Date of Award
5-1-2024
Language
English
Document Type
Master's Thesis
Degree Name
Master of Science (MS)
College/School/Department
Department of Environmental Health Sciences
Dissertation/Thesis Chair
Xiaobo Romeiko
Committee Members
Ursula Lauper, Pauline Wanjugi
Subject Categories
Epidemiology
Abstract
Healthcare facilities are high-risk areas for legionellosis infections, as they have large, complex potable water systems ideal for Legionella proliferation, and they host susceptible populations. New York State regulation 10 NYCRR § 4-2: Protection Against Legionella in Healthcare Facilities was implemented in July 2016 to reduce healthcare-acquired legionellosis. This regulation mandated environmental surveillance of healthcare facilities’ potable water systems via culture. Data from these environmental reports were paired with data for cases of healthcare-acquired legionellosis infections for the years 2017-2023. Using these data, geographic Legionella species and serogroup distributions were described, and logistic regressions evaluated facility attributes associated with potable water Legionella regulatory exceedances and cases. Non-pneumophila Legionella species were isolated in the most water systems while L. pneumophila ser. 1 was isolated in the majority of cases. The Legionella species and serogroup distributions suggested likely underdiagnosis of legionellosis attributable to species and serogroups other than L. pneumophila ser. 1. Exceedances were positively associated with hospital facility type and spring season, and negatively associated with number of beds, metropolitan area region, and chlorination and monochloramination water treatments. Cases were positively associated with number of beds, metropolitan area region, western region, summer and autumn seasons, and negatively associated with hospital facility type and copper-silver ionization and ultraviolet light water treatments. Our results suggested different facility attributes associated with elevated Legionella in potable water culture samples versus risk of healthcare-acquired infection which should be further investigated to improve nosocomial legionellosis prevention.
Recommended Citation
Brna, Roxann, "Species Distribution And Logistic Regression Analysis Of Nosocomial Legionella Detection And Infection In New York State, 2017 – 2023" (2024). Legacy Theses & Dissertations (2009 - 2024). 3296.
https://scholarsarchive.library.albany.edu/legacy-etd/3296