FEATURE ARTICLES
Although the enHealth guidelines only refer specifically to legionella, it would be wise, due to the considerable disease burden from other pathogens, to increase the scope of any management plan produced to include other OPPPs, especially Pseudomonas. The health and cost burden from these other diseases is large, and reducing it will have a large impact on improved patient outcomes and reduce length of stay. It would be a great lost opportunity to produce only a Legionella management plan, when for minimal extra cost and effort, a more comprehensive microbiological water management plan can be produced. The benefits to patients of controlling more of the major water borne risks are many, and can also reduce the burden of
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hospital acquired infections and reduce extra bed days and drug prescribing due to these. Many of the organisms associated with water also harbour the genes for antibiotic resistance, which are easily transferred among bacteria, and can make treatment of diseases more difficult. The enHealth guidelines concentrate on managing the risks, rather than responding to positive results. If a robust and well thought out management plan is in place, then hopefully any problems with the system will be noted and rectified before the system reaches a stage where legionella can proliferate. The first step of creating the plan is to establish a Legionella risk management system, the first step