Non-touch fittings in hospitals: a possible source of Pseudomonas aeruginosa and Legionella spp.

Non-touch fittings are gradually becoming very common in the bathrooms and toilets of public facilities and restaurants. Hospitals and other healthcare facilities have recently started to install these types of water taps to lower water consumption, thus saving costs, and to prevent healthcare workers from touching the tap, thus promoting hygiene. This study analysed the bacteriological water quality of 38 non-touch water taps in different settings in a 450-bed secondary-care hospital in Upper Austria. Two different tap types were installed: 23 taps were without temperature selection and 15 were with temperature selection (cold and warm). A membrane filtration method was used, and the authors screened for both indicator organisms and Pseudomonas aeruginosa in 100 ml water samples. In 10 non-touch taps without temperature selection, the authors also screened for Legionella spp. in 500 ml water samples. Seventy four percent of the taps without temperature selection and 7% of the taps with temperature selection showed contamination with P. aeruginosa (P<0.001). None of the taps showed contamination with indicator organisms. Detailed analysis of the source of contamination revealed that the magnetic valve and the outlet itself were heavily contaminated, whereas the junction from the central pipe system was free of contamination. All 10 analysed taps showed contamination with Legionella spp. It was concluded that the local contamination of non-touch fittings is a result of the low amount of water that flows through the outlet, the low water pressure and the column of water, which is 'still-standing' and has a temperature of about 35 degrees C, thus providing nearly ideal growth conditions for P. aeruginosa. Additionally, the presence of materials such as rubber, PVC, etc. in the fittings enhances the adhesion of P. aeruginosa and thus the production of biofilms. In conclusion, the authors wish to encourage infection control teams to evaluate the use of non-touch fittings in hospitals, especially when they are installed in risk areas.