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Colautti A, Civilini M, Bortolomeazzi R, Franchi M, Felice A, De Martin S, Iacumin L. Genotypic and phenotypic profiling of 127 Legionella pneumophila strains: Insights into regional spread. PLoS One 2024; 19:e0307646. [PMID: 39028750 PMCID: PMC11259292 DOI: 10.1371/journal.pone.0307646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 07/10/2024] [Indexed: 07/21/2024] Open
Abstract
Given the recent global surge in Legionnaires' disease cases, the monitoring of Legionella pneumophila becomes increasingly crucial. Epidemiological cases often stem from local outbreaks rather than widespread dissemination, emphasizing the need to study the characteristics of this pathogen at a local level. This study focuses on isolates of L. pneumophila in the Italian region of Friuli Venezia Giulia to assess specific genotype and phenotype distribution over time and space. To this end, a total of 127 L. pneumophila strains isolated between 2005 and 2017 within national surveillance programs were analysed. Rep-PCR, RAPD, and Sau-PCR were used for genotypic characterization, while phenotypic characterization was conducted through fatty acids analysis. RAPD and Sau-PCR effectively assessed genetic characteristics, identifying different profiles for the isolates and excluding the presence of clones. Although Sau-PCR is rarely used to analyse this pathogen, it emerged as the most discriminatory technique. Phenotypically, hierarchical cluster analysis categorized strains into three groups based on varying membrane fatty acid percentages. However, both phenotypic and genotypic analyses revealed a ubiquitous profile distribution at a regional level. These results suggest an absence of correlations between strain profiles, geographical location, and isolation time, indicating instead high variability and strain dissemination within this region.
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Affiliation(s)
- Andrea Colautti
- Department of Agricultural, Food, Environmental and Animal Science (Di4A), University of Udine, Udine, Italy
| | - Marcello Civilini
- Department of Agricultural, Food, Environmental and Animal Science (Di4A), University of Udine, Udine, Italy
| | - Renzo Bortolomeazzi
- Department of Agricultural, Food, Environmental and Animal Science (Di4A), University of Udine, Udine, Italy
| | - Marinella Franchi
- Laboratory of Microbiology, ARPA–Regional Agency for Environmental Protection Friuli Venezia Giulia, Udine, Italy
| | - Antonella Felice
- Laboratory of Microbiology, ARPA–Regional Agency for Environmental Protection Friuli Venezia Giulia, Udine, Italy
| | - Stefano De Martin
- Laboratory of Microbiology, ARPA–Regional Agency for Environmental Protection Friuli Venezia Giulia, Udine, Italy
| | - Lucilla Iacumin
- Department of Agricultural, Food, Environmental and Animal Science (Di4A), University of Udine, Udine, Italy
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Fang Z, Zhou X, Liao H, Xu H. A meta-analysis of Legionella pneumophila contamination in hospital water systems. Am J Infect Control 2023; 51:1250-1262. [PMID: 37054892 DOI: 10.1016/j.ajic.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/31/2023] [Accepted: 04/01/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND Legionella pneumophila is a common cause of community-acquired pneumonia. We aimed to determine the pooled rates of L pneumophila contamination in the water environment of the hospital. METHODS We searched PubMed, Embase, Web of Science, Chinese National Knowledge Infrastructure, WangFang and Science Direct, The Cochrane Library, and Science Finder, for relevant studies published until December 2022. Stata 16.0 software was used to determine pooled contamination rates, publication bias, and subgroup analysis. RESULTS Forty-eight eligible articles with a total of 23,640 samples of water were evaluated, and the prevalence of L pneumophila was 41.6%. The results of the subgroup analysis showed that the pollution rate of L pneumophila in hot water (47.6%) was higher than that in other water bodies. The rates of L pneumophila contamination were higher in developed countries (45.2%), culture methods (42.3%), published between 1985 and 2015 (42.9%), and studies with a sample size of less than 100 (53.0%). CONCLUSIONS L pneumophila contamination in medical institutions is still very serious and should be paid attention to, especially in developed countries and hot water tanks.
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Affiliation(s)
- Zisi Fang
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Xiaocong Zhou
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Hui Liao
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Hong Xu
- Department of Environmental Health, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
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Kitaya S, Baba H, Okamoto M, Sakamoto M, Nakayama A, Takei Y, Seike I, Takei K, Oshima K, Tokuda K, Shiga T, Kanamori H. Severe pneumonia due to Legionella and SARS-CoV-2 co-infection necessitating medical evacuation from a cargo ship. J Travel Med 2023; 30:taad067. [PMID: 37158457 DOI: 10.1093/jtm/taad067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/24/2023] [Accepted: 05/03/2023] [Indexed: 05/10/2023]
Abstract
Cargo ships are at risk of disease outbreaks like Legionella and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) due to their cramped and shared conditions. A case of medical evacuation due to co-infection of Legionella pneumophila with SARS-CoV-2 highlights the need for international infection control guidelines, information networks and molecular epidemiological approaches for identifying infection routes.
