{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:34:12Z","timestamp":1793072052755,"version":"4.5.0"},"reference-count":24,"publisher":"Cambridge University Press (CUP)","issue":"8","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"},{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/tdm\/tdmrep-policy.json"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X26104759_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Data demonstrating a reduction in the incidence of nosocomial legionellosis following chlorine treatment are limited. Therefore, we aimed to evaluate the effectiveness of chlorine treatment by comparing the incidence of nosocomial legionellosis before and after the installation of a chlorine concentration control system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104759_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A quasi-experimental study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104759_as3\">\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>A 2,700-bed tertiary care hospital in Seoul, South Korea.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104759_as4\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>An automatic chlorine concentration control system was sequentially installed in the hospital\u2019s water supply networks across multiple buildings between April 2019 and February 2020. The preintervention period was defined as January 2011 through March 2019, and the postintervention period as May 2020 through November 2025. Incidence rates of nosocomial legionellosis were compared between the two periods using exact Poisson methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104759_as5\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The incidence of nosocomial legionellosis was found to be 0.402 per 100,000 patient-days during the preintervention period and 0.181 per 100,000 patient-days during the postintervention period. The incidence rate ratio for legionellosis during the postintervention period compared with the preintervention period was 0.45 (95% confidence interval, 0.18\u20131.01;\n                      <jats:italic>P<\/jats:italic>\n                      = .043).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104759_as6\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The implementation of chlorine treatment in the hospital water distribution system was associated with a significant reduction in the incidence of nosocomial legionellosis. This finding provides long-term, real-world evidence supporting chlorine treatment as an effective water management strategy for preventing healthcare-associated legionellosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2026.10475","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T08:20:48Z","timestamp":1780906848000},"page":"793-797","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of chlorine treatment of hospital water systems in reducing the incidence of nosocomial legionellosis: a quasi-experimental study"],"prefix":"10.1017","volume":"47","author":[{"given":"Jiwon","family":"Jung","sequence":"first","affiliation":[{"name":"Asan Medical Center"},{"id":[{"id":"https:\/\/ror.org\/03s5q0090","id-type":"ROR","asserted-by":"publisher"}],"name":"Asan Medical Center, University of Ulsan College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seongman","family":"Bae","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03s5q0090","id-type":"ROR","asserted-by":"publisher"}],"name":"Asan Medical Center, University of Ulsan College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun-Kyung","family":"Kim","sequence":"additional","affiliation":[{"name":"Asan Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Lim","family":"Jo","sequence":"additional","affiliation":[{"name":"Asan Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeeyoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Asan Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won Il","family":"Choi","sequence":"additional","affiliation":[{"name":"Asan Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Hoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Asan Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwang Hoon","family":"Cho","sequence":"additional","affiliation":[{"name":"Asan Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1672-3185","authenticated-orcid":false,"given":"Yong Pil","family":"Chong","sequence":"additional","affiliation":[{"name":"Asan Medical Center"},{"id":[{"id":"https:\/\/ror.org\/03s5q0090","id-type":"ROR","asserted-by":"publisher"}],"name":"Asan Medical Center, University of Ulsan College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"S0899823X26104759_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2020.05.002"},{"key":"S0899823X26104759_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.watres.2020.116656"},{"key":"S0899823X26104759_ref2","unstructured":"2. Centers for Disease Control and Prevention (CDC). Legionellosis surveilllance and trends. https:\/\/www.cdc.gov\/legionella\/php\/surveillance.html. Accessed December 24, 2025."},{"key":"S0899823X26104759_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(14)70713-3"},{"key":"S0899823X26104759_ref24","doi-asserted-by":"publisher","DOI":"10.3201\/eid1003.020707"},{"key":"S0899823X26104759_ref7","volume-title":"Legionella and the Prevention of Legionellosis","year":"2007"},{"key":"S0899823X26104759_ref12","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2025.25"},{"key":"S0899823X26104759_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.csda.2007.02.024"},{"key":"S0899823X26104759_ref13","doi-asserted-by":"publisher","DOI":"10.1086\/518847"},{"key":"S0899823X26104759_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2018.12.036"},{"key":"S0899823X26104759_ref9","unstructured":"9. European Study Group for Legionella Infections (ESGLI). European technical guidelines for the prevention, control and investigation, of infections caused by legionella species. June 2017."},{"key":"S0899823X26104759_ref21","unstructured":"21. Centers for Disease Control and Prevention (CDC). Investigating Legionnaires\u2019 disease. https:\/\/www.cdc.gov\/investigate-legionella\/php\/healthcare-resources\/healthcare-facilities.html. Accessed on January 12, 2026."},{"key":"S0899823X26104759_ref3","unstructured":"3. European Centre for Disease Prevention and Control (ECDC). Increasing rates of Legionnaires\u2019 disease in the EU\/EEA. https:\/\/www.ecdc.europa.eu\/en\/news-events\/increasing-rates-legionnaires-disease-eueea. Accessed December 24, 2025."},{"key":"S0899823X26104759_ref10","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.03873-15"},{"key":"S0899823X26104759_ref19","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17062158"},{"key":"S0899823X26104759_ref1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.15.3.506-526.2002"},{"key":"S0899823X26104759_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.watres.2025.124107"},{"key":"S0899823X26104759_ref14","doi-asserted-by":"publisher","DOI":"10.1086\/502254"},{"key":"S0899823X26104759_ref4","unstructured":"4. Korea Disease Control and Prevention Agency (KDCA). Legionellosis. 2025. https:\/\/www.kdca.go.kr\/eng\/4359\/subview.do. Accessed January 12, 2026."},{"key":"S0899823X26104759_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.watres.2024.121794"},{"key":"S0899823X26104759_ref6","first-page":"407","article-title":"Factors influencing the case-fatality rate of Legionnaires\u2019 disease","volume":"13","author":"Dominguez","year":"2009","journal-title":"Int J Tuberc Lung Dis"},{"key":"S0899823X26104759_ref22","doi-asserted-by":"publisher","DOI":"10.32614\/RJ-2010-008"},{"key":"S0899823X26104759_ref17","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms11071794"},{"key":"S0899823X26104759_ref8","unstructured":"8. Centers for Medicare & Medicaid Services. Requirement to reduce Legionella risk in healthcare facility water systems to prevent cases and outbreaks of Legionnaires disease (LD). 2018. Report No.: 17-30-Hospitals\/CAHs\/NHs."}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X26104759","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X26104759","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:14:51Z","timestamp":1793070891000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X26104759\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,8]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["S0899823X26104759"],"URL":"https:\/\/doi.org\/10.1017\/ice.2026.10475","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,8]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}