1
|
Marras L, Bertolino G, Sanna A, Carraro V, Coroneo V. Legionella spp. Monitoring in the Water Supply Systems of Accommodation Facilities in Sardinia, Italy: A Two-Year Retrospective Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6722. [PMID: 37754582 PMCID: PMC10530320 DOI: 10.3390/ijerph20186722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/25/2023] [Accepted: 08/30/2023] [Indexed: 09/28/2023]
Abstract
Travel-associated Legionnaires' disease is a significant public health concern worldwide. A high number of cases are reported every year among travellers who stay at guest houses, hotels, and spas. Indeed, hot water systems, showers, and air-conditioning systems can be contaminated by Legionella, which grows at 25-42 °C. Studies have shown that in Sardinia, especially during the summer months, the water circulation in the hotels' pipes is exposed to extremely high temperatures. As a result, this study was conducted to assess the colonization of hotel water systems by Legionella in Sardinia, concerning a recent EU directive 2020/2184 for drinking water with a limit of 1000 CFU /L. Methods. A total of 112 accommodation facilities were analyzed, of which 61.3% were found to be colonized with Legionella, and out of a total of 807 samples, 32.5% were positive for Legionella presence. The results showed a higher number of positive samples in the summer season. This was also associated with the higher concentration presence of >1000 CFU/L in the samples. Consequently, this study confirms that local hotel operators should improve their water safety and prevention plans, especially in spring and summer.
Collapse
Affiliation(s)
- Luisa Marras
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Giacomo Bertolino
- Pharmaceutical Department, Azienda Ospedaliero, Universitaria di Cagliari, 09123 Cagliari, Italy;
| | - Adriana Sanna
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Valentina Carraro
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Valentina Coroneo
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| |
Collapse
|
2
|
Heining L, Welp L, Hugo A, Elsner M, Seidel M. Immunomagnetic separation coupled with flow cytometry for the analysis of Legionella pneumophila in aerosols. Anal Bioanal Chem 2023:10.1007/s00216-023-04738-z. [PMID: 37204446 PMCID: PMC10404198 DOI: 10.1007/s00216-023-04738-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/04/2023] [Accepted: 05/08/2023] [Indexed: 05/20/2023]
Abstract
Legionella pneumophila are pathogenic bacteria that can be found in high concentrations in artificial water systems like evaporative cooling towers, which have been the source of frequent outbreaks in recent years. Since inhaled L. pneumophila can lead to Legionnaires' disease, the development of suitable sampling and rapid analysis strategies for these bacteria in aerosols is therefore of great relevance. In this work, different concentrations of viable L. pneumophila Sg 1 were nebulized and sampled by the cyclone sampler Coriolis® µ under defined conditions in a bioaerosol chamber. To quantify intact Legionella cells, the collected bioaerosols were subsequently analyzed by immunomagnetic separation coupled with flow cytometry (IMS-FCM) on the platform rqmicro.COUNT. For analytical comparison, measurements with qPCR and cultivation were performed. Limits of detection (LOD) of 2.9 × 103 intact cells m-3 for IMS-FCM and 7.8 × 102 intact cells m-3 for qPCR indicating a comparable sensitivity as in culture (LOD = 1.5 × 103 culturable cells m-3). Over a working range of 103 - 106 cells mL-1, the analysis of nebulized and collected aerosol samples with IMS-FCM and qPCR provides higher recovery rates and more consistent results than by cultivation. Overall, IMS-FCM is a suitable culture-independent method for quantification of L. pneumophila in bioaerosols and is promising for field application due to its simplicity in sample preparation.
Collapse
Affiliation(s)
- Lena Heining
- Institute of Water Chemistry, Chair of Analytical Chemistry and Water Chemistry, School of Natural Sciences, Technical University of Munich, Lichtenbergstraße 4, 85748, Garching, Germany
| | - Laura Welp
- Institut für Energie- und Umwelttechnik e.V., Bliersheimer Straße 58-60, 47229, Duisburg, Germany
| | - Achim Hugo
- Institut für Energie- und Umwelttechnik e.V., Bliersheimer Straße 58-60, 47229, Duisburg, Germany
| | - Martin Elsner
- Institute of Water Chemistry, Chair of Analytical Chemistry and Water Chemistry, School of Natural Sciences, Technical University of Munich, Lichtenbergstraße 4, 85748, Garching, Germany
| | - Michael Seidel
- Institute of Water Chemistry, Chair of Analytical Chemistry and Water Chemistry, School of Natural Sciences, Technical University of Munich, Lichtenbergstraße 4, 85748, Garching, Germany.
| |
Collapse
|
3
|
Crespi S, Drašar V, Salvà-Serra F, Jaén-Luchoro D, Piñeiro-Iglesias B, Lindemann PC, Aliaga-Lozano F, Fernández-Juárez V, Coll-García G, Moore ERB, Bennasar-Figueras A. Legionella maioricensis sp. nov., a new species isolated from the hot water distribution systems of a hospital and a shopping center during routine sampling. Int J Syst Evol Microbiol 2023; 73. [PMID: 36748493 DOI: 10.1099/ijsem.0.005686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Two Legionella-like strains isolated from hot water distribution systems in 2012 have been characterized phenotypically, biochemically and genomically in terms of DNA relatedness. Both strains, HCPI-6T and EUR-108, exhibited biochemical phenotypic profiles typical of Legionella species. Cells were Gram-negative motile rods which grew on BCYEα agar but not on blood agar and displayed phenotypic characteristics typical of the family Legionellaceae, including a requirement for l-cysteine and testing catalase positive. Both strains were negative for oxidase, urease, nitrate reduction and hippurate negative, and non-fermentative. The major ubiquinone was Q12 (59.4 % HCPI-6T) and the dominant fatty acids were C16 : 1 ω7c (28.4 % HCPI-6T, ≈16 % EUR-108), C16 : 0 iso (≈22.5 % and ≈13 %) and C15 : 0 anteiso (19.5 % and ≈23.5 %, respectively). The percent G+C content of genomic DNA was determined to be 39.3 mol %. The 16S rRNA gene, mip sequence and comparative genome sequence-based analyses (average nucleotide identity, ANI; digital DNA-DNA hybridization, dDDH; and phylogenomic treeing) demonstrated that the strains represent a new species of the genus Legionella. The analysis based on the 16S rRNA gene sequences showed that the sequence similarities for both strains ranged from 98.8-90.1 % to other members of the genus. The core genome-based phylogenomic tree (protein-concatemer tree based on concatenation of 418 proteins present in single copy) revealed that these two strains clearly form a separate cluster within the genus Legionella. ANI and dDDH values confirmed the distinctiveness of the strains. Based on the genomic, genotypic and phenotypic findings from a polyphasic study, the isolates are considered to represent a single novel species, for which the name Legionella maioricensis sp. nov. is proposed. The type strain is HCPI-6T (=CCUG 75071T=CECT 30569T).
Collapse
Affiliation(s)
- Sebastian Crespi
- Biolinea Int.; Calle Sócrates, 4; ES-07007 Palma de Mallorca, Spain
| | - Vladimír Drašar
- Public Health Institute Ostrava - National Legionella Reference Laboratory; Masarykovo nam., 16; 682 01 Vyškov, Czech Republic
| | - Francisco Salvà-Serra
- Culture Collection University of Gothenburg (CCUG), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Clinical Microbiology, Sahlgrenska University Hospital; Region Västra Götaland, Gothenburg, Sweden.,Microbiologia - Departament de Biologia, Universitat de les Illes Balears; Campus UIB - Ctra. Valldemossa, Km 7.5; ES-07122 Palma de Mallorca, Spain
| | - Daniel Jaén-Luchoro
- Culture Collection University of Gothenburg (CCUG), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Beatriz Piñeiro-Iglesias
- Culture Collection University of Gothenburg (CCUG), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Francisco Aliaga-Lozano
- Laboratorio Microbiología. Clínica Rotger, Grupo Quirónsalud - Vía Roma, 3, Carrer de Santiago Rusiñol, 9: ES-07012 Palma de Mallorca, Spain
| | - Victor Fernández-Juárez
- Marine Biology Section, Department of Biology, University of Copenhagen, 3000 Helsingør, Denmark
| | - Guillem Coll-García
- Microbiologia - Departament de Biologia, Universitat de les Illes Balears; Campus UIB - Ctra. Valldemossa, Km 7.5; ES-07122 Palma de Mallorca, Spain
| | - Edward R B Moore
- Culture Collection University of Gothenburg (CCUG), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Clinical Microbiology, Sahlgrenska University Hospital; Region Västra Götaland, Gothenburg, Sweden
| | - Antoni Bennasar-Figueras
- Microbiologia - Departament de Biologia, Universitat de les Illes Balears; Campus UIB - Ctra. Valldemossa, Km 7.5; ES-07122 Palma de Mallorca, Spain
| |
Collapse
|
4
|
Doménech-Sánchez A, Laso E, Berrocal CI, Albertí S. Environmental surveillance of Legionella in tourist facilities of the Balearic Islands, Spain, 2006 to 2010 and 2015 to 2018. Euro Surveill 2022; 27:2100769. [PMID: 35621000 PMCID: PMC9137269 DOI: 10.2807/1560-7917.es.2022.27.21.2100769] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/20/2021] [Indexed: 06/15/2023] Open
Abstract
BackgroundLegionnaires' disease is a respiratory illness often associated with hotels and travel. Spain is a major tourist destination and one of the European countries with most cases of Legionnaires' disease , both community- and travel-associated. However, the prevalence of Legionella in tourist facilities is unknown.AimThe present investigation aimed to survey the tourist facilities in the Balearic Islands, Spain, for Legionella prevalence.MethodsWe visited tourist facilities in the Balearic Islands in two different periods (2006-2010 and 2015-2018) and took water samples following national and international guidelines. Legionella was investigated by culture methods following international standards (ISO 11731:1998).ResultsWe evaluated 13,472 samples from 465 facilities. Bacteria of the Legionella genus were detected in 65.4% of the surveyed facilities. Contamination of the facilities was significantly higher during the second decade (54.5 vs 78.6%). The most frequent colonisers were L. pneumophila serogroup 2-14. We detected the pathogen in 15.9% and 6.9% of hot and cold water distribution systems samples, respectively. The Legionella contamination rate in cold water systems samples was higher when free chlorine levels were < 0.2 mg/L and at > 25 °C temperatures, while in the hot water systems samples, the contamination rate was higher at < 50 °C. Of the samples from hot tubs, 10.9% were contaminated.ConclusionLegionella prevalence in hotels in the Balearic Islands was high but the contamination rates depended on the installations. Corrective measures are still needed to improve Legionella control.
Collapse
Affiliation(s)
- Antonio Doménech-Sánchez
- Saniconsult Ibérica SL, Palma de Mallorca, Spain
- Instituto Universitario de Investigación en Ciencias de la Salud (IUNICS), Universidad de las Islas Baleares, Palma de Mallorca, Spain
- Instituto de Investigación Sanitaria de les Illes Balears (IdIsBa), Palma de Mallorca, Spain
| | - Elena Laso
- Saniconsult Ibérica SL, Palma de Mallorca, Spain
| | | | - Sebastián Albertí
- Instituto Universitario de Investigación en Ciencias de la Salud (IUNICS), Universidad de las Islas Baleares, Palma de Mallorca, Spain
- Instituto de Investigación Sanitaria de les Illes Balears (IdIsBa), Palma de Mallorca, Spain
| |
Collapse
|
5
|
Yin X, Chen YZ, Ye QQ, Liao LJ, Cai ZR, Lin M, Li JN, Zhang GB, Peng XL, Shi WF, Guo XG. Detection performance of PCR for Legionella pneumophila in environmental samples: a systematic review and meta-analysis. Ann Clin Microbiol Antimicrob 2022; 21:12. [PMID: 35303873 PMCID: PMC8934000 DOI: 10.1186/s12941-022-00503-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 03/07/2022] [Indexed: 11/25/2022] Open
Abstract
Background Legionellosis remains a public health problem. The most common diagnostic method to detect Legionella pneumophila (L. pneumophila) is culture. Polymerase chain reaction (PCR) is a fast and accurate method for this detection in environmental samples. Methods Four databases were searched for studies that evaluated the detection efficiency of PCR in L. pneumophila. The quality evaluation was conducted using Review Manager 5.3. We used Meta-DiSc 1.4 software and the Stata 15.0 software to create forest plots, a meta-regression, a bivariate boxplot and a Deeks’ funnel plot. Results A total of 18 four-fold tables from 16 studies were analysed. The overall pooled sensitivity and specificity of PCR was 94% and 72%, respectively. The positive likelihood ratio (RLR) and negative likelihood ratio (NLR) was 2.73 and 0.12, respectively. The result of the diagnostic odds ratio (DOR) was 22.85 and the area under the curve (AUC) was 0.7884. Conclusion Establishing a laboratory diagnostic tool for L. pneumophila detection is important for epidemiological studies. In this work, PCR demonstrated a promising diagnostic accuracy for L. pneumophila. Supplementary Information The online version contains supplementary material available at 10.1186/s12941-022-00503-9.