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Affiliation(s)
- Shiori Kitaya
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - Hiroaki Baba
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
- Department of Intelligent Network for Infection Control, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - Michiko Okamoto
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8575, Japan
| | - Masahiro Sakamoto
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8575, Japan
| | - Asami Nakayama
- Department of Laboratory Medicine, Tohoku University Hospital, Sendai, Miyagi 980-8574, Japan
| | - Yumiko Takei
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - Issei Seike
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - Kentarou Takei
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
- Department of Intelligent Network for Infection Control, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - Kengo Oshima
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
- Department of Intelligent Network for Infection Control, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - Koichi Tokuda
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
- Department of Intelligent Network for Infection Control, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - Takuya Shiga
- Intensive Care Unit, Tohoku University Hospital, Sendai, Miyagi 980-8574, Japan
| | - Hajime Kanamori
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
- Department of Intelligent Network for Infection Control, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
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Valciņa O, Pūle D, Ķibilds J, Lazdāne A, Trofimova J, Makarova S, Konvisers G, Ķimse L, Krūmiņa A, Bērziņš A. Prevalence and Genetic Diversity of Legionella spp. in Hotel Water-Supply Systems in Latvia. Microorganisms 2023; 11:microorganisms11030596. [PMID: 36985170 PMCID: PMC10055240 DOI: 10.3390/microorganisms11030596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
Legionella is one of the most important waterborne pathogens that can lead to both outbreaks and sporadic cases. The majority of travel-associated Legionnaires’ disease (TALD) cases are contracted during hotel stays. The aim of this study was to evaluate the prevalence and genetic diversity of Legionella spp. in hotel water supply systems in Latvia. In total, 834 hot water samples were collected from the water systems of 80 hotels in Latvia. At least one Legionella spp. positive sample was detected in 47 out of 80 hotels (58.8%). Overall, 235 out of 834 samples (28.2%) were Legionella spp. positive. The average hot water temperature in Latvian hotels was 49.8 °C. The most predominant L. pneumophila serogroup (SG) was SG3 which was found in 113 (49.8%) positive samples from 27 hotels. For 79 sequenced L. pneumophila isolates, 21 different sequence types (ST) were obtained, including 3 new types—ST2582, ST2579, and ST2580. High Legionella contamination and high genetic diversity were found in the hotel water supply systems in Latvia, which, together with the insufficient hot water temperature, may indicate that the lack of regulation and control measures may promote the proliferation of Legionella.
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Affiliation(s)
- Olga Valciņa
- Institute of Food Safety, Animal Health and Environment “BIOR”, 1076 Rīga, Latvia
| | - Daina Pūle
- Institute of Food Safety, Animal Health and Environment “BIOR”, 1076 Rīga, Latvia
- Department of Water Engineering and Technology, Riga Technical University, 1048 Rīga, Latvia
| | - Juris Ķibilds
- Institute of Food Safety, Animal Health and Environment “BIOR”, 1076 Rīga, Latvia
| | - Andžela Lazdāne
- Department of Metabolic Genetics Laboratory, Children’s Clinical University Hospital, 1004 Rīga, Latvia
| | - Jūlija Trofimova
- National Reference Laboratory, Riga East University Hospital, 1038 Rīga, Latvia
| | - Svetlana Makarova
- Institute of Food Safety, Animal Health and Environment “BIOR”, 1076 Rīga, Latvia
| | - Genadijs Konvisers
- Institute of Food Safety, Animal Health and Environment “BIOR”, 1076 Rīga, Latvia
| | - Laima Ķimse
- Institute of Food Safety, Animal Health and Environment “BIOR”, 1076 Rīga, Latvia
| | - Angelika Krūmiņa
- Department of Infectology, Riga Stradiņš University, 1007 Rīga, Latvia
| | - Aivars Bērziņš
- Institute of Food Safety, Animal Health and Environment “BIOR”, 1076 Rīga, Latvia
- Correspondence: ; Tel.: +371-6780-8972
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Knežević M, Rončević D, Vukić Lušić D, Mihelčić M, Kogoj R, Keše D, Glad M, Cenov A, Ožanič M, Glažar Ivče D, Šantić M. Decreasing Pasteurization Treatment Efficiency against Amoeba-Grown Legionella pneumophila—Recognized Public Health Risk Factor. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031099. [PMID: 35162120 PMCID: PMC8834526 DOI: 10.3390/ijerph19031099] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/12/2022] [Accepted: 01/15/2022] [Indexed: 11/16/2022]
Abstract
Legionellae are gram-negative bacteria most commonly found in freshwater ecosystems and purpose-built water systems. In humans, the bacterium causes Legionnaires’ disease (LD) or a Pontiac fever. In this study, the different waters (drinking water, pool water, cooling towers) in which Legionella pneumophila has been isolated were studied to assess the possible risk of bacterial spreading in the population. The influence of physical and chemical parameters, and interactions with Acanthamoeba castellanii on L. pneumophila, were analyzed by Heterotrophic Plate Count, the Colony-forming units (CFU) methods, transmission electron microscopy (TEM), and Sequence-Based Typing (SBT) analysis. During the study period (2013–2019), a total of 1932 water samples were analyzed, with the average annual rate of Legionella-positive water samples of 8.9%, showing an increasing trend. The largest proportion of Legionella-positive samples was found in cooling towers and rehabilitation centers (33.9% and 33.3%, respectively). Among the isolates, L. pneumophila SGs 2–14 was the most commonly identified strain (76%). The survival of Legionella was enhanced in the samples with higher pH values, while higher electrical conductivity, nitrate, and free residual chlorine concentration significantly reduced the survival of Legionella. Our results show that growth in amoeba does not affect the allelic profile, phenotype, and morphology of the bacterium but environmental L. pneumophila becomes more resistant to pasteurization treatment.
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Affiliation(s)
- Maša Knežević
- Department of Microbiology and Parasitology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia; (M.K.); (M.M.); (M.O.); (M.Š.)
| | - Dobrica Rončević
- Department of Epidemiology, Teaching Institute of Public Health of Primorje-Gorski Kotar County, Krešimirova 52a, 51000 Rijeka, Croatia;
- Department of Public Health, Faculty of Health Studies, Viktora Cara Emina 5, 51000 Rijeka, Croatia
| | - Darija Vukić Lušić
- Department of Environmental Health, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia
- Department of Environmental Health, Teaching Institute of Public Health of Primorje-Gorski Kotar County, Krešimirova 52a, 51000 Rijeka, Croatia; (M.G.); (A.C.)
