx.doi.org/10.2217/ahe.09.42.

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40

Edwards, Margaret. "Pressure sore risk: validating an assessment tool." British Journal of Community Health Nursing 1, no. 5 (1996): 282–88. http://dx.doi.org/10.12968/bjch.1996.1.5.7357.

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41

Murphy, Brian L. "Risk assessment as a liability allocation tool." Environmental Claims Journal 8, no. 3 (1996): 129–44. http://dx.doi.org/10.1080/10406029609379268.

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42

Poe, Stephanie S., Maria Cvach, Patricia B. Dawson, Harriet Straus, and Elizabeth E. Hill. "The Johns Hopkins Fall Risk Assessment Tool." Journal of Nursing Care Quality 22, no. 4 (2007): 293–98. http://dx.doi.org/10.1097/01.ncq.0000290408.74027.39.

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43

Alarcón-Rodrı́guez, J. R., F. M. Martı́nez-Fadrique, and H. Klinkrad. "Development of a collision risk assessment tool." Advances in Space Research 34, no. 5 (2004): 1120–24. http://dx.doi.org/10.1016/j.asr.2003.01.015.

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44

Battista, Willow, Kendra Karr, Nicole Sarto, and Rod Fujita. "Comprehensive Assessment of Risk to Ecosystems (CARE): A cumulative ecosystem risk assessment tool." Fisheries Research 185 (January 2017): 115–29. http://dx.doi.org/10.1016/j.fishres.2016.09.017.

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45

Mouchtouri, Varvara A., Georgia Goutziana, Jenny Kremastinou, and Christos Hadjichristodoulou. "Legionella species colonization in cooling towers: Risk factors and assessment of control measures." American Journal of Infection Control 38, no. 1 (2010): 50–55. http://dx.doi.org/10.1016/j.ajic.2009.04.285.

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46

Lee, In-Sup, and Young-Gun Zo. "Quantitative Microbial Risk Assessment on Legionella Infection in Children Playing in Interactive Fountains." Korean Journal of Microbiology 49, no. 4 (2013): 360–68. http://dx.doi.org/10.7845/kjm.2013.3086.

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47

Young, Charlotte, Duncan Smith, Tim Wafer, and Brian Crook. "Rapid Testing and Interventions to Control Legionella Proliferation following a Legionnaires’ Disease Outbreak Associated with Cooling Towers." Microorganisms 9, no. 3 (2021): 615. http://dx.doi.org/10.3390/microorganisms9030615.

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Most literature to date on the use of rapid Legionella tests have compared different sampling and analytical techniques, with few studies on real-world experiences using such methods. Rapid tests offer a significantly shorter feedback loop on the effectiveness of the controls. This study involved a complex of five factories, three of which had a history of Legionella contamination in their cooling water distribution system. Multiple sampling locations were utilised to take monthly water samples over 39 months to analyse for Legionella by both culture and quantitative polymerase chain reaction
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48

Girolamini, Luna, Ada Dormi, Tiziana Pellati, et al. "Advances in Legionella Control by a New Formulation of Hydrogen Peroxide and Silver Salts in a Hospital Hot Water Network." Pathogens 8, no. 4 (2019): 209. http://dx.doi.org/10.3390/pathogens8040209.

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Legionella surveillance is an important issue in public health, linked to the severity of disease and the difficulty associated with eradicating this bacterium from the water environment. Different treatments are suggested to reduce Legionella risk, however long-term studies of their efficiency are lacking. This study focused on the activity of a new formulation of hydrogen peroxide and silver salts, WTP828, in the hospital hot water network (HWN) to contain Legionella contamination during two years of treatment. The effectiveness of WTP828 was tested measuring physical-chemical and microbiolo
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49

Kaposztasova, Daniela, and Zuzana Vranayova. "Water Hygiene Audit and Legionella Control in Hospitals." Proceedings 2, no. 11 (2018): 610. http://dx.doi.org/10.3390/proceedings2110610.

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The multidisciplinary Legionella research has developed hand in hand with the level of science and technology, health care, and other scientific fields. The primary aim of this paper is to present our research focused on the theoretical and experimental analysis of building water distribution systems from the point of view of microbiological risk in hospitals in the Slovak Republic. To assess the potential public health impact of Legionella colonization in hot and cold water, a study was undertaken to identify and qualify the levels of the microorganism. The measures proved that thermal disinf
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50

Decker, Brooke K., Monique B. Kelly, Joseph Mikolic, Jon D. Walker, and Cornelius J. Clancy. "1726. A Random Forest Prediction Model Accurately Identifies Periods at Increased Risk for Positive Legionella Cultures in a Hospital Water Distribution System." Open Forum Infectious Diseases 5, suppl_1 (2018): S54—S55. http://dx.doi.org/10.1093/ofid/ofy209.132.

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Abstract Background Hospitals devote considerable resources to water distribution system (WS) surveillance and remediation for Legionella in an effort to reduce risk of transmitting Legionnaires disease (LD). There are no models that accurately predict periods of greatest risk for Legionella culture positivity (cx +) within a WS. Our goal was to build and validate a model based on weather and water parameters that predicted Legionella cx+ in our hospital WS. Methods One liter water samples from fixtures at 2 campuses were cultured for Legionella on BCYE plates with cysteine as part of infectio
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