Collapse
Affiliation(s)
- Xin Yin
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Pediatrics, The Pediatrics School of Guangzhou Medical University, Guangzhou, 510182, China
| | - Ying-Zhou Chen
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The First Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Qi-Qing Ye
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Pediatrics, The Pediatrics School of Guangzhou Medical University, Guangzhou, 510182, China
| | - Li-Juan Liao
- Department of Clinical Medicine, The First Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Zhuo-Rui Cai
- Department of Preventive Medicine, The School of Public Health of Guangzhou Medical University, Guangzhou, 511436, China
| | - Min Lin
- Department of Traditional Chinese and Western Medicine in Clinical Medicine, The Clinical School of Traditional Chinese and Western Medicine of Guangzhou Medical University, Guangzhou, 511436, China
| | - Jia-Na Li
- Department of Medical Imaging, The Second Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Geng-Biao Zhang
- Department of Medical Imaging, The Second Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Xiao-Li Peng
- Department of Traditional Chinese and Western Medicine in Clinical Medicine, The Clinical School of Traditional Chinese and Western Medicine of Guangzhou Medical University, Guangzhou, 511436, China
| | - Wen-Fang Shi
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Xu-Guang Guo
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China. .,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China. .,Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China. .,Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.
| |
Collapse
|
6
|
Gattuso G, Rizzo R, Lavoro A, Spoto V, Porciello G, Montagnese C, Cinà D, Cosentino A, Lombardo C, Mezzatesta ML, Salmeri M. Overview of the Clinical and Molecular Features of Legionella Pneumophila: Focus on Novel Surveillance and Diagnostic Strategies. Antibiotics (Basel) 2022; 11:antibiotics11030370. [PMID: 35326833 PMCID: PMC8944609 DOI: 10.3390/antibiotics11030370] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 12/04/2022] Open
Abstract
Legionella pneumophila (L. pneumophila) is one of the most threatening nosocomial pathogens. The implementation of novel and more effective surveillance and diagnostic strategies is mandatory to prevent the occurrence of legionellosis outbreaks in hospital environments. On these bases, the present review is aimed to describe the main clinical and molecular features of L. pneumophila focusing attention on the latest findings on drug resistance mechanisms. In addition, a detailed description of the current guidelines for the disinfection and surveillance of the water systems is also provided. Finally, the diagnostic strategies available for the detection of Legionella spp. were critically reviewed, paying the attention to the description of the culture, serological and molecular methods as well as on the novel high-sensitive nucleic acid amplification systems, such as droplet digital PCR.
Collapse
Affiliation(s)
- Giuseppe Gattuso
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (G.G.); (R.R.); (A.L.); (V.S.); (A.C.); (C.L.); (M.L.M.)
| | - Roberta Rizzo
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (G.G.); (R.R.); (A.L.); (V.S.); (A.C.); (C.L.); (M.L.M.)
| | - Alessandro Lavoro
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (G.G.); (R.R.); (A.L.); (V.S.); (A.C.); (C.L.); (M.L.M.)
| | - Vincenzoleo Spoto
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (G.G.); (R.R.); (A.L.); (V.S.); (A.C.); (C.L.); (M.L.M.)
| | - Giuseppe Porciello
- Epidemiology and Biostatistics Unit, National Cancer Institute IRCCS Fondazione G. Pascale, 80131 Naples, Italy; (G.P.); (C.M.)
| | - Concetta Montagnese
- Epidemiology and Biostatistics Unit, National Cancer Institute IRCCS Fondazione G. Pascale, 80131 Naples, Italy; (G.P.); (C.M.)
| | - Diana Cinà
- Health Management of the “Cannizzaro” Emergency Hospital of Catania, 95126 Catania, Italy;
- Clinical Pathology and Clinical Molecular Biology Unit, “Garibaldi Centro” Hospital, ARNAS Garibaldi, 95123 Catania, Italy
| | - Alessia Cosentino
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (G.G.); (R.R.); (A.L.); (V.S.); (A.C.); (C.L.); (M.L.M.)
| | - Cinzia Lombardo
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (G.G.); (R.R.); (A.L.); (V.S.); (A.C.); (C.L.); (M.L.M.)
| | - Maria Lina Mezzatesta
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (G.G.); (R.R.); (A.L.); (V.S.); (A.C.); (C.L.); (M.L.M.)
| | - Mario Salmeri
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (G.G.); (R.R.); (A.L.); (V.S.); (A.C.); (C.L.); (M.L.M.)
- Correspondence: ; Tel.: +39-095-478-1244
| |
Collapse
|
7
|
Doménech-Sánchez A, Laso E, Albertí S. Determination of Legionella spp. prevalence in Spanish hotels in five years. Are tourists really at risk? Travel Med Infect Dis 2022; 46:102269. [DOI: 10.1016/j.tmaid.2022.102269] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/26/2022] [Indexed: 11/17/2022]
|
8
|
Quantitative Microbial Risk Assessment Applied to Legionella Contamination on Long-Distance Public Transport. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041960. [PMID: 35206148 PMCID: PMC8872098 DOI: 10.3390/ijerph19041960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 01/01/2023]
Abstract
The quantitative microbial risk assessment (QMRA) framework is used for assessing health risk coming from pathogens in the environment. In this paper, we used QMRA to evaluate the infection risk of L. pneumophila attributable to sink usage in a toilet cabin on Italian long-distance public transportation (LDT). LDT has water distribution systems with risk points for Legionella proliferation, as well as premise plumbing for drinking water, but they are not considered for risk assessment. Monitoring data revealed that approximately 55% of water samples (217/398) were positive for L. pneumophila, and the most frequently isolated was L. pneumophila sg1 (64%, 139/217); therefore, such data were fitted to the best probability distribution function to be used as a stochastic variable in the QMRA model. Then, a sink-specific aerosolization ratio was applied to calculate the inhaled dose, also considering inhalation rate and exposure time, which were used as stochastic parameters based on literature data. At L. pneumophila sg1 concentration ≤100 CFU/L, health risk was approximately 1 infection per 1 million exposures, with an increase of up to 5 infections per 10,000 exposures when the concentrations were ≥10,000 CFU/L. Our QMRA results showed a low Legionella infection risk from faucets on LDT; however, it deserves consideration since LDT can be used by people highly susceptible for the development of a severe form of the disease, owing to their immunological status or other predisposing factors. Further investigations could also evaluate Legionella-laden aerosols from toilet flushing.
Collapse
|
9
|
Girolamini L, Salaris S, Pascale MR, Mazzotta M, Cristino S. Dynamics of Legionella Community Interactions in Response to Temperature and Disinfection Treatment: 7 Years of Investigation. MICROBIAL ECOLOGY 2022; 83:353-362. [PMID: 34091718 PMCID: PMC8891097 DOI: 10.1007/s00248-021-01778-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/17/2021] [Indexed: 05/12/2023]
Abstract
In man-made water distribution systems, Legionella community interactions remain unknown, due to their ability to change from sessile to planktonic states or live in viable but non-culturable forms, in response to anthropic and environmental stress. During 7 years of hospital Legionella surveillance, in 191 hot water positive samples, the interactions among the Legionella species, temperature, and disinfection treatment were evaluated. Legionella was isolated following ISO 11731:2017, and identification was performed by mip gene sequencing and sequence-based typing (SBT) for L. anisa or L. rubrilucens and L. pneumophila, respectively. The species with the higher frequency of isolation was L. pneumophila serogroup 1 (78.53%; 4865.36 ± 25,479.11 cfu/L), followed by L. anisa (54.45%; 558.79 ± 2637.41 cfu/L) and L. rubrilucens (21.99%; 307.73 ± 1574.95 cfu/L), which were sometimes present together. Spearman's rho correlation test was conducted among the species with respect to temperature and disinfectant (H2O2/Ag+). The results showed a generally positive interaction among these species sharing the same environment, except for competition between L. anisa and L. rubrilucens. High temperature (48.83 ± 2.59 °C) and disinfection treatment (11.58 ± 4.99 mg/L) affected the presence of these species. An exception was observed with L. anisa, which showed disinfection treatment resistance. For the purposes of environmental surveillance, it is fundamental to better understand the interactions and dynamic of the Legionella community in man-made water systems in order to choose the proper physical or chemical treatments. The simultaneous presence of different Legionella species could result in an increased resistance to high temperature and disinfectant treatment, leading to changes in contamination level and species diversity.
Collapse
Affiliation(s)
- Luna Girolamini
- Department of Biological, Geological, and Environmental Sciences, University of Bologna, via San Giacomo 12, 40126 Bologna, BO Italy
| | - Silvano Salaris
- Department of Biological, Geological, and Environmental Sciences, University of Bologna, via San Giacomo 12, 40126 Bologna, BO Italy
| | - Maria Rosaria Pascale
- Department of Biological, Geological, and Environmental Sciences, University of Bologna, via San Giacomo 12, 40126 Bologna, BO Italy
| | - Marta Mazzotta
- Department of Biological, Geological, and Environmental Sciences, University of Bologna, via San Giacomo 12, 40126 Bologna, BO Italy
| | - Sandra Cristino
- Department of Biological, Geological, and Environmental Sciences, University of Bologna, via San Giacomo 12, 40126 Bologna, BO Italy
| |
Collapse
|
10
|
De Giglio O, Napoli C, Diella G, Fasano F, Lopuzzo M, Apollonio F, D'Ambrosio M, Campanale C, Triggiano F, Caggiano G, Montagna MT. Integrated approach for legionellosis risk analysis in touristic-recreational facilities. ENVIRONMENTAL RESEARCH 2021; 202:111649. [PMID: 34252427 DOI: 10.1016/j.envres.2021.111649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 06/13/2023]
Abstract
Legionellosis is a severe pneumonia caused by the inhalation of aerosols containing Legionella, Gram-negative bacteria present in the water systems of touristic-recreational facilities. The purpose of this study was to develop a scoring tool to predict the risk of both environmental contamination and Legionnaires' disease cases in such facilities in the Apulia region of southern Italy. We analyzed 47 structural and management parameters/risk factors related to the buildings, water systems, and air conditioning at the facilities. A Poisson regression model was used to compute an overall risk score for each facility with respect to three outcomes: water samples positive for Legionella (risk score range: 7-54), water samples positive for Legionella with an average load exceeding 1000 colony-forming units per liter (CFU/L) (risk score range: 22-179,871), and clinical cases of Legionnaire's disease (risk score range: 6-31). The cut-off values for three outcomes were determined by receiver operating characteristic curves (first outcome, samples positive for Legionella in a touristic-recreational facility: 19; second outcome, samples positive for Legionella in a touristic-recreational facility with an average load exceeding 1000 CFU/L: 2062; third outcome, clinical cases of Legionnaire's disease in a touristic-recreational facility: 22). Above these values, there was a significant probability of observing the outcome. We constructed this predictive model using 70% of a large dataset (18 years of clinical and environmental surveillance) and tested the model on the remaining 30% of the dataset to demonstrate its reliability. Our model enables the assessment of risk for a touristic facility and the creation of a conceptual framework to link the risk analysis with prevention measures.