- Center for Advanced Computing and Modeling, University of Rijeka, Radmile Matejčić 2, 51000 Rijeka, Croatia
- Correspondence: ; Tel.: +385-(0)51-358-755
| | - Mirna Mihelčić
- Department of Microbiology and Parasitology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia; (M.K.); (M.M.); (M.O.); (M.Š.)
| | - Rok Kogoj
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloska 4, 1000 Ljubljana, Slovenia; (R.K.); (D.K.)
| | - Darja Keše
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloska 4, 1000 Ljubljana, Slovenia; (R.K.); (D.K.)
| | - Marin Glad
- Department of Environmental Health, Teaching Institute of Public Health of Primorje-Gorski Kotar County, Krešimirova 52a, 51000 Rijeka, Croatia; (M.G.); (A.C.)
| | - Arijana Cenov
- Department of Environmental Health, Teaching Institute of Public Health of Primorje-Gorski Kotar County, Krešimirova 52a, 51000 Rijeka, Croatia; (M.G.); (A.C.)
| | - Mateja Ožanič
- Department of Microbiology and Parasitology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia; (M.K.); (M.M.); (M.O.); (M.Š.)
| | - Daniela Glažar Ivče
- Branch Office Rab, Teaching Institute of Public Health of Primorje-Gorski Kotar County, Palit 143a, 51280 Rab, Croatia;
| | - Marina Šantić
- Department of Microbiology and Parasitology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia; (M.K.); (M.M.); (M.O.); (M.Š.)
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6
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Prabhu FR, Hobart K, Sulapas I, Sikes A. Pulmonary Infections. Fam Med 2022. [DOI: 10.1007/978-3-030-54441-6_91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Assaidi A, Soummane A, Ellouali M, Latrache H, Timinouni M, Zahir H, Mliji EM. Environmental surveillance of Legionella pneumophila in hot water systems of hotels in Morocco. JOURNAL OF WATER AND HEALTH 2021; 19:855-863. [PMID: 34665777 DOI: 10.2166/wh.2021.175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Environmental monitoring of Legionella in hot water systems of hotels in Morocco was performed during the period from January 2016 to April 2018. A total of 149 water samples from 118 different hotels were analyzed. METHODS A total of 149 water samples from 118 different hotels were analyzed. Possible risk factors were prospectively recorded, and data were analyzed in connection with building and plumbing systems characteristics. Data about building and risk factors were collected through a questionnaire survey. RESULTS Out of the 149 samples, 77(51.7%) were positive for L. pneumophila. Serological typing of the isolates revealed that 54 (70.1%) are L. pneumophila serogroup 2-15 and 23 (29.9%) are L. pneumophila serogroup 1. 56.8% of all buildings were colonized by L. pneumophila. Counts were over 1,000 CFU/L in 44%. Contamination was strongly correlated with temperature in the circulation, the age of the premise plumbing and the size of the building. CONCLUSIONS The results showed a relevant exposure to L. pneumophila in the community and the identified risk factors can serve as indicators for risk assessment and relevant actions.
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Affiliation(s)
- Abdelwahid Assaidi
- Laboratory of Bioprocess and Biointerfaces, Faculty of Sciences and Technics, Sultan Moulay Slimane University, Beni Mellal, Morocco; Laboratory of Water Microbiology and Environmental Hygiene, Institut Pasteur du Maroc, Casablanca, Morocco E-mail:
| | - Afaf Soummane
- Laboratory of Water Microbiology and Environmental Hygiene, Institut Pasteur du Maroc, Casablanca, Morocco E-mail:
| | - Mostafa Ellouali
- Laboratory of Bioprocess and Biointerfaces, Faculty of Sciences and Technics, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - Hassan Latrache
- Laboratory of Bioprocess and Biointerfaces, Faculty of Sciences and Technics, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - Mohammed Timinouni
- Laboratory of Water Microbiology and Environmental Hygiene, Institut Pasteur du Maroc, Casablanca, Morocco E-mail:
| | - Hafida Zahir
- Laboratory of Bioprocess and Biointerfaces, Faculty of Sciences and Technics, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - El Mostafa Mliji
- Laboratory of Water Microbiology and Environmental Hygiene, Institut Pasteur du Maroc, Casablanca, Morocco E-mail:
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Legionella pneumophila-Epidemiology and Characterization of Clinical Isolates, Slovenia, 2006-2020. Diagnostics (Basel) 2021; 11:diagnostics11071201. [PMID: 34359283 PMCID: PMC8308060 DOI: 10.3390/diagnostics11071201] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/18/2021] [Accepted: 06/24/2021] [Indexed: 11/21/2022] Open
Abstract
Legionella pneumophila is the causative agent of severe Legionnaires’ disease (LD). Although an increasing number of LD cases have been observed, published data from Slovenia are very limited and data on molecular epidemiology are even scarcer. The present retrospective study (2006–2020) reports the results of the microbiological diagnosis of LD, as well as the epidemiology and characterization of the Legionella clinical isolates. We tested urine samples from 15,540 patients with pneumonia symptoms for L. pneumophila infection by urine antigen test, of which 717 (4.6%) tested positive. Isolation of L. pneumophila was successfully performed from 88 clinical specimens, with 82 (93.2%) being identified as L. pneumophila sg 1 and six (6.8%) as L. pneumophila sg 2–14. Sequence-based typing (SBT) identified 33 different sequence types (STs), the most frequent being ST1 and ST23. Sequence type 1 mainly comprised isolates belonging to the Philadelphia subgroup, and ST23 mostly to Allentown/France. The standard SBT scheme, as well as Dresden phenotyping for L. pneumophila, presented a high diversity among isolates.
