Healthcare Testing & Services

Preventing Healthcare-Associated Infections (HAIs) since 1993!

In 1993, a local hospital contacted EST concerned over the potential for Healthcare-Associated Infections (HAIs) involving Aspergillus related to construction projects.  Uniquely positioned with expertise in environmental microbiology, epidemiology, and industrial hygiene, EST was able to answer that call and assist that facility.  From that initial contact Dr. Miller’s expertise in Legionella detection and isolation provided our healthcare customers with another powerful tool to prevent Legionnaires’ Disease.  Over the years new environmental concerns have come to light, and EST continues to innovate to meet these demands.  Our team has expanded expertise since that time and can develop a specific testing program designed to fit the needs of your facility or healthcare network.  Whether it is emerging pathogens, multidrug-resistant (MDR) bacteria, or microbiological contamination of pharmaceutical spaces, EST can provide the expertise and solutions you need. 





  • Water Management Plan (WMP) Validation for Legionella and other Pathogens

    • Legionella pneumophila serogroup 1
    • Legionella pneumophila serogroups 2-14 
    • Legionella(other species)
    • Heterotrophic Plate Count (HPC) – Aerobic Bacterial Count
    • Other opportunistic waterborne pathogens 


  • Water Systems at Risk for Legionaries Disease (LD)

    • Potable Water
    • Ice Machines
    • Therapy Pools
    • Cooling Towers
    • Decorative Fountains


  • Outbreak Response

    • Onsite Investigations and Sampling
    • Next Day Viable Legionella PCR Analyses
    • Disinfection Consultation


  • Interpretations and Recommendations

Surface Pathogen Testing

  • Investigation of Potential Reservoirs of Pathogens
  • Validation of Surface Disinfection Protocols
  • Laboratory Analyses of Surface Samples

Outbreak Investigation

  • Onsite Investigations and Sampling
  • Investigation of Potential Reservoirs of Pathogens in Response to an Outbreak
  • Interpretations and Recommendations
  • Remediation Validation

Infection Prevention Consultation

Cleanroom Validation Testing

  • Onsite Investigations and Sampling
  • Fungal, Bacterial or Chemical Sampling
  • Air and Surface Sampling
  • ISO or Internal Standard Evaluations

Environmental Microbial Contamination Testing

  • Pharmacopeia 797 Follow up Investigations
  • Investigation of Potential Sources of Microbial Contamination
  • Air, Surface, and Fingertip Sample Collection
  • Air Flow and Pressurization Evaluations
  • Laboratory Analyses of Viable Microbial Samples

HVAC and Filtration Consultation

Infection Control Risk Assessment (ICRA) Consultation

  • Developing ICRA Matrix
  • Construction Barrier Consultation
  • ICRA Contractor Training

Construction ICRA Validation

  • Routine Fungal Air Culture Sampling
  • Airborne Particle Count Collection
  • Construction Barrier Inspection and Validation

Air Quality Complaint Response

  • Maintenance Activity or Disaster Related Issues
  • Onsite Investigations and Sampling
  • Fungal, Bacterial or Chemical Air or Surface Sampling
  • Remediation Consultation

Interpretations and Recommendations for Air Quality

Healthcare services

Powerful tools to aid the Healthcare Industry prevent HAIs

Since 1993, EST has been a leader in environmental sampling for the healthcare industry.  Providing air quality testing for construction projects along with Legionella testing for cooling towers and potable water EST gives our healthcare partners the tools they need to minimize infections. 

Legionella Testing

    • Standard turnaround 7-10 days

    • ISO 11731:2017 process method

    • Reporting pneumophila Serogroup 1 (SG 1), L. pneumophila SG 2-14, and L. non-pneumophila species

    • Rapid turnaround in 96 hours

    • Traditional culture processing

    • Reporting pneumophila SG 1, L. pneumophila SG 2-14, and L. non-pneumophila species

    • Same Day or Next Business Day turnaround
    • Viable specific version of Legionella qPCR ISO/TS 12869:2019
    • Validated to accurately report CFU/ml
    • Reporting viable pneumophila SG 1 and L. pneumophila SG 2-15
  • CMS/Environmental Waterborne Pathogens Test

      • ANSI/ASHRAE Standard 188-2021 drove the need to perform Legionellatesting as validation of an implemented and verified WMP.  However, there are additional waterborne pathogens that may be present that also need to be kept under surveillance.  In the above-mentioned memorandum CMS listed six additional pathogens to keep watch for in patient populations, especially the immunocompromised.  In response, EST developed a new combination Waterborne Pathogen Test. Because these other CMS pathogens have been overshadowed by the regulatory and legal focus on Legionella, these waterborne pathogens are sometimes referred to as the “Forgotten Six”:
        • Pseudomonas aeruginosa
        • Acinetobacter species
        • Burkholderia cepacia complex
        • Stenotrophomonas maltophilia
        • Mycobacterium species – Non-tuberculous (NTM)
          • Total NTM
          • M. avium
          • M. chimaera
        • Fungi (Molds and Yeast)
      • All pathogens also available as individual analysis.
  • Don’t let Candida auris or ESKAPE drug-resistant pathogens become the source of an outbreak  at your facility.

    It has been well-established that environmental surfaces play an important role in the endemic and epidemic transmission of certain pathogens that cause healthcare-associated infections.  These bacteria (especially the so-called ESKAPE bacteria) and certain fungal/yeast pathogens (specifically Candida auris) share the ability to be shed from infected or colonized patients, survive as infectious agents on dry surfaces for extended periods, are difficult to treat because of multiple drug-resistances (MDRs), and are difficult to eradicate from their environmental locations, even with the recommended cleaning and disinfection agents and practices.

              • Candida auris
              • Enterococcus faecium + VRE
              • Staphylococcus aureus + MRSA
              • Klebsiella pneumoniae + CRE
              • Acinetobacter baumannii
              • Pseudomonas aeruginosa
              • Enterobacter species  + CRE
              • Clostridioides difficile (C. diff)
              • Others pathogens of interest upon request
    Analyses can be ordered individually, by select grouping, or all at the same time.
       All analyses for a sample site can be run from a single EST supplied surface swab. 
  • Analyses that measure regulatory (City or State) controlled disinfection parameters:
    • Escherichia coli (E. coli)
    • Heterotrophic Plate Count (HPC) – Total Bacterial Count
  • Analyses that measure Legionella control:
    • L. pneumophila serogroup 1
    • L.  pneumophila serogroup 2-14
    • Legionella (other species)
  • Analyses that measure other associated waterborne pathogen control:
      • Pseudomonas aeruginosa
      • Mycobacterium species – Non-tuberculous (NTM)
          • Total NTM
          • M. avium
          • M. chimaera

Dr. Legionella™ And EST

With all our great Legionella services you get access to Dr. Legionella and his extensive Legionella knowledge and experience.

COVID-19 and Legionella

The impact COVID-19 has had on everyone extends to building water systems, both cooling towers, and potable water systems. Inactivity and limited use can contribute to the formation of biofilm allowing for Legionella proliferation. EST can assist in developing a reopening plan for your facility, including highly effective re-commissioning disinfection procedures and follow-up validation testing.

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