Collapse
Affiliation(s)
- Osvalda De Giglio
- Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Christian Napoli
- Department of Medical Surgical Sciences and Translational Medicine, "Sapienza" University of Rome, Via di Grottarossa 1035/1039, 00189, Rome, Italy.
| | - Giusy Diella
- Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Fabrizio Fasano
- Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Marco Lopuzzo
- Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Francesca Apollonio
- Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Marilena D'Ambrosio
- Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Carmen Campanale
- Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Francesco Triggiano
- Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Giuseppina Caggiano
- Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Maria Teresa Montagna
- Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124, Bari, Italy.
| |
Collapse
|
11
|
Martinelli M, Calaresu E, Musumeci R, Giubbi C, Perdoni F, Frugoni S, Castriciano S, Scaturro M, Ricci ML, Cocuzza CE. Evaluation of an Environmental Transport Medium for Legionella pneumophila Recovery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168551. [PMID: 34444305 PMCID: PMC8394066 DOI: 10.3390/ijerph18168551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 11/16/2022]
Abstract
The collection and storage of water-related matrices such as biofilm from collection to processing are critical for the detection of Legionella pneumophila by cultural and molecular tests. SRK™ is a liquid medium that acts both as an antimicrobial neutralizing agent and a transport medium for bacterial culture enumeration and is useful to maintain the stability of the sample from collection to analysis. The aims of this study were to evaluate Legionella pneumophila viability and bacterial nucleic acids’ stability in SRK™ medium over time at different storage conditions. Artificial bacterial inoculates with an approximate concentration of 104, 103 and 102 CFU/mL were made using Legionella pneumophila certified reference material suspended in SRK™ medium. Bacteria recovery was analyzed by cultural and molecular methods at time 0, 24 and 48 h at room temperature and at 0, 24, 48 and 72 h at 2–8 °C, respectively. SRK™ medium supported Legionella pneumophila culture viability with CFU counts within the expected range. The recovery after 72 h at 2–8 °C was 83–100% and 75–95% after 48 h at room temperature. Real-time PCR appropriately detected Legionella pneumophila DNA at each temperature condition, dilution and time point. Results demonstrated a good performance of SRK™ medium for the reliable recovery of environmental Legionella.
Collapse
Affiliation(s)
- Marianna Martinelli
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (E.C.); (R.M.); (C.G.); (F.P.); (S.F.); (C.E.C.)
- Correspondence: ; Tel.: +39-02-6448-8359
| | - Enrico Calaresu
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (E.C.); (R.M.); (C.G.); (F.P.); (S.F.); (C.E.C.)
| | - Rosario Musumeci
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (E.C.); (R.M.); (C.G.); (F.P.); (S.F.); (C.E.C.)
| | - Chiara Giubbi
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (E.C.); (R.M.); (C.G.); (F.P.); (S.F.); (C.E.C.)
| | - Federica Perdoni
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (E.C.); (R.M.); (C.G.); (F.P.); (S.F.); (C.E.C.)
| | - Sergio Frugoni
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (E.C.); (R.M.); (C.G.); (F.P.); (S.F.); (C.E.C.)
| | | | - Maria Scaturro
- Istituto Superiore di Sanità, 00161 Roma, Italy; (M.S.); (M.L.R.)
| | | | - Clementina E. Cocuzza
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (E.C.); (R.M.); (C.G.); (F.P.); (S.F.); (C.E.C.)
| |
Collapse
|
12
|
Donohue MJ. Quantification of Legionella pneumophila by qPCR and culture in tap water with different concentrations of residual disinfectants and heterotrophic bacteria. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 774:145142. [PMID: 33610980 PMCID: PMC8358786 DOI: 10.1016/j.scitotenv.2021.145142] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 05/21/2023]
Abstract
Legionellosis prevalence is increasing in the United States. This disease is caused primarily by the bacterium Legionella pneumophila found in water and transmitted by aerosol inhalation. This pathogen has a slow growth rate and can "hide" in amoeba, making it difficult to monitor by the traditional culture method on selective media. Tap water samples (n = 358) collected across the United States were tested for L. pneumophila by both culture and quantitative Polymerase Chain Reaction (qPCR). The presence of other bacteria was quantified by heterotrophic plate counts (HPC). Residual disinfectant concentrations (free chlorine or monochloramine) were measured in all samples. Legionella pneumophila had the highest prevalence and concentration in the chlorinated water samples that had a free‑chlorine value of less than 0.2 mg Cl2/L. In total, 24% (87/358) of the samples were positive for L. pneumophila either by qPCR or 3% (11/358) were positive by culture. In chloramine-treated samples, L. pneumophila was detected by qPCR in 21% (31/148) and 1% (2/148) by culture, despite a high monochloramine residual >1 mg Cl2/L. Despite the presence of a high disinfectant residual (>1 mg Cl2/L), HPC counts were substantial. This study indicates that both culture and qPCR methods have limitations when predicting a potential risk for disease associated with L. pneumophila in tap water. Measuring disinfectant residuals and quantifying HPC in water samples may be useful adjunct parameters for reducing Legionellosis' risk from public water supplies at high-risk locations.
Collapse
Affiliation(s)
- Maura J Donohue
- United States Environmental Protection Agency, Office Research and Development, Center for Environmental Solutions and Emergency Response, Cincinnati, OH 45268, United States of America.
| |
Collapse
|
13
|
Toplitsch D, Platzer S, Zehner R, Maitz S, Mascher F, Kittinger C. Comparison of Updated Methods for Legionella Detection in Environmental Water Samples. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105436. [PMID: 34069615 PMCID: PMC8161308 DOI: 10.3390/ijerph18105436] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 12/04/2022]
Abstract
The difficulty of cultivation of Legionella spp. from water samples remains a strenuous task even for experienced laboratories. The long incubation periods for Legionellae make isolation difficult. In addition, the water samples themselves are often contaminated with accompanying microbial flora, and therefore require complex cultivation methods from diagnostic laboratories. In addition to the recent update of the standard culture method ISO 11731:2017, new strategies such as quantitative PCR (qPCR) are often discussed as alternatives or additions to conventional Legionella culture approaches. In this study, we compared ISO 11731:2017 with qPCR assays targeting Legionella spp., Legionella pneumophila, and Legionella pneumophila serogroup 1. In samples with a high burden of accompanying microbial flora, qPCR shows an excellent negative predictive value for Legionella pneumophila, thus making qPCR an excellent tool for pre-selection of negative samples prior to work-intensive culture methods. This and its low limit of detection make qPCR a diagnostic asset in Legionellosis outbreak investigations, where quick-risk assessments are essential, and are a useful method for monitoring risk sites.
Collapse
|
14
|
Eble D, Gehrig V, Schubert-Ullrich P, Köppel R, Füchslin HP. Comparison of the culture method with multiplex PCR for the confirmation of Legionella spp. and Legionella pneumophila. J Appl Microbiol 2021; 131:2600-2609. [PMID: 33847421 PMCID: PMC9292777 DOI: 10.1111/jam.15103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/04/2021] [Accepted: 04/09/2021] [Indexed: 11/30/2022]
Abstract
AIMS The detection and enumeration of Legionella spp. in water samples are typically performed via a cultural technique standardized in ISO 11731. This method is time-consuming (up to 15 days), and the specificity of the confirmation step is questionable. This study proposes the use of multiplex polymerase chain reaction (PCR) to confirm presumptive Legionella colonies directly from the culture plate; this shortens the response time by 2-5 days while still reporting results in colony forming units (CFU). METHODS AND RESULTS Two laboratories analysed a total of 290 colonies to compare the confirmation step of Legionella spp. and Legionella pneumophila in accordance with ISO 11731 by culture growth and agglutination vs multiplex PCR. Discordant results were resolved by the swiss national reference laboratory. The data were evaluated following ISO 16140 and showed that the PCR-technique had higher specificity. CONCLUSIONS The confirmation of Legionella spp., L. pneumophila and L. pneumophila serogroup 1 by multiplex PCR allows detection of positive colonies more rapidly and with higher specificity. SIGNIFICANCE AND IMPACT OF THE STUDY The study highlights a possibility to shorten the response time significantly during the enumeration of Legionella spp. and achieving a higher specificity while adhering to the legally recognized reporting in CFU.
Collapse
Affiliation(s)
- D Eble
- Industrielle Werke Basel, Basel, Switzerland
| | - V Gehrig
- Kantonales Labor Zürich, Zürich, Switzerland
| | | | - R Köppel
- Kantonales Labor Zürich, Zürich, Switzerland
| | | |
Collapse
|
15
|
Cytotoxicity, Intracellular Replication, and Contact-Dependent Pore Formation of Genotyped Environmental Legionella pneumophila Isolates from Hospital Water Systems in the West Bank, Palestine. Pathogens 2021; 10:pathogens10040417. [PMID: 33915921 PMCID: PMC8066006 DOI: 10.3390/pathogens10040417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/15/2021] [Accepted: 03/28/2021] [Indexed: 12/02/2022] Open
Abstract
Legionella pneumophila is the causative agent of Legionnaires’ disease. Due to the hot climate and intermittent water supply, the West Bank, Palestine, can be considered a high-risk area for this often fatal atypical pneumonia. L. pneumophila occurs in biofilms of natural and man-made freshwater environments, where it infects and replicates intracellularly within protozoa. To correlate the genetic diversity of the bacteria in the environment with their virulence properties for protozoan and mammalian host cells, 60 genotyped isolates from hospital water systems in the West Bank were analyzed. The L. pneumophila isolates were previously genotyped by high resolution Multi Locus Variable Number of Tandem Repeat Analysis (MLVA-8(12)) and sorted according to their relationship in clonal complexes (VACC). Strains of relevant genotypes and VACCs were compared according to their capacity to infect Acanthamoeba castellanii and THP-1 macrophages, and to mediate pore-forming cytotoxicity in sheep red blood cells (sRBCs). Based on a previous detailed analysis of the biogeographic distribution and abundance of the MLVA-8(12)-genotypes, the focus of the study was on the most abundant L. pneumophila- genotypes Gt4(17), Gt6 (18) and Gt10(93) and the four relevant clonal complexes [VACC1, VACC2, VACC5 and VACC11]. The highly abundant genotypes Gt4(17) and Gt6(18) are affiliated with VACC1 and sequence type (ST)1 (comprising L. pneumophila str. Paris), and displayed seroroup (Sg)1. Isolates of these two genotypes exhibited significantly higher virulence potentials compared to other genotypes and clonal complexes in the West Bank. Endemic for the West Bank was the clonal complex VACC11 (affiliated with ST461) represented by three relevant genotypes that all displayed Sg6. These genotypes unique for the West Bank showed a lower infectivity and cytotoxicity compared to all other clonal complexes and their affiliated genotypes. Interestingly, the L. pneumophila serotypes ST1 and ST461 were previously identified by in situ-sequence based typing (SBT) as main causative agents of Legionnaires’ disease (LD) in the West Bank at a comparable level. Overall, this study demonstrates the site-specific regional diversity of L. pneumophila genotypes in the West Bank and suggests that a combination of MLVA, cellular infection assays and hierarchical agglomerative cluster analysis allows an improved genotype-based risk assessment.
Collapse
|
16
|
Leftwich B, Opoku ST, Yin J, Adhikari A. Assessing Hotel Employee Knowledge on Risk Factors and Risk Management Procedures for Microbial Contamination of Hotel Water Distribution Systems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3539. [PMID: 33805459 PMCID: PMC8037688 DOI: 10.3390/ijerph18073539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/13/2021] [Accepted: 03/25/2021] [Indexed: 11/16/2022]
Abstract
Water management plans (WMPs), sometimes referred to as risk management plans (RMPs) or water safety plans (WSPs), are not mandatory for hotels in many countries of the world, including the US. As such, many hotel personnel are uninformed of WMPs and the precautions to take if their hotel water system is compromised. The purpose of this study was to identify hotel personnel's knowledge and practices of WMPs through a survey incorporating the Health Belief Model (HBM). Data were collected from 59 hotels within Fulton County, Georgia, USA, through a questionnaire, and questions were developed tailored to the HBM. Significant associations were found between the perceived susceptibility of contracting a waterborne illness and WMP for hotel personnel as well as between cues to action and having a WMP in general linear models (p ≤ 0.05). The study concludes that many key personnel are not aware of WMPs. Many hotel facilities do not have a plan in place, and some facilities are unaware of a current plan is in place. The study findings provide insight into the importance of WMPs and the risk factors associated with microbial contamination in a hotel building's plumbing system. Future research and potential law change should be emphasized to increase hotel employees' and owner's WMP knowledge.