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Islam MA, Hassen WM, Tayabali AF, Dubowski JJ. Short Ligand, Cysteine-Modified Warnericin RK Antimicrobial Peptides Favor Highly Sensitive Detection of Legionella pneumophila. ACS OMEGA 2021; 6:1299-1308. [PMID: 33490789 PMCID: PMC7818584 DOI: 10.1021/acsomega.0c04753] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/14/2020] [Indexed: 06/12/2023]
Abstract
Culture-based methods for the detection of Legionella pneumophila are prohibitively slow and frequently inadequate. The problem has been addressed with biosensing technology that employs a variety of ligands for the specific capture of bacteria. However, the limited success of the application of mammalian antibodies, aptamers, and nucleic acid-based probes for sensitive biosensing has generated growing interest in exploring alternative biosensing architectures, such as those based on antimicrobial peptides (AMP) that are known for their attractive therapeutic applications. We report on the successful employment of cysteine-modified warnericin RK AMP for the operation of a highly sensitive biosensor of L. pneumophila based on digital photocorrosion of GaAs/AlGaAs nanoheterostructures. The replacement of the relatively cumbersome procedure commonly applied for the attachment of antibodies to COOH-terminated mercaptohexadecanoic acid self-assembled monolayers has allowed for a significant reduction in the distance at which bacteria are immobilized above the biosensor surface. An important consequence of this approach is the attractive limit of detection of L. pneumophila estimated at 2 × 102 CFU/mL. The target bacteria were captured four times more efficiently than P. fluorescens, B. subtilis, and E. coli, which is highly promising for environmental monitoring.
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Affiliation(s)
- M. Amirul Islam
- Interdisciplinary
Institute for Technological Innovation (3IT), CNRS UMI-3463, Laboratory
for Quantum Semiconductors and Photon-based BioNanotechnology, Department
of Electrical and Computer Engineering, Université de Sherbrooke, 3000, boul. de l’Université, Sherbrooke, Québec J1K 0A5, Canada
| | - Walid M. Hassen
- Interdisciplinary
Institute for Technological Innovation (3IT), CNRS UMI-3463, Laboratory
for Quantum Semiconductors and Photon-based BioNanotechnology, Department
of Electrical and Computer Engineering, Université de Sherbrooke, 3000, boul. de l’Université, Sherbrooke, Québec J1K 0A5, Canada
| | - Azam F. Tayabali
- Environmental
Health Science Research Bureau, Healthy
Environments and Consumer Safety Branch, Health Canada, Ottawa, Ontario K1A 0K9, Canada
| | - Jan J. Dubowski
- Interdisciplinary
Institute for Technological Innovation (3IT), CNRS UMI-3463, Laboratory
for Quantum Semiconductors and Photon-based BioNanotechnology, Department
of Electrical and Computer Engineering, Université de Sherbrooke, 3000, boul. de l’Université, Sherbrooke, Québec J1K 0A5, Canada
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10
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Diagnostic tools for bacterial infections in travellers: Current and future options. Travel Med Infect Dis 2020; 37:101856. [PMID: 32841728 DOI: 10.1016/j.tmaid.2020.101856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 04/30/2020] [Accepted: 08/19/2020] [Indexed: 11/22/2022]
Abstract
International travel has increased dramatically over the past 50 years, and travel destinations have diversified. Although physicians are more familiar with the panel of aetiological agents responsible for illnesses of returning travellers, thanks to regular epidemiological studies, the spectrum of pathogens potentially encountered in various travel destinations is nevertheless increasing. In addition, the wide array of approaches currently available and addressed in this paper could render the procedures for microbiological analyses increasingly complex. As the time to result is crucial to adequately manage patients, modern approaches have been developed to shorten diagnosis delays. The syndromic approach, which consists of simultaneously testing a wide panel of microorganisms, substantially increases the diagnostic yield with significant time savings, particularly when coupled with point-of-care laboratories. The tools commonly used for this purpose are immunochromatographic tests, mainly targeting bacterial antigens, and multiplex real-time PCR. The emergence of next-generation sequencing technologies, which enable random amplification of genetic material of any microbe present in a clinical specimen, provides further exciting perspectives in the diagnosis of infectious diseases.
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11
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Assaidi A, Ellouali M, Latrache H, Timinouni M, Zahir H, Karoumi A, Barguigua A, Mliji EM. Antimicrobial Susceptibility Patterns of Legionella spp. Strains Isolated from Water Systems in Morocco. Microb Drug Resist 2020; 26:991-996. [PMID: 32125920 DOI: 10.1089/mdr.2019.0218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: Legionella is a waterborne pathogen that causes a severe form of pneumonia called Legionnaires' diseases, which is normally acquired by inhalation of aerosols containing Legionella originating from natural and man-made water systems. The aim of this study was to describe the level of antimicrobial susceptibility of environmental Legionella spp. strains to preferred and recommended therapeutic agents to treat Legionella disease. Methods: The minimum inhibitory concentrations (MICs) of 60 environmental Legionella spp. strains were tested using the broth dilution method. Susceptibility testing was performed for 12 antimicrobial agents: macrolides (erythromycin, azithromycin [AZI], and clarithromycin [CLA]), fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin, and gemifloxacin), a ketolide (telithromycin), cefotaxime (CEF), tigecycline (TIG), doxycycline (DOX), and rifampicin (RIF). Results: All tested strains of Legionella spp. were inhibited by low concentrations of fluoroquinolones and macrolides. Regarding the macrolides, CLA was the most active antibiotic, and AZI was the least active. RIF was the most effective antibiotic against the isolates in vitro. All isolates were inhibited by the following antibiotics (in decreasing order of their MICs): DOX>CEF>TIG. Conclusions: No resistance against these drugs was detected, and all isolates were inhibited by low concentrations of the tested antibiotics. Susceptibility testing of environmental Legionella spp. isolates must be monitored often to detect and evaluate the possible development of antibiotic resistance.
