DOI: https://doi.org/10.14710/jkli.79439

Legionellosis pada Tenaga Kesehatan dan Potensi Sumber Penularannya di Bali 2025: Investigasi Epidemiologi

1Program Studi Magister Ilmu Kesehatan Masyarakat, Fakultas Kedokteran Universitas Udayana, Kota Denpasar, Bali, Indonesia

2Departemen Kesehatan Masyarakat dan Kedokteran Pencegahan, Universitas Udayana, Kota Denpasar, Bali, Indonesia

3Dinas Kesehatan Provinsi Bali, Kota Denpasar, Bali, Indonesia

Open Access Copyright 2026 Jurnal Kesehatan Lingkungan Indonesia under http://creativecommons.org/licenses/by-sa/4.0.

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Abstract

Latar belakang: Legionellosis merupakan penyakit infeksi yang ditularkan melalui inhalasi aerosol air yang terkontaminasi Legionella pneumophila. Sistem air buatan pada bangunan, dapat menjadi reservoir bakteri apabila tidak dikelola dengan baik terutama di wilayah beriklim tropis. Pada Februari 2025 ditemukan satu kasus konfirmasi pada tenaga kesehatan di Bali sehingga diperlukan investigasi epidemiologi untuk mengidentifikasi sumber paparan dan faktor risiko lingkungan.

Metode:  Penelitian ini merupakan studi observasional deskriptif dengan  desain  penelitian cross sectional. Penelusuran dilakukan terhadap kasus indeks, 4 orang anggota keluarga serumah, dan 84 tenaga kesehatan dengan paparan lingkungan serupa. Investigasi meliputi wawancara, penelusuran individu bergejala pada lingkungan rumah tangga dan fasilitas pelayanan kesehatan, observasi sistem distribusi air, pemeriksaan kualitas lingkungan meliputi pengukuran suhu, pH, residu klorin, dan analisis mikrobiologi pada sampel air dan swab titik berisiko. Investigasi dilakukan pada periode 20 Februari - 5 Maret 2025 Analisis dilakukan secara deskriptif dengan pendekatan epidemiologi berdasarkan dimensi orang, waktu, dan tempat untuk mengidentifikasi pola paparan.

Hasil: Kasus indeks adalah perempuan usia 37 tahun dengan pneumonia terkonfirmasi Legionella pneumophila. Sebanyak 27% tenaga kesehatan dan seluruh anggota keluarga serumah mengalami gejala respirasi serupa dalam kurun waktu berdekatan. Pemeriksaan lingkungan menemukan kontaminasi Legionella pneumophila pada sistem air rumah, terutama pada filter air dan water heater, dengan suhu air 25–37 °C dan kadar klorin <0,05 mg/L. Data pemantauan sebelumnya juga menunjukkan keberadaan Legionella pada sistem distribusi air rumah sakit. Kondisi suhu air hangat dan kadar disinfektan rendah merupakan faktor yang mendukung kolonisasi bakteri.

Simpulan: Sistem air rumah tangga dan fasilitas pelayanan kesehatan yang tidak terkelola optimal berpotensi menjadi reservoir Legionella pneumophila. Penguatan pengelolaan kualitas air berbasis manajemen risiko melalui pemantauan rutin, pengendalian suhu, dan disinfeksi yang adekuat diperlukan untuk mencegah kejadian serupa di fasilitas kesehatan maupun rumah tangga.

 

ABSTRACT

Title: Legionellosis in a Health Care Worker and Its Potential Sources in Bali 2025: an Epidemiologic Investigation

Background: Legionellosis is an infectious disease transmitted through inhalation of water aerosols contaminated with Legionella pneumophila. Artificial water systems in buildings can become bacterial reservoirs if not properly managed, particularly in tropical climates. In February 2025, a confirmed case was identified in a healthcare worker in Bali, prompting an epidemiological investigation to determine potential exposure sources and environmental risk factors.

Method: This study was a descriptive observational study using a cross-sectional design. Tracing was conducted among the index case, four household members, and 84 healthcare workers with similar environmental exposure. The investigation included interviews, identification of symptomatic individuals in household and healthcare settings, observation of water distribution systems, and environmental assessment through measurements of temperature, pH, residual chlorine, and microbiological analysis of water samples and swabs from high-risk points. The investigation was carried out from February 20 to March 5, 2025. Data were analyzed descriptively using an epidemiological approach based on person, time, and place to identify exposure patterns.

Result: The index case was a 37-year-old woman with pneumonia confirmed as Legionella pneumophila. Similar respiratory symptoms occurred in 27% of healthcare workers and all household members within a close time frame. Environmental examination detected contamination of Legionella pneumophila in the household water system, particularly in the water filter and water heater, with water temperatures of 25–37 °C and chlorine levels <0.05 mg/L. Previous monitoring data also indicated the presence of Legionella in the hospital water distribution system. Warm water temperatures and low disinfectant levels were identified as factors supporting bacterial colonization.

Conclusion: Suboptimally managed household and healthcare water systems may serve as reservoirs for Legionella pneumophila. Strengthening risk-based water quality management through routine monitoring, temperature control, and adequate disinfection is necessary to prevent similar occurrences in healthcare facilities and domestic environments.

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Keywords: Legionellosis; Legionella pneumophila; Waterborne Disease

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Language : ID
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