Collapse
Affiliation(s)
- Brandon Leftwich
- Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA; (B.L.); (S.T.O.)
| | - Samuel T. Opoku
- Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA; (B.L.); (S.T.O.)
| | - Jingjing Yin
- Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA;
| | - Atin Adhikari
- Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA;
| |
Collapse
|
17
|
Editorial Comments to the Special Issue: " Legionella Contamination in Water Environment". Pathogens 2020; 9:pathogens9121017. [PMID: 33276607 PMCID: PMC7761553 DOI: 10.3390/pathogens9121017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/01/2020] [Indexed: 11/29/2022] Open
|
18
|
Zayed AR, Butmeh S, Pecellin M, Salah A, Alalam H, Steinert M, Höfle MG, Bitar DM, Brettar I. Biogeography and Environmental Drivers of Legionella pneumophila Abundance and Genotype Composition Across the West Bank: Relevance of a Genotype-Based Ecology for Understanding Legionella Occurrence. Pathogens 2020; 9:pathogens9121012. [PMID: 33271905 PMCID: PMC7761038 DOI: 10.3390/pathogens9121012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/27/2020] [Accepted: 11/27/2020] [Indexed: 12/20/2022] Open
Abstract
The West Bank can be considered as a high-risk area for Legionella prevalence in drinking water due to high ambient temperature, intermittent water supply, frequent pressure loss, and storage of drinking water in roof containers. To assess occurrence of Legionella species, especially L. pneumophila, in the drinking water of the West Bank, the drinking water distribution systems of eight hospitals were sampled over a period of 2.3 years covering the seasonal cycle and the major geographic regions. To gain insight into potential environmental drivers, a set of physico-chemical and microbiological parameters was recorded. Sampling included drinking water and biofilm analyzed by culture and PCR-based methods. Cultivation led to the isolation of 180 strains of L. pneumophila that were genotyped by Multi-Locus Variable Number of Tandem Repeat Analysis (MLVA). Surprisingly, the abundance of culturable L. pneumophila was low in drinking water of the sampling sites, with only three out of eight sites where Legionella was observed at all (range: 30–500 CFU/Liter). By contrast, biofilm and PCR-based analyses showed a higher prevalence. Statistical analyses with physico-chemical parameters revealed a decrease of L. pneumophila abundance for water and biofilm with increasing magnesium concentrations (>30 mg/L). MLVA-genotype analysis of the L. pneumophila isolates and their spatial distribution indicated three niches characterized by distinct physico-chemical parameters and inhabited by specific consortia of genotypes. This study provides novel insights into mechanisms shaping L. pneumophila populations and triggering their abundance leading to an understanding of their genotype-specific niches and ecology in support of improved prevention measures.
Collapse
Affiliation(s)
- Ashraf R. Zayed
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research (HZI), Inhoffenstrasse 7, 38124 Braunschweig, Germany; (A.R.Z.); (M.P.); (M.G.H.)
- Department of Microbiology and Immunology, Al-Quds University, Abu-Dis, University Street, Jerusalem 19356, Palestine; (S.B.); (A.S.); (H.A.); (D.M.B.)
| | - Suha Butmeh
- Department of Microbiology and Immunology, Al-Quds University, Abu-Dis, University Street, Jerusalem 19356, Palestine; (S.B.); (A.S.); (H.A.); (D.M.B.)
| | - Marina Pecellin
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research (HZI), Inhoffenstrasse 7, 38124 Braunschweig, Germany; (A.R.Z.); (M.P.); (M.G.H.)
| | - Alaa Salah
- Department of Microbiology and Immunology, Al-Quds University, Abu-Dis, University Street, Jerusalem 19356, Palestine; (S.B.); (A.S.); (H.A.); (D.M.B.)
| | - Hanna Alalam
- Department of Microbiology and Immunology, Al-Quds University, Abu-Dis, University Street, Jerusalem 19356, Palestine; (S.B.); (A.S.); (H.A.); (D.M.B.)
| | - Michael Steinert
- Department of Life Sciences, Institute of Microbiology, Technical University of Braunschweig, Universitätsplatz 2, 38106 Braunschweig, Germany;
| | - Manfred G. Höfle
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research (HZI), Inhoffenstrasse 7, 38124 Braunschweig, Germany; (A.R.Z.); (M.P.); (M.G.H.)
| | - Dina M. Bitar
- Department of Microbiology and Immunology, Al-Quds University, Abu-Dis, University Street, Jerusalem 19356, Palestine; (S.B.); (A.S.); (H.A.); (D.M.B.)
| | - Ingrid Brettar
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research (HZI), Inhoffenstrasse 7, 38124 Braunschweig, Germany; (A.R.Z.); (M.P.); (M.G.H.)
- Correspondence:
| |
Collapse
|
19
|
Li S, Yang Z, Hu D, Cao L, He Q. Understanding building-occupant-microbiome interactions toward healthy built environments: A review. FRONTIERS OF ENVIRONMENTAL SCIENCE & ENGINEERING 2020; 15:65. [PMID: 33145119 PMCID: PMC7596174 DOI: 10.1007/s11783-020-1357-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/30/2020] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
Built environments, occupants, and microbiomes constitute a system of ecosystems with extensive interactions that impact one another. Understanding the interactions between these systems is essential to develop strategies for effective management of the built environment and its inhabitants to enhance public health and well-being. Numerous studies have been conducted to characterize the microbiomes of the built environment. This review summarizes current progress in understanding the interactions between attributes of built environments and occupant behaviors that shape the structure and dynamics of indoor microbial communities. In addition, this review also discusses the challenges and future research needs in the field of microbiomes of the built environment that necessitate research beyond the basic characterization of microbiomes in order to gain an understanding of the causal mechanisms between the built environment, occupants, and microbiomes, which will provide a knowledge base for the development of transformative intervention strategies toward healthy built environments. The pressing need to control the transmission of SARS-CoV-2 in indoor environments highlights the urgency and significance of understanding the complex interactions between the built environment, occupants, and microbiomes, which is the focus of this review.
Collapse
Affiliation(s)
- Shuai Li
- Department of Civil and Environmental Engineering, University of Tennessee, Knoxville, TN 37996 USA
| | - Zhiyao Yang
- Lyles School of Civil Engineering, Purdue University, West Lafayette, IN 47907 USA
| | - Da Hu
- Department of Civil and Environmental Engineering, University of Tennessee, Knoxville, TN 37996 USA
| | - Liu Cao
- Department of Civil and Environmental Engineering, University of Tennessee, Knoxville, TN 37996 USA
| | - Qiang He
- Department of Civil and Environmental Engineering, University of Tennessee, Knoxville, TN 37996 USA
- Institute for a Secure & Sustainable Environment, University of Tennessee, Knoxville, TN 37996 USA
| |
Collapse
|
20
|
Zayed AR, Pecellin M, Salah A, Alalam H, Butmeh S, Steinert M, Lesnik R, Brettar I, Höfle MG, Bitar DM. Characterization of Legionella pneumophila Populations by Multilocus Variable Number of Tandem Repeats (MLVA) Genotyping from Drinking Water and Biofilm in Hospitals from Different Regions of the West Bank. Pathogens 2020; 9:E862. [PMID: 33105606 PMCID: PMC7690423 DOI: 10.3390/pathogens9110862] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/17/2020] [Accepted: 10/19/2020] [Indexed: 01/26/2023] Open
Abstract
The West Bank can be considered a high-risk area for Legionnaires' disease (LD) due to its hot climate, intermittent water supply and roof storage of drinking water. Legionella, mostly L. pneumophila, are responsible for LD, a severe, community-acquired and nosocomial pneumonia. To date, no extensive assessment of Legionella spp and L. pneumophila using cultivation in combination with molecular approaches in the West Bank has been published. Two years of environmental surveillance of Legionella in water and biofilms in the drinking water distribution systems (DWDS) of eight hospitals was carried out; 180 L. pneumophila strains were isolated, mostly from biofilms in DWDS. Most of the isolates were identified as serogroup (Sg) 1 (60%) and 6 (30%), while a minor fraction comprised Sg 8 and 10. Multilocus Variable number of tandem repeats Analysis using 13 loci (MLVA-8(12)) was applied as a high-resolution genotyping method and compared to the standard Sequence Based Typing (SBT). The isolates were genotyped in 27 MLVA-8(12) genotypes (Gt), comprising four MLVA clonal complexes (VACC 1; 2; 5; 11). The major fraction of isolates constituted Sequence Type (ST)1 and ST461. Most of the MLVA-genotypes were highly diverse and often unique. The MLVA-genotype composition showed substantial regional variability. In general, the applied MLVA-method made it possible to reproducibly genotype the isolates, and was consistent with SBT but showed a higher resolution. The advantage of the higher resolution was most evident for the subdivision of the large strain sets of ST1 and ST461; these STs were shown to be highly pneumonia-relevant in a former study. This shows that the resolution by MLVA is advantageous for back-tracking risk sites and for the avoidance of outbreaks of L. pneumophila. Overall, our results provide important insights into the detailed population structure of L. pneumophila, allowing for better risk assessment for DWDS.
Collapse
Affiliation(s)
- Ashraf R. Zayed
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research (HZI), Inhoffenstrasse 7, 38124 Braunschweig, Germany; (A.R.Z.); (M.P.); (R.L.); (I.B.)
- Department of Microbiology and Immunology, Al-Quds University, Abu-Dies, East Jerusalem 19356, Palestine; (A.S.); (H.A.); (S.B.); (D.M.B.)
| | - Marina Pecellin
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research (HZI), Inhoffenstrasse 7, 38124 Braunschweig, Germany; (A.R.Z.); (M.P.); (R.L.); (I.B.)
| | - Alaa Salah
- Department of Microbiology and Immunology, Al-Quds University, Abu-Dies, East Jerusalem 19356, Palestine; (A.S.); (H.A.); (S.B.); (D.M.B.)
| | - Hanna Alalam
- Department of Microbiology and Immunology, Al-Quds University, Abu-Dies, East Jerusalem 19356, Palestine; (A.S.); (H.A.); (S.B.); (D.M.B.)
| | - Suha Butmeh
- Department of Microbiology and Immunology, Al-Quds University, Abu-Dies, East Jerusalem 19356, Palestine; (A.S.); (H.A.); (S.B.); (D.M.B.)
| | - Michael Steinert
- Department of Life Sciences, Institute of Microbiology, Technical University of Braunschweig, Universitätsplatz 2, 38106 Braunschweig, Germany;
| | - Rene Lesnik
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research (HZI), Inhoffenstrasse 7, 38124 Braunschweig, Germany; (A.R.Z.); (M.P.); (R.L.); (I.B.)
| | - Ingrid Brettar
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research (HZI), Inhoffenstrasse 7, 38124 Braunschweig, Germany; (A.R.Z.); (M.P.); (R.L.); (I.B.)
| | - Manfred G. Höfle
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research (HZI), Inhoffenstrasse 7, 38124 Braunschweig, Germany; (A.R.Z.); (M.P.); (R.L.); (I.B.)
| | - Dina M. Bitar
- Department of Microbiology and Immunology, Al-Quds University, Abu-Dies, East Jerusalem 19356, Palestine; (A.S.); (H.A.); (S.B.); (D.M.B.)
| |
Collapse
|
21
|
Falzone L, Gattuso G, Lombardo C, Lupo G, Grillo CM, Spandidos DA, Libra M, Salmeri M. Droplet digital PCR for the detection and monitoring of Legionella pneumophila. Int J Mol Med 2020; 46:1777-1782. [PMID: 33000184 PMCID: PMC7521553 DOI: 10.3892/ijmm.2020.4724] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/14/2020] [Indexed: 02/07/2023] Open
Abstract
Legionella pneumophila(L. pneumophila is a harmful pathogen often found in water systems. In hospitals, the absence of L. pneumophila in water systems is mandatory by law, therefore, frequent and effective monitoring of water is of fundamental importance. Molecular methods based on reverse transcription-quantitative polymerase chain reaction (RT-qPCR) have been proposed for the detection of L. pneumophila, however, the sensitivity and accuracy of these methods have not been validated yet. Therefore, it is important to evaluate other strategies able to overcome the limits of culture-based and RT-qPCR methods. On these bases, we compared the sensitivity and accuracy of droplet digital PC (ddPCR) and RT-qPCR in water samples with known concentrations of L. pneumophila and in an in vitro model of water heat treatments. ddPCR showed a higher sensitivity rate and accuracy compared to RT-qPCR in detecting low bacterial load. In addition, ddPCR is not affected by the presence of fragmented DNA and showed higher accuracy than RT-qPC in monitoring the efficacy of heat shock treatments. In conclusion, ddPCR represents an innovative strategy to effectively detect L. pneumophila in water samples. Thanks to its high robustness, ddPCR could be applied also for the detection of L. pneumophila in patients with suspected legionellosis.