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Affiliation(s)
- Abdelwahid Assaidi
- Laboratory of Bioprocess and Biointerfaces, Life Sciences Department, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, Beni Mellal, Morocco.,Laboratory of Water Microbiology and Environmental Hygiene, Food Safety & Environment Department, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Mostafa Ellouali
- Laboratory of Bioprocess and Biointerfaces, Life Sciences Department, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - Hassan Latrache
- Laboratory of Bioprocess and Biointerfaces, Life Sciences Department, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - Mohammed Timinouni
- Laboratory of Water Microbiology and Environmental Hygiene, Food Safety & Environment Department, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Hafida Zahir
- Laboratory of Bioprocess and Biointerfaces, Life Sciences Department, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - Abdelaziz Karoumi
- Laboratory of Water Microbiology and Environmental Hygiene, Food Safety & Environment Department, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Abouddihaj Barguigua
- Laboratory of Biotechnology and Sustainable Development of Natural Ressources, Life Sciences Department, Polydisciplinary Faculty, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - El Mostafa Mliji
- Laboratory of Water Microbiology and Environmental Hygiene, Food Safety & Environment Department, Institut Pasteur du Maroc, Casablanca, Morocco
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Pulmonary Infections. Fam Med 2020. [DOI: 10.1007/978-1-4939-0779-3_91-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ge ZH, Long QS, Yuan PB, Pan X, Shen D, Lu YJ. The Temporal Expression of Global Regulator Protein CsrA Is Dually Regulated by ClpP During the Biphasic Life Cycle of Legionella pneumophila. Front Microbiol 2019; 10:2495. [PMID: 31787938 PMCID: PMC6853998 DOI: 10.3389/fmicb.2019.02495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/16/2019] [Indexed: 11/16/2022] Open
Abstract
Legionella pneumophila, an environmental bacterium that parasitizes protozoa, is the causative pathogen of Legionnaires' disease. L. pneumophila adopts a distinct biphasic life cycle that allows it to adapt to environmental conditions for survival, replication, and transmission. This cycle consists of a non-virulent replicative phase (RP) and a virulent transmissive phase (TP). Timely and fine-tuned expression of growth and virulence factors in a life cycle-dependent manner is crucial. Herein, we report evidence that CsrA, a key regulator of the switch between the RP and the TP, is dually regulated in a ClpP-dependent manner during the biphasic life cycle of L. pneumophila. First, we show that the protein level of CsrA is temporal during the life cycle and is degraded by ClpP during the TP. The ectopic expression of CsrA in a ΔclpP mutant, but not in the wild type, inhibits both the initiation of the RP in vitro and the invasiveness to Acanthamoeba castellanii, indicating that the ClpP-mediated proteolytic pathway regulates the CsrA protein level. We further show that the temporally expressed IHFB is the transcriptional inhibitor of csrA and is degraded via a ClpP-dependent manner during the RP. During the RP, the level of CsrA is increased by promoting the degradation of IHFB and reducing the degradation of the accumulated CsrA via a ClpP-dependent manner. During the TP, the level of CsrA is decreased by inhibiting the degradation of IHFB and promoting the degradation of the accumulated CsrA via a ClpP-dependent manner as well. In conclusion, our results show that the growth-stage-specific expression level of CsrA is dually regulated by ClpP-dependent proteolysis at both the transcription and protein levels during the biphasic life cycle of L. pneumophila.
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Affiliation(s)
- Zhen-Huang Ge
- School of Life Sciences, Sun Yat-sen University, Guangzhou, China.,Biomedical Center, Sun Yat-sen University, Guangzhou, China
| | - Qin-Sha Long
- School of Life Sciences, Sun Yat-sen University, Guangzhou, China.,Biomedical Center, Sun Yat-sen University, Guangzhou, China
| | - Pei-Bo Yuan
- School of Life Sciences, Sun Yat-sen University, Guangzhou, China.,Biomedical Center, Sun Yat-sen University, Guangzhou, China
| | - Xin Pan
- School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Dong Shen
- School of Life Sciences, Sun Yat-sen University, Guangzhou, China.,Biomedical Center, Sun Yat-sen University, Guangzhou, China
| | - Yong-Jun Lu
- School of Life Sciences, Sun Yat-sen University, Guangzhou, China.,Biomedical Center, Sun Yat-sen University, Guangzhou, China
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Wilmes D, Coche E, Rodriguez-Villalobos H, Kanaan N. Bacterial pneumonia in kidney transplant recipients. Respir Med 2018; 137:89-94. [PMID: 29605219 DOI: 10.1016/j.rmed.2018.02.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 02/06/2018] [Accepted: 02/26/2018] [Indexed: 12/16/2022]
Abstract
Bacterial pathogens are the most frequent cause of pneumonia after transplantation. Early after transplantation, recipients are at higher risk for nosocomial infections. The most commonly encountered pathogens during this period are gram-negative bacilli (Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa …), but gram-positive coccus such as Staphylococcus aureus or Streptococcus pneumoniae and anaerobic bacteria can also be found. Empirical antibiotic therapy should be guided by previous colonisation of the recipient and bacterial resistance pattern in the hospital. Six months after transplantation, pneumonias are mostly due to community-acquired bacteria (S. pneumonia, H. influenza, Mycoplasma, Chlamydia and others). Opportunistic pathogens take advantage of the state of immunosuppression which is usually highest from one to six months after transplantation. During this period, but also occurring many years later in the setting of a chronically depressed immune system, bacterial pathogens with low intrinsic virulence can cause pneumonia. The diagnosis of pneumonia caused by opportunistic pathogens can be challenging. The delay in diagnosis preventing the early instauration of adequate treatment in kidney transplant recipients with a depressed immune system, frequently coupled with co-morbid conditions and a state of frailty, will affect prognosis and outcome, increasing morbidity and mortality. This review will focus on the most common opportunistic bacterial pathogens causing pneumonia in kidney transplant recipients: Legionella, Nocardia, Mycobacterium tuberculosis/nontuberculous, and Rhodococcus. Recognition of their specificities in the setting of immunosuppression will allow early diagnosis, crucial for initiation of effective therapy and successful outcome. Interactions with immunosuppressive therapy should be considered as well as reducing immunosuppression if necessary.
