Historically, the Centers for Disease Control and Prevention (CDC) had no official stance on the results of Legionella testing. 2021 marked the first year they published guidance for the public. The CDC’s graphic “Figure 1. Routine Legionella testing: A multifactorial approach to performance indicator interpretation” highlights four areas of consideration for Legionella testing results. The first section discusses which concentration indicates that Legionella growth appears uncontrolled, poorly controlled, or well controlled. Concentrations expressed as CFU/mL are for test results by traditional plate culture methods. If other test methods are used, consult an expert for interpretation.
The detection of greater than or equal to 10 CFU/mL in potable water or the detection of greater than or equal to 100 CFU/mL in non-potable water indicates that Legionella growth appears uncontrolled.
The detection of 1.0-9.9 CFU/mL in potable water or the detection of 10-99 CFU/mL in non-potable water indicates that Legionella growth appears poorly controlled.
The detection of any to 0.9 CFU/mL in potable water or the detection of any to 9 CFU/mL in non-potable water indicates that Legionella growth appears well controlled.
No Legionella detected also indicates that Legionella growth appears well controlled, and is a stronger indication that Legionella is well controlled than detection of any Legionella.
The second section relates to the way in which concentration change over time indicates that Legionella growth appears uncontrolled, poorly controlled, or well controlled.
A 100-fold or greater increase in concentration (for example, an increase from 0.7 CFU/mL to 70 CFU/mL) indicates that Legionella growth appears uncontrolled.
A 10-fold increase in concentration (for example, an increase from 0.7 CFU/mL to 7 CFU/mL) indicates that Legionella growth appears poorly controlled.
Steady Legionella concentration (for example, 0.7 CFU/mL for two consecutive sampling rounds) indicates that Legionella growth appears well controlled.