Collapse
Affiliation(s)
- Luca Falzone
- Epidemiology Unit, IRCCS Istituto Nazionale Tumori 'Fondazione G. Pascale', I‑80131 Naples, Italy
| | - Giuseppe Gattuso
- Department of Biomedical and Biotechnological Sciences, Section of General Pathology, University of Catania, I‑95123 Catania, Italy
| | - Cinzia Lombardo
- Department of Biomedical and Biotechnological Sciences, Section of Microbiology, University of Catania, I‑95123 Catania, Italy
| | - Gabriella Lupo
- Department of Biomedical and Biotechnological Sciences, Section of Biochemistry, University of Catania, I‑95123 Catania, Italy
| | - Caterina Maria Grillo
- Department of Medical Sciences, Surgical and Advanced Technologies, GF Ingrassia, University of Catania, I‑95123 Catania, Italy
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, Section of General Pathology, University of Catania, I‑95123 Catania, Italy
| | - Mario Salmeri
- Department of Biomedical and Biotechnological Sciences, Section of Microbiology, University of Catania, I‑95123 Catania, Italy
| |
Collapse
|
22
|
Rasheduzzaman M, Singh R, Haas CN, Gurian PL. Required water temperature in hotel plumbing to control Legionella growth. WATER RESEARCH 2020; 182:115943. [PMID: 32590203 DOI: 10.1016/j.watres.2020.115943] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 05/07/2023]
Abstract
Legionella spp. occurring in hotel hot water systems, in particular Legionella pneumophila, are causing serious pneumonic infections, and water temperature is a key factor to control their occurrence in plumbing systems. We performed a systematic review and meta-analyses of the available evidence on the association between water temperature and Legionella colonization to identify the water temperature in hotel hot water systems required for control of Legionella. Qualitative synthesis and quantitative analysis were performed on 13 studies that met our inclusion criteria to identify the effect of temperature. The Receiver Operating Characteristic (ROC) curve identified 55 °C as a cutoff point for hotel hot water temperature with an Area Under the Curve (AUC) value of 0.914. The odds ratios (OR) for detecting Legionella at temperatures >55 °C compared to lower temperatures from a meta-analysis of three studies was 0.17 [95% CI: 0.11, 0.25], which indicates a strong negative association between temperature and Legionella colonization. A logistic regression on results from multiple studies using both molecular and culture methods found a temperature of 59 °C associated with an 8% probability of detectable Legionella. Only two studies reported sufficiently detailed data to allow a model of concentration vs. temperature to be fit, and this model was not statistically significant. Additional research or more detailed reporting of existing datasets is required to assess if Legionella growth can be limited below particular concentration targets at different temperatures.
Collapse
Affiliation(s)
- Md Rasheduzzaman
- Department of Civil, Architectural and Environmental Engineering, Drexel University, 3141 Chestnut Street, Philadelphia, PA, 19104, USA.
| | - Rajveer Singh
- Department of Civil, Architectural and Environmental Engineering, Drexel University, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Charles N Haas
- Department of Civil, Architectural and Environmental Engineering, Drexel University, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Patrick L Gurian
- Department of Civil, Architectural and Environmental Engineering, Drexel University, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
| |
Collapse
|
23
|
Yakunin E, Kostyal E, Agmon V, Grotto I, Valinsky L, Moran-Gilad J. A Snapshot of the Prevalence and Molecular Diversity of Legionella pneumophila in the Water Systems of Israeli Hotels. Pathogens 2020; 9:pathogens9060414. [PMID: 32471136 PMCID: PMC7350324 DOI: 10.3390/pathogens9060414] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/19/2020] [Accepted: 05/23/2020] [Indexed: 11/16/2022] Open
Abstract
Exposure to Legionella spp. contaminated aerosols in hotel settings confers risk for travel-associated Legionnaire’s disease (TALD). In this study, we investigated the prevalence of Legionella contamination and its molecular diversity in hotels and resorts across Israel. The study was comprised of a convenience sample of water systems from 168 hotels and resorts countrywide, routinely inspected between March 2015 and February 2017. Isolation and quantitation of Legionella were performed in a water laboratory using the ISO 11731 method. The distribution of Legionella isolates was analyzed according to geography and source. The genetic diversity of a subset of isolates was analyzed by sequence-based typing (SBT) at the National Reference Laboratory for Legionella and compared to the national database. Out of 2830 samples tested, 470 (17%) obtained from 102 different premises (60% of hotels) were positive for Legionella spp. In 230 samples (49% of all positive, 8% of total samples), accounting for 37% of hotels, Legionella spp. counts exceeded the regulatory threshold of 1000 CFU/L. The most frequently contaminated water sources were cooling towers (38%), followed by faucets, hot tubs, water lines, and storage tanks (14–17% each). Furthermore, 32% and 17% of samples obtained from cooling towers and hot tubs, respectively, exceeded the regulatory thresholds. SBT was performed on 78 strains and revealed 27 different sequence types (STs), including two novel STs. The most prevalent STs found were ST1 (26%), ST87 (10%), ST93 (6%), and ST461 and ST1516 (5% each). Several L. pneumophila STs were found to be limited to certain geographical regions. This is the first study to investigate the prevalence and diversity of Legionella in hotels and resorts in Israel during non-outbreak environmental inspections. These findings will inform risk assessment, surveillance, and control measures of TALD.
Collapse
Affiliation(s)
- Eugenia Yakunin
- Central Laboratories and Public Health Services, Ministry of Health, Jerusalem 9134302, Israel; (E.Y.); (V.A.); (I.G.); (L.V.)
| | - Eszter Kostyal
- Department of Water Microbiology, Biolab Ltd., Jerusalem 9134001, Israel;
| | - Vered Agmon
- Central Laboratories and Public Health Services, Ministry of Health, Jerusalem 9134302, Israel; (E.Y.); (V.A.); (I.G.); (L.V.)
| | - Itamar Grotto
- Central Laboratories and Public Health Services, Ministry of Health, Jerusalem 9134302, Israel; (E.Y.); (V.A.); (I.G.); (L.V.)
- Department of Health Systems Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Lea Valinsky
- Central Laboratories and Public Health Services, Ministry of Health, Jerusalem 9134302, Israel; (E.Y.); (V.A.); (I.G.); (L.V.)
| | - Jacob Moran-Gilad
- Central Laboratories and Public Health Services, Ministry of Health, Jerusalem 9134302, Israel; (E.Y.); (V.A.); (I.G.); (L.V.)
- Department of Health Systems Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
- Correspondence:
| |
Collapse
|
24
|
Edagawa A, Kimura A, Miyamoto H. Investigations on Contamination of Environmental Water Samples by Legionella using Real-Time Quantitative PCR Combined with Amoebic Co-Culturing. Biocontrol Sci 2020; 24:213-220. [PMID: 31875613 DOI: 10.4265/bio.24.213] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
We analyzed the contamination of environmental water samples with Legionella spp. using a conventional culture method, real-time quantitative PCR (qPCR), and real-time qPCR combined with an amoebic co-culture method. Samples (n = 110) were collected from 19 cooling towers, 31 amenity water facilities, and 60 river water sources of tap water in Japan. Legionella was detected in only three samples (3/110, 2.7%) using the culture method. The rate of Legionella detection using amoebic co-culture followed by qPCR was 74.5%, while that using qPCR without amoebic co-culture was 75.5%. A higher than 10-fold bacterial count was observed in 19 samples (19/110, 17.3%) using real-time qPCR subsequent to amoebic co-culture, compared with identical samples analyzed without co-culture. Of these 19 samples, 13 were identified as Legionella spp., including L. pneumophila and L. anisa, and the non-culturable species were identified as L. lytica and L. rowbothamii. This study showed that the detection of Legionella spp., even in those samples where they were not detected by the culture method, was possible using real-time qPCR and an amoebic co-culture method. In addition, this analytical test combination is a useful tool to detect viable and virulent Legionella spp..
Collapse
Affiliation(s)
- Akiko Edagawa
- Department of Environment Health, Osaka Prefectural Institute of Public Health
| | - Akio Kimura
- Department of Environment Health, Osaka Prefectural Institute of Public Health
| | - Hiroshi Miyamoto
- Department of Pathology and Microbiology Faculty of Medicine, Saga University
| |
Collapse
|
25
|
Ghanizadeh G, Gholinezhad M, Khaledi A, Esmaeili D. Heterogeneous catalytically ozonation as a novel disinfectant for inhibition of Legionella pneumophila virulence. GENE REPORTS 2019. [DOI: 10.1016/j.genrep.2019.100534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
26
|
Beauté J, Sandin S, de Jong B, Hallström LP, Robesyn E, Giesecke J, Sparén P, On Behalf Of The European Legionnaires' Disease Surveillance Network. Factors associated with Legionnaires' disease recurrence in hotel and holiday rental accommodation sites. ACTA ACUST UNITED AC 2019; 24. [PMID: 31115313 PMCID: PMC6530253 DOI: 10.2807/1560-7917.es.2019.24.20.1800295] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BackgroundThe detection of a cluster of travel-associated Legionnaires' disease (TALD) cases in any European Union/European Economic Area (EU/EEA) country prompts action at the accommodation, follow-up by health authorities and reporting of measures taken. Some accommodations incur further cases despite presumed implementation of adequate control measures.AimTo identify factors associated with the occurrence of a further TALD case after the implementation of control measures.MethodsWe conducted a retrospective cohort study of hotel and holiday rental accommodations in the EU/EEA associated with two or more TALD cases with onset dates less than 2 years apart (a 'cluster') and notification between 1 June 2011-31 December 2016. We fitted Cox regression models to estimate the association between accommodation characteristics and the occurrence of a further case, defined as any case with onset date after the report on measures taken.ResultsOf the 357 accommodations in the analysis, 90 (25%) were associated with at least one further case after the report on measures taken (12.4/100 accommodation-years). Accommodations associated with two or more cases before the cluster notification were more likely to be associated with a further case, compared with those not previously associated with any case (adjusted hazard ratio 1.85; 95% confidence interval: 1.14-3.02). Neither the detection of Legionella in the water system nor the type of disinfection were found to be associated with the risk of a further case.ConclusionAccommodation size and previous TALD cases were predictive of further Legionnaires' disease cases after implementation of control measures.
Collapse
Affiliation(s)
- Julien Beauté
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Sven Sandin
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, United States.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, United States.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Birgitta de Jong
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - Emmanuel Robesyn
- Department of Public Health Sciences, Karolinska Institutet, Sweden.,European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Johan Giesecke
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Pär Sparén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | |
Collapse
|
27
|
Kyritsi MA, Mouchtouri VA, Katsioulis A, Kostara E, Nakoulas V, Hatzinikou M, Hadjichristodoulou C. Legionella Colonization of Hotel Water Systems in Touristic Places of Greece: Association with System Characteristics and Physicochemical Parameters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2707. [PMID: 30513698 PMCID: PMC6313630 DOI: 10.3390/ijerph15122707] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 11/21/2018] [Accepted: 11/25/2018] [Indexed: 11/17/2022]
Abstract
This study aimed to assess the colonization of hotel water systems in central Greece and Corfu by Legionella, and to investigate the association between physicochemical parameters and Legionella colonization. Standardized hygiene inspection was conducted in 51 hotels, and 556 water samples were analyzed for Legionella spp. Free chlorine concentration, pH, hardness, conductivity, and trace metals were defined in cold water samples. The results of inspections and chemical analyses were associated with the microbiological results using univariate and logistic regression analysis. According to the score of the checklist used for the inspections, 17.6% of the hotels were classified as satisfactory, 15.7% as adequate, and 66.7% as unsatisfactory. Moreover, 74.5% of the hotels were colonized by Legionella spp. and 31.4% required remedial measures according to the European guidelines. Legionella spp. were isolated in 28% of the samples. Unsatisfactory results of inspections were associated with Legionella presence (relative risk (RR) = 7.67, p-value = 0.043). In hot-water systems, <50 °C temperatures increased the risk of Legionella colonization (RR = 5.36, p-value < 0.001). In cold-water systems, free chlorine concentration <0.375 mg/L (odds ratio (OR) = 9.76, p-value = 0.001), pH ≥ 7.45 (OR = 4.05, p-value = 0.007), and hardness ≥321 mgCaCO₃/L (OR = 5.63, p-value = 0.003) increased the risk, whereas copper pipes demonstrated a protective role (OR = 0.29, p-value = 0.0024). The majority of the hotels inspected were colonized with Legionella. Supplementary monitoring of the risk factors that were identified should be considered.