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Affiliation(s)
- D Wilmes
- Division of Internal Medicine, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - E Coche
- Division of Radiology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - H Rodriguez-Villalobos
- Division of Microbiology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - N Kanaan
- Division of Nephrology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
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A Review of Roof Harvested Rainwater in Australia. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2018; 2018:6471324. [PMID: 29606962 PMCID: PMC5828256 DOI: 10.1155/2018/6471324] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/15/2017] [Accepted: 11/20/2017] [Indexed: 12/19/2022]
Abstract
To address concern regarding water sustainability, the Australian Federal Government and many state governments have implemented regulatory mechanisms and incentives to support households to purchase and install rainwater harvesting systems. This has led to an increase in rainwater harvesting in regional and urban Australia. This review examines the implementation of the regulatory mechanisms across Australia. In addition, the literature investigating the potential health consequences of rainwater consumption in Australia was explored. Studies demonstrated that although trace metals such as arsenic, cadmium, chromium, lead, and iron were present in Australian rainwater, these metallic elements were generally found below the health limit guideline, except in high industrial areas. In addition, pathogenic or indicator microorganisms that include, but are not limited to, Escherichia coli, total and faecal coliforms, Campylobacter, Salmonella, Legionella, Pseudomonas, Cryptosporidium, Enterococci, Giardia, Aeromonas, and Mycobacterium avium Complex (MAC) have been detected in rainwater collected in Australia. However, epidemiological evidence suggests that drinking rainwater does not increase the risk of gastrointestinal disease. It was also identified that there is a need for further research investigating the potential for rainwater to be a source of infection for opportunistic pathogens.
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Abstract
Pneumonia is a lung infection involving the alveoli and can be caused by a variety of microbes including bacteria, viruses, and fungi. It is the leading infectious cause of hospitalization and death in the United States [1]. In 2010, in the United States, pneumonia resulted in 1.1 million discharges from the hospital with an average length of stay of 5.2 days. Pneumonia accounted for 3.4 % of hospital deaths in 2006. In 2013 it accounted for 16.9 deaths per 100,000 population [2]. Pneumonia continues to be the leading killer of young children around the world, causing 14 % of all deaths in children ages 1 month to 5 years [3].
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Affiliation(s)
- Paul M. Paulman
- Department of Family Medicine, University of Nebraska Medical Center, Omaha, Nebraska USA
| | - Robert B. Taylor
- Department of Family and Community Medicine, Eastern Virginia Medical School, Norfolk, Virginia USA
| | - Audrey A. Paulman
- Department of Family Medicine, University of Nebraska Medical Center, Omaha, Nebraska USA
| | - Laeth S. Nasir
- Department of Family Medicine, Creighton University School of Medicine, Omaha, Nebraska USA
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Abstract
The modern cruise ship is a small city on the seas, with populations as large as 5,000 seen on large ships. The growth of the cruise ship industry has continued in the twenty-first century, and it was estimated that nearly 21.3 million passengers traveled on cruise ships in 2013, with the majority of these sailing from North America. The presence of large numbers of individuals in close proximity to each other facilitates transmission of infectious diseases, often through person-to-person spread or via contaminated food or water. An infectious agent introduced into the environment of a cruise ship has the potential to be distributed widely across the ship and to cause significant morbidity. The median cruise ship passenger is over 45 years old and often has chronic medical problems, so it is important that, to have a safe cruise ship experience, any potential for the introduction of an infecting agent as well as its transmission be minimized. The majority of cruise ship infections involve respiratory and gastrointestinal infections. This article discusses infectious outbreaks on cruise ships and suggests preventative measures for passengers who plan to travel on cruise ships.
