Assessing risk of health care-acquired Legionnaires' disease from environmental sampling: the limits of using a strict percent positivity approach.

摘要: Background Elevated percent positivity (≥30%) of Legionella in hospital domestic water systems has been suggested as a metric for assessing the risk health care–acquired Legionnaires' disease (LD). Methods We examined validity this by analyzing data from peer-reviewed studies containing reports prevalence (ie, positivity) and temporally matched patients with LD. Results Our literature review identified 31 publications reporting data. abstracted total 206 points, representing 119 hospitals, these articles. determined that proposed 30% 59% sensitivity 74% specificity 41% false-negative rate 26% false-positive rate). These notable error rates could have significant implications, given we 16 articles 6 government guidance documents referenced assessment tool. Conclusions Environmental sampling distribution can be an important component management However, possible consequence using low is many hospitals might fail to mitigate when true present, or unnecessarily allocate limited resources deal negligible risk.