Legionellosis in health care facilities: state of the art in control and prevention in Italy

Background. Nosocomial water systems may be contaminated by Legionella spp; therefore, health care facilities represent a potential health risk for patients and health care staff. Active, well planned clinical and environmental surveillance in hospitals is the most important instrument of prevention. Aim and Methods. The aim of the present article was to outline the state of the art in legionellosis control and prevention among Italian health care facilities by reporting some experiences in the field. Results. Our results showed that Legionella spp. are largely reported as both hospital water system contaminants and etiological agents in water-related health care-associated infections (HCAI) in Italy. Among the numerous sources of HCAI, water is the most investigated, although it has been demonstrated that air sampling may provide additional information for risk assessment. Conclusions. More appropriate risk assessment is needed, especially in large facilities. In addition, more sensitive diagnostic tests should be used and dedicated training courses should be implemented in health care facilities.