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Prabhu FR, Sikes AR, Sulapas I. Pulmonary Infections. Fam Med 2015. [DOI: 10.1007/978-1-4939-0779-3_91-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Muñoz-Gómez S, Cunha BA. Fever of unknown origin (FUO) due to Legionnaire's disease. Heart Lung 2015; 44:72-4. [PMID: 25444558 DOI: 10.1016/j.hrtlng.2014.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 09/19/2014] [Accepted: 09/24/2014] [Indexed: 10/24/2022]
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Żbikowska E, Kletkiewicz H, Walczak M, Burkowska A. Coexistence of Legionella pneumophila Bacteria and Free-Living Amoebae in Lakes Serving as a Cooling System of a Power Plant. WATER, AIR, AND SOIL POLLUTION 2014; 225:2066. [PMID: 25132694 PMCID: PMC4127003 DOI: 10.1007/s11270-014-2066-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 07/09/2014] [Indexed: 05/24/2023]
Abstract
The study was aimed at determining whether potentially pathogenic free-living amoebae (FLA) and Legionella pneumophila can be found in lakes serving as a natural cooling system of a power plant. Water samples were collected from five lakes forming the cooling system of the power plants Pątnów and Konin (Poland). The numbers of investigated organisms were determined with the use of a very sensitive molecular method-fluorescence in situ hybridization (FISH). The result of the present study shows that thermally altered aquatic environments provide perfect conditions for the growth of L. pneumophila and amoebae. The bacteria were identified in the biofilm throughout the entire research period and in the subsurface water layer in July and August. Hartmanella sp. and/or Naegleria fowleri were identified in the biofilm throughout the entire research period.
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Affiliation(s)
- Elżbieta Żbikowska
- Department of Invertebrate Zoology, Faculty of Biology and Environment Protection, Nicolaus Copernicus University, Lwowska 1, 87-100 Toruń, Poland
| | - Hanna Kletkiewicz
- Department of Animal Physiology, Faculty of Biology and Environment Protection, Nicolaus Copernicus University, Toruń, Poland
| | - Maciej Walczak
- Department of Environmental Microbiology and Biotechnology, Faculty of Biology and Environment Protection, Nicolaus Copernicus University, Toruń, Poland
| | - Aleksandra Burkowska
- Department of Environmental Microbiology and Biotechnology, Faculty of Biology and Environment Protection, Nicolaus Copernicus University, Toruń, Poland
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Walczak M, Kletkiewicz H, Burkowska A. Occurrence of Legionella pneumophila in lakes serving as a cooling system of a power plant. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2013; 15:2273-2278. [PMID: 24141270 DOI: 10.1039/c3em00452j] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study was aimed at determining whether Legionella pneumophila can be found in lakes serving as a natural cooling system of a power plant. Water samples were collected from five lakes forming the cooling system of the power plants Pątnów and Konin (Poland). The numbers of bacteria belonging to different phylogenetic groups (bacteria, Legionella sp. and L. pneumophila) were determined with the use of a molecular FISH method. The results of the present study show that thermally altered aquatic environments provide perfect conditions for the growth of L. pneumophila. These microorganisms were identified in the biofilm throughout the entire research period, and in the subsurface water layer in July and August. The percentage of L. pneumophila species in the Legionella genus was 11.55-12.42%.
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Affiliation(s)
- Maciej Walczak
- Department of Environmental Microbiology and Biotechnology, Nicolaus Copernicus University, Toruń, Poland.
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Pitre CAJ, Tanner JR, Patel P, Brassinga AKC. Regulatory control of temporally expressed integration host factor (IHF) in Legionella pneumophila. Microbiology (Reading) 2013; 159:475-492. [DOI: 10.1099/mic.0.062117-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Chantalle A. J. Pitre
- Department of Microbiology, Faculty of Science, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Jennifer R. Tanner
- Department of Microbiology, Faculty of Science, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Palak Patel
- Department of Microbiology, Faculty of Science, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Ann Karen C. Brassinga
- Department of Microbiology, Faculty of Science, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
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Viasus D, Di Yacovo S, Garcia-Vidal C, Verdaguer R, Manresa F, Dorca J, Gudiol F, Carratalà J. Community-acquired Legionella pneumophila pneumonia: a single-center experience with 214 hospitalized sporadic cases over 15 years. Medicine (Baltimore) 2013; 92:51-60. [PMID: 23266795 PMCID: PMC5348137 DOI: 10.1097/md.0b013e31827f6104] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Legionella pneumophila has been increasingly recognized as a cause of community-acquired pneumonia (CAP) and an important public health problem worldwide. We conducted the present study to assess trends in epidemiology, diagnosis, clinical features, treatment, and outcomes of sporadic community-acquired L. pneumophila pneumonia requiring hospitalization at a university hospital over a 15-year period (1995-2010). Among 3934 nonimmunosuppressed hospitalized patients with CAP, 214 (5.4%) had L. pneumophila pneumonia (16 cases were categorized as travel-associated pneumonia, and 21 were part of small clusters). Since the introduction of the urinary antigen test, the diagnosis of L. pneumophila using this method remained stable over the years (p = 0.42); however, diagnosis by means of seroconversion and culture decreased (p < 0.001 and p = 0.001, respectively). The median age of patients with L. pneumophila pneumonia was 58.2 years (SD 13.8), and 76.4% were male. At least 1 comorbid condition was present in 119 (55.6%) patients with L. pneumophila pneumonia, mainly chronic heart disease, diabetes mellitus, and chronic pulmonary disease. The frequency of older patients (aged >65 yr) and comorbidities among patients with L. pneumophila pneumonia increased over the years (p = 0.06 and p = 0.02, respectively). In addition, 100 (46.9%) patients were classified into high-risk classes according to the Pneumonia Severity Index (groups IV-V). Twenty-four (11.2%) patients with L. pneumophila pneumonia received inappropriate empirical antibiotic therapy at hospital admission. Compared with patients who received appropriate empirical antibiotic, patients who received inappropriate therapy more frequently had acute onset of illness (p = 0.004), pleuritic chest pain (p = 0.03), and pleural effusion (p = 0.05). The number of patients who received macrolides decreased over the study period (p < 0.001), whereas the number of patients who received levofloxacin increased (p < 0.001). No significant difference was found in the outcomes between patients who received erythromycin and clarithromycin. However, compared with macrolide use during hospital admission, levofloxacin therapy was associated with a trend toward a shorter time to reach clinical stability (median, 3 vs. 5 d; p = 0.09) and a shorter length of hospital stay (median, 7 vs. 10 d; p < 0.001). Regarding outcomes, 38 (17.8%) patients required intensive care unit (ICU) admission, and the inhospital case-fatality rate was 6.1% (13 of 214 patients). The frequency of ICU admission (p = 0.34) and the need for mechanical ventilation (p = 0.57) remained stable over the study period, but the inhospital case-fatality rate decreased (p = 0.04). In the logistic regression analysis, independent factors associated with severe disease (ICU admission and death) were current/former smoker (odds ratio [OR], 2.96; 95% confidence interval [CI], 1.01-8.62), macrolide use (OR, 2.40; 95% CI, 1.03-5.56), initial inappropriate therapy (OR, 2.97; 95% CI, 1.01-8.74), and high-risk Pneumonia Severity Index classes (OR, 9.1; 95% CI, 3.52-23.4). In conclusion, L. pneumophila is a relatively frequent causative pathogen among hospitalized patients with CAP and is associated with high morbidity. The annual number of L. pneumophila cases remained stable over the study period. In recent years, there have been significant changes in diagnosis and treatment, and the inhospital case-fatality rate of L. pneumophila pneumonia has decreased.