Collapse
Affiliation(s)
- Maria A Kyritsi
- Department of Hygiene and Epidemiology, Medical School, University of Thessaly, 41222 Larissa, Greece.
| | - Varvara A Mouchtouri
- Department of Hygiene and Epidemiology, Medical School, University of Thessaly, 41222 Larissa, Greece.
| | - Antonis Katsioulis
- Department of Hygiene and Epidemiology, Medical School, University of Thessaly, 41222 Larissa, Greece.
- Regional Public Health Laboratory of Thessaly, 41222 Larissa, Greece.
| | - Elina Kostara
- Department of Hygiene and Epidemiology, Medical School, University of Thessaly, 41222 Larissa, Greece.
| | - Vasileios Nakoulas
- Department of Hygiene and Epidemiology, Medical School, University of Thessaly, 41222 Larissa, Greece.
| | - Marina Hatzinikou
- Department of Hygiene and Epidemiology, Medical School, University of Thessaly, 41222 Larissa, Greece.
- Regional Public Health Laboratory of Thessaly, 41222 Larissa, Greece.
| | - Christos Hadjichristodoulou
- Department of Hygiene and Epidemiology, Medical School, University of Thessaly, 41222 Larissa, Greece.
- Regional Public Health Laboratory of Thessaly, 41222 Larissa, Greece.
| |
Collapse
|
28
|
Bonetta S, Pignata C, Bonetta S, Meucci L, Giacosa D, Marino E, Gorrasi I, Gilli G, Carraro E. Effectiveness of a neutral electrolysed oxidising water (NEOW) device in reducing Legionella pneumophila in a water distribution system: A comparison between culture, qPCR and PMA-qPCR detection methods. CHEMOSPHERE 2018; 210:550-556. [PMID: 30029147 DOI: 10.1016/j.chemosphere.2018.07.053] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 05/22/2023]
Abstract
Disinfection of hot water systems is critical for reducing Legionnaires' disease in high-risk buildings. The use of neutral electrolysed oxidising water (NEOW) is a promising method for the control of microorganisms in hot water systems. However, full-scale evaluations of the efficacy of NEOW devices to control Legionella pneumophila are currently lacking. The aim of this study was to assess the effectiveness of a NEOW device in reducing L. pneumophila in a hotel water network. Water samples (n = 67) were collected from different sites of a hotel distribution system before and after the installation of the NEOW device at the 1st, 4th, 8th and 12th week. Detection of L. pneumophila was performed comparing culture, qPCR and PMA-qPCR methods. Total bacterial counts (22 °C and 37 °C), Pseudomonas spp. and physico-chemical parameters were also monitored. The NEOW treatment resulted in a reduction of the amount of L. pneumophila positive samples (-32%) and of the number of heavily contaminated points (>104 CFU/L and >103 CFU/L) (-100% and -96%, respectively). Treatment maintained L. pneumophila at low levels (<102 CFU/L), which do not require specific intervention measures. The effectiveness of the disinfection system was also confirmed by PMA-qPCR (p < 0.001). The use of PMA resulted in a signal decrease in almost all samples upon the disinfection treatment. The NEOW disinfection device appears to be a promising approach to reduce the colonisation of hot water systems by L. pneumophila; however, further investigations are needed to ascertain its efficiency over longer time periods.
Collapse
Affiliation(s)
- Sara Bonetta
- Department of Public Health and Pediatrics, University of Torino, Piazza Polonia 94, 10126, Torino, Italy.
| | - Cristina Pignata
- Department of Public Health and Pediatrics, University of Torino, Piazza Polonia 94, 10126, Torino, Italy
| | - Silvia Bonetta
- Department of Public Health and Pediatrics, University of Torino, Piazza Polonia 94, 10126, Torino, Italy
| | - Lorenza Meucci
- Società Metropolitana Acque Torino S.P.A, C.so XI Febbraio 14, 10152, Torino, Italy
| | - Donatella Giacosa
- Società Metropolitana Acque Torino S.P.A, C.so XI Febbraio 14, 10152, Torino, Italy
| | - Elena Marino
- Società Metropolitana Acque Torino S.P.A, C.so XI Febbraio 14, 10152, Torino, Italy
| | - Ilaria Gorrasi
- Department of Public Health and Pediatrics, University of Torino, Piazza Polonia 94, 10126, Torino, Italy
| | - Giorgio Gilli
- Department of Public Health and Pediatrics, University of Torino, Piazza Polonia 94, 10126, Torino, Italy
| | - Elisabetta Carraro
- Department of Public Health and Pediatrics, University of Torino, Piazza Polonia 94, 10126, Torino, Italy
| |
Collapse
|
29
|
Xiao M, Salam N, Liu L, Jiao JY, Zheng ML, Wang J, Li S, Chen C, Li WJ, Qu PH. Fastidiosibacter lacustris gen. nov., sp. nov., isolated from a lake water sample, and proposal of Fastidiosibacteraceae fam. nov. within the order Thiotrichales. Int J Syst Evol Microbiol 2018; 68:347-352. [PMID: 29185937 DOI: 10.1099/ijsem.0.002510] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Min Xiao
- State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-Sen University, Guangzhou, 510275, PR China
| | - Nimaichand Salam
- State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-Sen University, Guangzhou, 510275, PR China
| | - Lan Liu
- State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-Sen University, Guangzhou, 510275, PR China
| | - Jian-Yu Jiao
- State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-Sen University, Guangzhou, 510275, PR China
| | - Min-Ling Zheng
- Department of Clinical Laboratory, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 51006, PR China
| | - Juan Wang
- Laboratory Medicine Department, Zhongshan People's Hospital, the affiliated hospital of Sun Yat-Sen University, Guangdong Province, PR China
| | - Song Li
- Department of Clinical Laboratory, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, 51006, PR China
| | - Cha Chen
- Department of Clinical Laboratory, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 51006, PR China
- Department of Clinical Laboratory, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, 51006, PR China
| | - Wen-Jun Li
- State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-Sen University, Guangzhou, 510275, PR China
| | - Ping-Hua Qu
- Department of Clinical Laboratory, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 51006, PR China
- Department of Clinical Laboratory, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, 51006, PR China
| |
Collapse
|
30
|
Samhan FA, Stedtfeld TM, Waseem H, Williams MR, Stedtfeld RD, Hashsham SA. On-filter direct amplification of Legionella pneumophila for rapid assessment of its abundance and viability. WATER RESEARCH 2017; 121:162-170. [PMID: 28527390 PMCID: PMC5525548 DOI: 10.1016/j.watres.2017.05.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/08/2017] [Accepted: 05/12/2017] [Indexed: 05/14/2023]
Abstract
Guidelines and regulations to control Legionella pneumophila in cooling water systems of large buildings are evolving due to the increasing number of outbreaks. Rapid, on-site, simple, and sensitive quantification methods that are also able to assess viability may be extremely useful in monitoring and control. Culture-based methods for measuring L. pneumophila may take 4-10 days and qPCR-based methods are also slow, requiring at least a day from sample to result, albeit mainly due to the need for sample transport to a centralized laboratory. This study reports a rapid isothermal amplification method for L. pneumophila concentration and detection with live/dead differentiation under field conditions. Using an on-filter direct amplification (i.e., amplification of cells without DNA extraction and purification) approach with propidium monoazide (PMA), and a real time isothermal amplification platform (Gene-Z), L. pneumophila could be detected in 1-2 h at ∼1 cfu/100 ml of tap water. Signature sequences from 16S rRNA and cadA genes were used as genetic markers for L. pneumophila and loop-mediated isothermal amplification (LAMP) primers were designed using Primer Explorer V4. Result were also compared with direct amplification of cells spiked into distilled, tap, and cooling water samples as well as extracted DNA by qPCR. This method may be useful to managers of cooling water systems in large buildings for rapid detection of L. pneumophila. The overall approach of on-site sample concentration, on-filter amplification, and live/dead differentiation may be extended to other organisms where analytical sensitivity and speed are equally important.
Collapse
Affiliation(s)
- Farag A Samhan
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, USA
| | - Tiffany M Stedtfeld
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, USA
| | - Hassan Waseem
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, USA
| | - Maggie R Williams
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, USA
| | - Robert D Stedtfeld
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, USA
| | - Syed A Hashsham
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, USA; Center for Microbial Ecology, Michigan State University, East Lansing, MI, USA.
| |
Collapse
|
31
|
Kober C, Niessner R, Seidel M. Quantification of viable and non-viable Legionella spp. by heterogeneous asymmetric recombinase polymerase amplification (haRPA) on a flow-based chemiluminescence microarray. Biosens Bioelectron 2017; 100:49-55. [PMID: 28863324 DOI: 10.1016/j.bios.2017.08.053] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/01/2017] [Accepted: 08/23/2017] [Indexed: 11/19/2022]
Abstract
Increasing numbers of legionellosis outbreaks within the last years have shown that Legionella are a growing challenge for public health. Molecular biological detection methods capable of rapidly identifying viable Legionella are important for the control of engineered water systems. The current gold standard based on culture methods takes up to 10 days to show positive results. For this reason, a flow-based chemiluminescence (CL) DNA microarray was developed that is able to quantify viable and non-viable Legionella spp. as well as Legionella pneumophila in one hour. An isothermal heterogeneous asymmetric recombinase polymerase amplification (haRPA) was carried out on flow-based CL DNA microarrays. Detection limits of 87 genomic units (GU) µL-1 and 26GUµL-1 for Legionella spp. and Legionella pneumophila, respectively, were achieved. In this work, it was shown for the first time that the combination of a propidium monoazide (PMA) treatment with haRPA, the so-called viability haRPA, is able to identify viable Legionella on DNA microarrays. Different proportions of viable and non-viable Legionella, shown with the example of L. pneumophila, ranging in a total concentration between 101 to 105GUµL-1 were analyzed on the microarray analysis platform MCR 3. Recovery values for viable Legionella spp. were found between 81% and 133%. With the combination of these two methods, there is a chance to replace culture-based methods in the future for the monitoring of engineered water systems like condensation recooling plants.
Collapse
Affiliation(s)
- Catharina Kober
- Institute of Hydrochemistry, Chair of Analytical Chemistry and Water Chemistry, Technical University of Munich, Marchioninistrasse 17, 81377 München, Germany
| | - Reinhard Niessner
- Institute of Hydrochemistry, Chair of Analytical Chemistry and Water Chemistry, Technical University of Munich, Marchioninistrasse 17, 81377 München, Germany
| | - Michael Seidel
- Institute of Hydrochemistry, Chair of Analytical Chemistry and Water Chemistry, Technical University of Munich, Marchioninistrasse 17, 81377 München, Germany.
| |
Collapse
|
32
|
Wang H, Bédard E, Prévost M, Camper AK, Hill VR, Pruden A. Methodological approaches for monitoring opportunistic pathogens in premise plumbing: A review. WATER RESEARCH 2017; 117:68-86. [PMID: 28390237 PMCID: PMC5693313 DOI: 10.1016/j.watres.2017.03.046] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/19/2017] [Accepted: 03/22/2017] [Indexed: 05/06/2023]
Abstract
Opportunistic premise (i.e., building) plumbing pathogens (OPPPs, e.g., Legionella pneumophila, Mycobacterium avium complex, Pseudomonas aeruginosa, Acanthamoeba, and Naegleria fowleri) are a significant and growing source of disease. Because OPPPs establish and grow as part of the native drinking water microbiota, they do not correspond to fecal indicators, presenting a major challenge to standard drinking water monitoring practices. Further, different OPPPs present distinct requirements for sampling, preservation, and analysis, creating an impediment to their parallel detection. The aim of this critical review is to evaluate the state of the science of monitoring OPPPs and identify a path forward for their parallel detection and quantification in a manner commensurate with the need for reliable data that is informative to risk assessment and mitigation. Water and biofilm sampling procedures, as well as factors influencing sample representativeness and detection sensitivity, are critically evaluated with respect to the five representative bacterial and amoebal OPPPs noted above. Available culturing and molecular approaches are discussed in terms of their advantages, limitations, and applicability. Knowledge gaps and research needs towards standardized approaches are identified.
