Testing technology for reducing Legionella risk in healthcare in the US

A Case Study with Trusted Water

“The Hydrosense kits are a screening tool, which saves time and money and allows clients to test more sample points (…) This could not be done with traditional lab culture testing.”

Legionella in Healthcare
Worldwide, cases of hospital-acquired Legionnaires’ disease have been on the rise, with research showing that the potentially fatal bug is present in 12-85% of all hospital water systems. A study carried out by Centers for Disease Control and Prevention (CDC) found that 19% of cases are associated with long-term care facilities and 15% with hospitals. The majority of cases have been linked to Legionella pneumophila Serogroup 1.

Legionnaires’ disease is life-threatening unless treated quickly. This is especially true in healthcare facilities where mortality rates are as high as 40% due to the vulnerability of residents. Because of this, such facilities should be highly aware of the risks and where they come from and should aim to reduce risk factors to 0 by using a preventative approach to water system management.

About Trusted Water
Trusted Water is a water service company based in the US. The company specialises in on-site water quality management. Trusted Water designs water management programs for healthcare facilities and provides water testing services as well as DIY water inspection kits for this sector.

Trusted Water specialises in water management programs, certification and monitoring for healthcare, educational, residential, and business clients. By utilising onsite and remote water quality testing they assess their clients’ water and their risk of creating or delivering contaminated water to their customers. The company performs facility risk assessments and develops water management programs to meet Center for Medicare and Medicaid Services (CMS) certification requirements for Legionella risk reduction.

Application of Hydrosense Technology by Trusted Water
Trusted Water first heard about the Hydrosense product during a presentation given at the NSF Legionella Management Conference in 2018. Interested in the concept of rapid Legionella testing, the company decided to evaluate the products based on three criteria: ease-of-use, cost and response time - they wanted to ensure that the test would fit their business model and could be fully conducted on-site along with other water quality parameters. They were also looking for a test that could encourage their clients to do more frequent testing at a lower cost.

Upon receiving satisfactory results, Trusted Water decided to incorporate Hydrosense into their service, mainly for compliance reasons - to meet the Centers for Medicare & Medicaid Services (CMS) directive for Legionella Risk Reduction for their clients.

Trusted Water started using Hydrosense rapid testing technology alongside a combination of other general water quality parameters such as 2-factor ATP testing, HPC, and Pseudomonas. Their engineers are now using Hydrosense as part of their escalation-based sampling protocol, meaning that the breadth of testing done is escalated based on the results of other general water tests. Thus, if general testing suggests that there is a possible risk of Legionella in the system, Hydrosense is used. Other Legionella testing methods may also be used if the Hydrosense test comes back positive. This escalation strategy has allowed Trusted Water to save time and money and has facilitated the testing of more sample points on a fixed budget.

Benefits Gained from the Implementation of Hydrosense Technology
Adopting the Hydrosense test has given Trusted Water a clear competitive advantage. Not only has the test allowed them to improve their Legionella testing offering by facilitating more testing at a lower cost, but it has also allowed them to provide results for their customers while still on-site – thus enabling immediate action if a problem is found. This has been valuable for offering clients peace of mind and for avoiding lengthy shut-downs. The option for customers to carry out the test themselves was also very appealing to clients – this could be achieved with a lab test.

“Speed of response, allowing confirmation of presence/absence of Legionella during our onsite service, is the most important aspect of using the Hydrosense test method. If we suspect that there is Legionella bacteria at a certain water outlet, we can quickly check before leaving the facility.

This provides our clients with additional peace of mind and allows us to save time and money. The Hydrosense testing methods is a great screening tool and helps us to test more locations on a fixed budget. No more waiting for lab results, no loss of control of information (chain of custody stays at client location), and clients can opt to do the testing themselves if they choose. This could not be done with traditional lab culture testing.”

 - Terry Stange, President of Trusted Water