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Affiliation(s)
- Diego Viasus
- From the Departments of Infectious Diseases (DV, SDY, CGV, FG, JC), Microbiology (RV), and Respiratory Medicine (FM, JD), Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona; and Department of Clinical Science (FM, JD, FG, JC), University of Barcelona, Barcelona, Spain
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Detection of Legionella bozemanae, a new cause of septic arthritis, by PCR followed by specific culture. J Clin Microbiol 2012; 50:4180-2. [PMID: 23052316 DOI: 10.1128/jcm.01899-12] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Legionella bozemanae is a rare isolate in clinical specimens. We describe a case of joint infection due to L. bozemanae in an immunocompromised patient with dermatomyositis. Without the use of PCR screening or culture on specialized medium, the organism would not have been detected.
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Quaranta G, Vincenti S, Ferriero AM, Boninti F, Sezzatini R, Turnaturi C, Gliubizzi MD, Munafò E, Ceccarelli G, Causarano C, Accorsi M, Del Nord P, Ricciardi W, Laurenti P. Legionella on board trains: effectiveness of environmental surveillance and decontamination. BMC Public Health 2012; 12:618. [PMID: 22870945 PMCID: PMC3519711 DOI: 10.1186/1471-2458-12-618] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 07/30/2012] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Legionella pneumophila is increasingly recognised as a significant cause of sporadic and epidemic community-acquired and nosocomial pneumonia. Many studies describe the frequency and severity of Legionella spp. contamination in spa pools, natural pools, hotels and ships, but there is no study analysing the environmental monitoring of Legionella on board trains. The aims of the present study were to conduct periodic and precise environmental surveillance of Legionella spp. in water systems and water tanks that supply the toilet systems on trains, to assess the degree of contamination of such structures and to determine the effectiveness of decontamination. METHODS A comparative pre-post ecological study was conducted from September 2006 to January 2011. A total of 1,245 water samples were collected from plumbing and toilet water tanks on passenger trains. The prevalence proportion of all positive samples was calculated. The unpaired t-test was performed to evaluate statistically significant differences between the mean load values before and after the decontamination procedures; statistical significance was set at p ≤ 0.05. RESULTS In the pre-decontamination period, 58% of the water samples were positive for Legionella. Only Legionella pneumophila was identified: 55.84% were serogroup 1, 19.03% were serogroups 2-14 and 25.13% contained both serogroups. The mean bacterial load value was 2.14 × 10(3) CFU/L. During the post-decontamination period, 42.75% of water samples were positive for Legionella spp.; 98.76% were positive for Legionella pneumophila: 74.06% contained serogroup 1, 16.32% contained serogroups 2-14 and 9.62% contained both. The mean bacterial load in the post-decontamination period was 1.72 × 10(3) CFU/L. According to the t-test, there was a statistically significant decrease in total bacterial load until approximately one and a half year after beginning the decontamination programme (p = 0.0097). CONCLUSIONS This study indicates that systematic environmental surveillance could be a useful approach for assessing the risk of exposure to Legionella bacteria, which still represents a public health threat. According to the study results, an environmental surveillance programme, followed by decontamination procedures where necessary, would decrease the total bacterial count, protecting the health of travellers and workers.
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Affiliation(s)
- Gianluigi Quaranta
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Sara Vincenti
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Anna Maria Ferriero
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Federica Boninti
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Romina Sezzatini
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Cinzia Turnaturi
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Maria Daniela Gliubizzi
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Elio Munafò
- RFI (Italian Railway) Health Service, Via F. A. Pigafetta 3, 00154, Rome, Italy
| | - Gianluca Ceccarelli
- RFI (Italian Railway) Health Service, Via F. A. Pigafetta 3, 00154, Rome, Italy
| | - Carmelo Causarano
- RFI (Italian Railway) Health Service, Via F. A. Pigafetta 3, 00154, Rome, Italy
| | - Massimo Accorsi
- RFI (Italian Railway) Health Service, Via F. A. Pigafetta 3, 00154, Rome, Italy
| | - Pasquale Del Nord
- Trenitalia Environmental Work Quality and Safety, Via F. A. Pigafetta 3, 00154, Rome, Italy
| | - Walter Ricciardi
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Patrizia Laurenti
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
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