Collapse
Affiliation(s)
- Hong Wang
- State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai 200092, China.
| | - Emilie Bédard
- Department of Civil Engineering, Polytechnique Montreal, Montreal, QC, Canada
| | - Michèle Prévost
- Department of Civil Engineering, Polytechnique Montreal, Montreal, QC, Canada
| | - Anne K Camper
- Center for Biofilm Engineering and Department of Civil Engineering, Montana State University, Bozeman, MT 59717, USA
| | - Vincent R Hill
- Waterborne Disease Prevention Branch, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329, USA
| | - Amy Pruden
- Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA 24061, USA
| |
Collapse
|
33
|
Bonetta S, Pignata C, Bonetta S, Meucci L, Giacosa D, Marino E, Gilli G, Carraro E. Viability of Legionella pneumophila in Water Samples: A Comparison of Propidium Monoazide (PMA) Treatment on Membrane Filters and in Liquid. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14050467. [PMID: 28448459 PMCID: PMC5451918 DOI: 10.3390/ijerph14050467] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/18/2017] [Accepted: 04/20/2017] [Indexed: 11/16/2022]
Abstract
Legionella pneumophila is a ubiquitous microorganism widely distributed in aquatic environments and can cause Legionellosis in humans. A promising approach to detect viable cells in water samples involves the use of quantitative polymerase chain reaction (qPCR) in combination with photoactivatable DNA intercalator propidium monoazide (PMA). However, the PMA efficiency could be different depending on the experimental conditions used. The aim of this study was to compare two PMA exposure protocols: (A) directly on the membrane filter or (B) in liquid after filter washing. The overall PMA-induced qPCR means reductions in heat-killed L. pneumophila cells were 2.42 and 1.91 log units for exposure protocols A and B, respectively. A comparison between the results obtained reveals that filter exposure allows a higher PMA-qPCR signal reduction to be reached, mainly at low concentrations (p < 0.05). This confirms the potential use of this method to quantify L. pneumophila in water with low contamination.
Collapse
Affiliation(s)
- Sara Bonetta
- Department of Public Health and Pediatrics, University of Torino, P.zza Polonia 94, 10126 Torino, Italy.
| | - Cristina Pignata
- Department of Public Health and Pediatrics, University of Torino, P.zza Polonia 94, 10126 Torino, Italy.
| | - Silvia Bonetta
- Department of Public Health and Pediatrics, University of Torino, P.zza Polonia 94, 10126 Torino, Italy.
| | - Lorenza Meucci
- Società Metropolitana Acque Torino S.p.A., C.so XI Febbraio, 14, 10152 Torino, Italy.
| | - Donatella Giacosa
- Società Metropolitana Acque Torino S.p.A., C.so XI Febbraio, 14, 10152 Torino, Italy.
| | - Elena Marino
- Società Metropolitana Acque Torino S.p.A., C.so XI Febbraio, 14, 10152 Torino, Italy.
| | - Giorgio Gilli
- Department of Public Health and Pediatrics, University of Torino, P.zza Polonia 94, 10126 Torino, Italy.
| | - Elisabetta Carraro
- Department of Public Health and Pediatrics, University of Torino, P.zza Polonia 94, 10126 Torino, Italy.
| |
Collapse
|
34
|
Lösch LS, Merino LA. [Presence of Legionella spp. in household drinking water reservoirs in Resistencia, Chaco, Argentina. Preliminary report]. Rev Argent Microbiol 2016; 48:329-332. [PMID: 28029443 DOI: 10.1016/j.ram.2016.07.002] [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: 04/04/2016] [Revised: 06/16/2016] [Accepted: 07/05/2016] [Indexed: 11/30/2022] Open
Abstract
Legionella spp. is an environmental bacterium that can survive in a wide range of physicochemical conditions and may colonize distribution systems of drinking water and storage tanks. Legionella pneumophila is the major waterborne pathogen that can cause 90% of Legionnaires' disease cases. The aim of this study was to detect the presence of Legionella spp. in household drinking water tanks in the city of Resistencia, Chaco. The detection of Legionella in water samples was performed by culture methods as set out in ISO 11731:1998. Thirty two water samples were analyzed and Legionella spp. was recovered in 12 (37.5%) of them. The monitoring of this microorganism in drinking water is the first step towards addressing the control of its spread to susceptible hosts.
Collapse
Affiliation(s)
- Liliana S Lösch
- Área de Bacteriología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Chaco, Argentina; Cátedra de Microbiología, Parasitología e Inmunología, Facultad de Medicina, Universidad Nacional del Nordeste, Corrientes, Argentina.
| | - Luis A Merino
- Área de Bacteriología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Chaco, Argentina; Cátedra de Microbiología, Parasitología e Inmunología, Facultad de Medicina, Universidad Nacional del Nordeste, Corrientes, Argentina
| |
Collapse
|
35
|
Ahmed W, Staley C, Sidhu J, Sadowsky M, Toze S. Amplicon-based profiling of bacteria in raw and secondary treated wastewater from treatment plants across Australia. Appl Microbiol Biotechnol 2016; 101:1253-1266. [DOI: 10.1007/s00253-016-7959-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 10/18/2016] [Accepted: 10/24/2016] [Indexed: 11/28/2022]
|
36
|
Hamilton KA, Ahmed W, Palmer A, Sidhu JPS, Hodgers L, Toze S, Haas CN. Public health implications of Acanthamoeba and multiple potential opportunistic pathogens in roof-harvested rainwater tanks. ENVIRONMENTAL RESEARCH 2016; 150:320-327. [PMID: 27336236 DOI: 10.1016/j.envres.2016.06.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 06/07/2016] [Accepted: 06/08/2016] [Indexed: 06/06/2023]
Abstract
A study of six potential opportunistic pathogens (Acanthamoeba spp., Legionella spp., Legionella longbeachae, Pseudomonas aeruginosa, Mycobacterium avium and Mycobacterium intracellulare) and an accidental human pathogen (Legionella pneumophila) in 134 roof-harvested rainwater (RHRW) tank samples was conducted using quantitative PCR (qPCR). All five opportunistic pathogens and accidental pathogen L. pneumophila were detected in rainwater tanks except Legionella longbeachae. Concentrations ranged up to 3.1×10(6) gene copies per L rainwater for Legionella spp., 9.6×10(5) gene copies per L for P. aeruginosa, 6.8×10(5) gene copies per L for M. intracellulare, 6.6×10(5) gene copies per L for Acanthamoeba spp., 1.1×10(5) gene copies per L for M. avium, and 9.8×10(3) gene copies per L for L. pneumophila. Among the organisms tested, Legionella spp. (99% tanks) were the most prevalent followed by M. intracellulare (78%). A survey of tank-owners provided data on rainwater end-uses. Fecal indicator bacteria (FIB) Escherichia coli and Enterococcus spp. were enumerated using culture-based methods, and assessed for correlations with opportunistic pathogens and L. pneumophila tested in this study. Opportunistic pathogens did not correlate well with FIB except E. coli vs. Legionella spp. (tau=0.151, P=0.009) and E. coli vs. M. intracellulare (tau=0.14, P=0.015). However, M. avium weakly correlated with both L. pneumophila (Kendall's tau=0.017, P=0.006) and M. intracellulare (tau=0.088, P=0.027), and Legionella spp. also weakly correlated with M. intracellulare (tau=0.128, P=0.028). The presence of these potential opportunistic pathogens in tank water may present health risks from both the potable and non-potable uses documented from the current survey data.
Collapse
Affiliation(s)
- K A Hamilton
- CSIRO Land and Water, Ecosciences Precinct, 41 Boggo Road, Qld 4102, Australia; Drexel University, 3141 Chestnut Street, Philadelphia, PA 19104, USA
| | - W Ahmed
- CSIRO Land and Water, Ecosciences Precinct, 41 Boggo Road, Qld 4102, Australia.
| | - A Palmer
- CSIRO Land and Water, Ecosciences Precinct, 41 Boggo Road, Qld 4102, Australia
| | - J P S Sidhu
- CSIRO Land and Water, Ecosciences Precinct, 41 Boggo Road, Qld 4102, Australia
| | - L Hodgers
- CSIRO Land and Water, Ecosciences Precinct, 41 Boggo Road, Qld 4102, Australia
| | - S Toze
- CSIRO Land and Water, Ecosciences Precinct, 41 Boggo Road, Qld 4102, Australia
| | - C N Haas
- Drexel University, 3141 Chestnut Street, Philadelphia, PA 19104, USA
| |
Collapse
|
37
|
Ahmadrajabi R, Shakibaie MR, Iranmanesh Z, Mollaei HR, Sobhanipoor MH. Prevalence of mip virulence gene and PCR-base sequence typing of Legionella pneumophila from cooling water systems of two cities in Iran. Virulence 2016; 7:602-9. [PMID: 27028760 DOI: 10.1080/21505594.2016.1170944] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Legionella pneumophila is the primary respiratory pathogen and mostly transmitted to human through water cooling systems and cause mild to severe pneumonia with high mortality rate especially in elderly both in hospitals and community. However, current Legionella risk assessments may be compromised by uncertainties in Legionella detection methods. Here, we investigated the presence of L. pneumophila mip gene in water samples collected from different hospitals cooling towers, nursing homes and building/hotels water coolants from two geographical locations of Iran (Kerman and Bam cities) during summer season of 2015 by both nested and real-time PCR methods. Analysis of the 128 water samples for presence of the mip gene by nested-PCR revealed, 18 (23%) positive cases in Kerman and 7(14%) in Bam. However, when samples were tested by real-time PCR, we identified 4 more new cases of L. pneumophila in the hospitals as well as nursing homes water systems that were missed by nested-PCR. The highest rate of contamination was detected in water obtained from hospitals cooling towers in both the cities (p≤0.05). Dendrogram analysis and clonal relationship by PCR-base sequence typing (SBT) of the L. pneumophila genomic DNAs in Kerman water samples showed close clonal similarities among the isolates, in contrast, isolates identified from Bam city demonstrated two fingerprint patterns. The clones from hospital water samples were more related to the L. pneumophila serogroup- 1.
