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Legionella Colonization of Hotel Water Systems in Touristic Places of Greece: Association with System Characteristics and Physicochemical Parameters

Author

Listed:
  • Maria A. Kyritsi

    (Department of Hygiene and Epidemiology, Medical School, University of Thessaly, 41222 Larissa, Greece)

  • Varvara A. Mouchtouri

    (Department of Hygiene and Epidemiology, Medical School, University of Thessaly, 41222 Larissa, Greece)

  • Antonis Katsioulis

    (Department of Hygiene and Epidemiology, Medical School, University of Thessaly, 41222 Larissa, Greece
    Regional Public Health Laboratory of Thessaly, 41222 Larissa, Greece)

  • Elina Kostara

    (Department of Hygiene and Epidemiology, Medical School, University of Thessaly, 41222 Larissa, Greece)

  • Vasileios Nakoulas

    (Department of Hygiene and Epidemiology, Medical School, University of Thessaly, 41222 Larissa, Greece)

  • Marina Hatzinikou

    (Department of Hygiene and Epidemiology, Medical School, University of Thessaly, 41222 Larissa, Greece
    Regional Public Health Laboratory of Thessaly, 41222 Larissa, Greece)

  • Christos Hadjichristodoulou

    (Department of Hygiene and Epidemiology, Medical School, University of Thessaly, 41222 Larissa, Greece
    Regional Public Health Laboratory of Thessaly, 41222 Larissa, Greece)

Abstract

This study aimed to assess the colonization of hotel water systems in central Greece and Corfu by Legionella , and to investigate the association between physicochemical parameters and Legionella colonization. Standardized hygiene inspection was conducted in 51 hotels, and 556 water samples were analyzed for Legionella spp. Free chlorine concentration, pH, hardness, conductivity, and trace metals were defined in cold water samples. The results of inspections and chemical analyses were associated with the microbiological results using univariate and logistic regression analysis. According to the score of the checklist used for the inspections, 17.6% of the hotels were classified as satisfactory, 15.7% as adequate, and 66.7% as unsatisfactory. Moreover, 74.5% of the hotels were colonized by Legionella spp. and 31.4% required remedial measures according to the European guidelines. Legionella spp. were isolated in 28% of the samples. Unsatisfactory results of inspections were associated with Legionella presence (relative risk (RR) = 7.67, p -value = 0.043). In hot-water systems, <50 °C temperatures increased the risk of Legionella colonization (RR = 5.36, p -value < 0.001). In cold-water systems, free chlorine concentration <0.375 mg/L (odds ratio (OR) = 9.76, p -value = 0.001), pH ≥ 7.45 (OR = 4.05, p -value = 0.007), and hardness ≥321 mgCaCO 3 /L (OR = 5.63, p -value = 0.003) increased the risk, whereas copper pipes demonstrated a protective role (OR = 0.29, p -value = 0.0024). The majority of the hotels inspected were colonized with Legionella . Supplementary monitoring of the risk factors that were identified should be considered.

Suggested Citation

  • Maria A. Kyritsi & Varvara A. Mouchtouri & Antonis Katsioulis & Elina Kostara & Vasileios Nakoulas & Marina Hatzinikou & Christos Hadjichristodoulou, 2018. "Legionella Colonization of Hotel Water Systems in Touristic Places of Greece: Association with System Characteristics and Physicochemical Parameters," IJERPH, MDPI, vol. 15(12), pages 1-12, November.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:12:p:2707-:d:186875
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    References listed on IDEAS

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    1. Michele Totaro & Paola Valentini & Anna Laura Costa & Lorenzo Frendo & Alessia Cappello & Beatrice Casini & Mario Miccoli & Gaetano Privitera & Angelo Baggiani, 2017. "Presence of Legionella spp. in Hot Water Networks of Different Italian Residential Buildings: A Three-Year Survey," IJERPH, MDPI, vol. 14(11), pages 1-9, October.
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    Cited by:

    1. Luisa Marras & Giacomo Bertolino & Adriana Sanna & Valentina Carraro & Valentina Coroneo, 2023. "Legionella spp. Monitoring in the Water Supply Systems of Accommodation Facilities in Sardinia, Italy: A Two-Year Retrospective Analysis," IJERPH, MDPI, vol. 20(18), pages 1-9, September.
    2. Michele Totaro & Anna Laura Costa & Lorenzo Frendo & Sara Profeti & Beatrice Casini & Antonio Gallo & Gaetano Privitera & Angelo Baggiani, 2020. "Evaluation of Legionella spp. Colonization in Residential Buildings Having Solar Thermal System for Hot Water Production," IJERPH, MDPI, vol. 17(19), pages 1-8, September.
    3. Gergely, László Zsolt & Csoknyai, Tamás & Horváth, Miklós, 2022. "Novel load matching indicators for photovoltaic system sizing and evaluation," Applied Energy, Elsevier, vol. 327(C).
    4. Søren A. Uldum & Lars G. Schjoldager & Sharmin Baig & Kelsie Cassell, 2022. "A Tale of Four Danish Cities: Legionella pneumophila Diversity in Domestic Hot Water and Spatial Variations in Disease Incidence," IJERPH, MDPI, vol. 19(5), pages 1-18, February.

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