Collapse
Affiliation(s)
- Roya Ahmadrajabi
- a Faculty of Medicine, Microbiology Section, Bam University of Medical Sciences , Bam , Iran
| | - Mohammad Reza Shakibaie
- b Department of Microbiology and Virology , Kerman University of Medical Sciences , Kerman , Iran.,c Environmental Health and Engineering Research Center, Kerman University of Medical Sciences , Kerman , Iran
| | - Zahra Iranmanesh
- b Department of Microbiology and Virology , Kerman University of Medical Sciences , Kerman , Iran
| | - Hamid Reza Mollaei
- b Department of Microbiology and Virology , Kerman University of Medical Sciences , Kerman , Iran
| | | |
Collapse
|
38
|
Scaturro M, Fontana S, Dell’eva I, Helfer F, Marchio M, Stefanetti MV, Cavallaro M, Miglietta M, Montagna MT, De Giglio O, Cuna T, Chetti L, Sabattini MAB, Carlotti M, Viggiani M, Stenico A, Romanin E, Bonanni E, Ottaviano C, Franzin L, Avanzini C, Demarie V, Corbella M, Cambieri P, Marone P, Rota MC, Bella A, Ricci ML. A multicenter study of viable PCR using propidium monoazide to detect Legionella in water samples. Diagn Microbiol Infect Dis 2016; 85:283-288. [DOI: 10.1016/j.diagmicrobio.2016.04.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/21/2016] [Accepted: 04/11/2016] [Indexed: 11/26/2022]
|
39
|
Edagawa A, Kimura A, Kawabuchi-Kurata T, Adachi S, Furuhata K, Miyamoto H. Investigation of Legionella Contamination in Bath Water Samples by Culture, Amoebic Co-Culture, and Real-Time Quantitative PCR Methods. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:13118-30. [PMID: 26492259 PMCID: PMC4627020 DOI: 10.3390/ijerph121013118] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/13/2015] [Accepted: 10/14/2015] [Indexed: 11/16/2022]
Abstract
We investigated Legionella contamination in bath water samples, collected from 68 bathing facilities in Japan, by culture, culture with amoebic co-culture, real-time quantitative PCR (qPCR), and real-time qPCR with amoebic co-culture. Using the conventional culture method, Legionella pneumophila was detected in 11 samples (11/68, 16.2%). Contrary to our expectation, the culture method with the amoebic co-culture technique did not increase the detection rate of Legionella (4/68, 5.9%). In contrast, a combination of the amoebic co-culture technique followed by qPCR successfully increased the detection rate (57/68, 83.8%) compared with real-time qPCR alone (46/68, 67.6%). Using real-time qPCR after culture with amoebic co-culture, more than 10-fold higher bacterial numbers were observed in 30 samples (30/68, 44.1%) compared with the same samples without co-culture. On the other hand, higher bacterial numbers were not observed after propagation by amoebae in 32 samples (32/68, 47.1%). Legionella was not detected in the remaining six samples (6/68, 8.8%), irrespective of the method. These results suggest that application of the amoebic co-culture technique prior to real-time qPCR may be useful for the sensitive detection of Legionella from bath water samples. Furthermore, a combination of amoebic co-culture and real-time qPCR might be useful to detect viable and virulent Legionella because their ability to invade and multiply within free-living amoebae is considered to correlate with their pathogenicity for humans. This is the first report evaluating the efficacy of the amoebic co-culture technique for detecting Legionella in bath water samples.
Collapse
Affiliation(s)
- Akiko Edagawa
- Division of Environment Health, Osaka Prefectural Institute of Public Health, Osaka 537-0025, Japan.
- Division of Microbiology, Department of Pathology and Microbiology, Faculty of Medicine, Saga University, Saga 849-8501, Japan.
| | - Akio Kimura
- Division of Planning and Coordination, Osaka Prefectural Institute of Public Health, Osaka 537-0025, Japan.
| | | | - Shinichi Adachi
- Division of Environment Health, Osaka Prefectural Institute of Public Health, Osaka 537-0025, Japan.
| | - Katsunori Furuhata
- School of Life and Environmental Science, Azabu University, Kanagawa 252-5201, Japan.
| | - Hiroshi Miyamoto
- Division of Microbiology, Department of Pathology and Microbiology, Faculty of Medicine, Saga University, Saga 849-8501, Japan.
| |
Collapse
|
40
|
Mouchtouri VA, Rudge JW. Legionnaires' Disease in Hotels and Passenger Ships: A Systematic Review of Evidence, Sources, and Contributing Factors. J Travel Med 2015. [PMID: 26220258 DOI: 10.1111/jtm.12225] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Travel-associated Legionnaires' disease (LD) is a serious problem, and hundreds of cases are reported every year among travelers who stayed at hotels, despite the efforts of international and governmental authorities and hotel operators to prevent additional cases. METHODS A systematic review of travel-associated LD events (cases, clusters, outbreaks) and of environmental studies of Legionella contamination in accommodation sites was conducted. Two databases were searched (PubMed and EMBASE). Data were extracted from 50 peer-reviewed articles that provided microbiological and epidemiological evidence for linking the accommodation sites with LD. The strength of evidence was classified as strong, possible, and probable. RESULTS Three of the 21 hotel-associated events identified and four of nine ship-associated events occurred repeatedly on the same site. Of 197 hotel-associated cases, 158 (80.2%) were linked to hotel cooling towers and/or potable water systems. Ship-associated cases were most commonly linked to hot tubs (59/83, 71.1%). Common contributing factors included inadequate disinfection, maintenance, and monitoring; water stagnation; poor temperature control; and poor ventilation. Across all 30 events, Legionella concentrations in suspected water sources were >10,000 cfu/L, <10,000 cfu/L, and unknown in 11, 3, and 13 events, respectively. In five events, Legionella was not detected only after repeated disinfections. In environmental studies, Legionella was detected in 81.1% of ferries (23/28) and 48.9% of hotels (587/1,200), while all 12 cruise ships examined were negative. CONCLUSIONS This review highlights the need for LD awareness strategies targeting operators of accommodation sites. Increased standardization of LD investigation and reporting, and more rigorous follow-up of LD events, would help generate stronger, more comparable evidence on LD sources, contributing factors, and control measure effectiveness.
Collapse
Affiliation(s)
- Varvara A Mouchtouri
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - James W Rudge
- Communicable Diseases Policy Research Group, London School of Hygiene & Tropical Medicine, Bangkok Office, Mahidol University, Bangkok, Thailand
| |
Collapse
|
41
|
Divan Khosroshahi N, Naserpour Farivar T, Johari P. Identification of Legionella Pneumophila in Intubated Patients With TaqMan Real Time PCR. Jundishapur J Microbiol 2015; 8:e15094. [PMID: 25834717 PMCID: PMC4377168 DOI: 10.5812/jjm.15094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Revised: 06/07/2014] [Accepted: 06/14/2014] [Indexed: 11/16/2022] Open
Abstract
Background: Legionellaceae contains Legionella genus with over 52 species and 64 serogroups. It is one of the most important causes of respiratory disease in human. More than 30% of hospital-acquired pneumonia is caused by Legionella. Ventilator-associated pneumonia (VAP) is an infection acquired in hospital wards, particularly in intensive care unit (ICU). This disease approximately affects 9% to 20% of intubated patients. Mortality in these patients varies between 8% and 76%. Legionella is one of the important factors for infection in intubated patients. Objectives: The present study was aimed to investigate the use of molecular methods in diagnosis of infection caused by Legionella pneumophila. Materials and Methods: In this study, 109 samples of lung secretions collected from intubated patients admitted to ICU wards of four university hospitals in a three-month period were examined. Cultivation and Real time Polymerase Chain Reaction (PCR) methods were used to assess L. pneumophila colonization in these samples. Results: Eleven samples had positive results using real time PCR analysis of 16s rRNA gene fragments specific for L. pneumophila, but according to culture method on specific buffered charcoal-yeast extract medium (BCYE), no positive cases were detected. Of the total positive cases, six were males, one female and four infants. The seven adults aged 40-65 years. Conclusions: Using molecular methods in diagnosis of infection caused by L. pneumophila has a great value because of its high specificity and rapid diagnosis potency.
Collapse
Affiliation(s)
- Nader Divan Khosroshahi
- Cellular and Molecular Research Centre, Qazvin University of Medical Sciences, Qazvin, IR Iran
| | - Taghi Naserpour Farivar
- Cellular and Molecular Research Centre, Qazvin University of Medical Sciences, Qazvin, IR Iran
- Corresponding author: Taghi Naserpour Farivar, Cellular and Molecular Research Centre, Qazvin University of Medical Sciences, Qazvin, IR Iran. Tel: +98-9128801401, Fax: +98-2833324971., E-mail:
| | - Pouran Johari
- Cellular and Molecular Research Centre, Qazvin University of Medical Sciences, Qazvin, IR Iran
| |
Collapse
|
42
|
Bédard E, Fey S, Charron D, Lalancette C, Cantin P, Dolcé P, Laferrière C, Déziel E, Prévost M. Temperature diagnostic to identify high risk areas and optimize Legionella pneumophila surveillance in hot water distribution systems. WATER RESEARCH 2015; 71:244-56. [PMID: 25622002 DOI: 10.1016/j.watres.2015.01.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Revised: 12/22/2014] [Accepted: 01/05/2015] [Indexed: 05/08/2023]
Abstract
Legionella pneumophila is frequently detected in hot water distribution systems and thermal control is a common measure implemented by health care facilities. A risk assessment based on water temperature profiling and temperature distribution within the network is proposed, to guide effective monitoring strategies and allow the identification of high risk areas. Temperature and heat loss at control points (water heater, recirculation, representative points-of-use) were monitored in various sections of five health care facilities hot water distribution systems and results used to develop a temperature-based risk assessment tool. Detailed investigations show that defective return valves in faucets can cause widespread temperature losses because of hot and cold water mixing. Systems in which water temperature coming out of the water heaters was kept consistently above 60 °C and maintained above 55 °C across the network were negative for Legionella by culture or qPCR. For systems not meeting these temperature criteria, risk areas for L. pneumophila were identified using temperature profiling and system's characterization; higher risk was confirmed by more frequent microbiological detection by culture and qPCR. Results confirmed that maintaining sufficiently high temperatures within hot water distribution systems suppressed L. pneumophila culturability. However, the risk remains as shown by the persistence of L. pneumophila by qPCR.
Collapse
Affiliation(s)
- Emilie Bédard
- Department of Civil Engineering, Polytechnique Montréal, Montréal, QC, Canada; INRS-Institut Armand-Frappier, Laval, QC, Canada.
| | - Stéphanie Fey
- Department of Civil Engineering, Polytechnique Montréal, Montréal, QC, Canada
| | - Dominique Charron
- Department of Civil Engineering, Polytechnique Montréal, Montréal, QC, Canada
| | | | - Philippe Cantin
- Centre d'expertise en analyse environnementale du Québec, Québec, QC, Canada
| | - Patrick Dolcé
- Department of Medical Microbiology and Infectious Diseases, Centre Hospitalier Régional de Rimouski, Rimouski, QC, Canada
| | - Céline Laferrière
- Department of Microbiology and Immunology (Infection Control), CHU Ste-Justine, Université de Montréal, Montréal, QC, Canada
| | - Eric Déziel
- INRS-Institut Armand-Frappier, Laval, QC, Canada
| | - Michèle Prévost
- Department of Civil Engineering, Polytechnique Montréal, Montréal, QC, Canada
| |
Collapse
|
43
|
Liao C, Peng ZY, Li JB, Cui XW, Zhang ZH, Malakar PK, Zhang WJ, Pan YJ, Zhao Y. Simultaneous construction of PCR-DGGE-based predictive models of Listeria monocytogenes and Vibrio parahaemolyticus on cooked shrimps. Lett Appl Microbiol 2015; 60:210-6. [PMID: 25470339 DOI: 10.1111/lam.12376] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 11/28/2014] [Accepted: 12/01/2014] [Indexed: 11/27/2022]
Abstract
UNLABELLED The aim of this study was to simultaneously construct PCR-DGGE-based predictive models of Listeria monocytogenes and Vibrio parahaemolyticus on cooked shrimps at 4 and 10°C. Calibration curves were established to correlate peak density of DGGE bands with microbial counts. Microbial counts derived from PCR-DGGE and plate methods were fitted by Baranyi model to obtain molecular and traditional predictive models. For L. monocytogenes, growing at 4 and 10°C, molecular predictive models were constructed. It showed good evaluations of correlation coefficients (R(2) > 0.92), bias factors (Bf ) and accuracy factors (Af ) (1.0 ≤ Bf ≤ Af ≤ 1.1). Moreover, no significant difference was found between molecular and traditional predictive models when analysed on lag phase (λ), maximum growth rate (μmax ) and growth data (P > 0.05). But for V. parahaemolyticus, inactivated at 4 and 10°C, molecular models show significant difference when compared with traditional models. Taken together, these results suggest that PCR-DGGE based on DNA can be used to construct growth models, but it is inappropriate for inactivation models yet. This is the first report of developing PCR-DGGE to simultaneously construct multiple molecular models. SIGNIFICANCE AND IMPACT OF THE STUDY It has been known for a long time that microbial predictive models based on traditional plate methods are time-consuming and labour-intensive. Denaturing gradient gel electrophoresis (DGGE) has been widely used as a semiquantitative method to describe complex microbial community. In our study, we developed DGGE to quantify bacterial counts and simultaneously established two molecular predictive models to describe the growth and survival of two bacteria (Listeria monocytogenes and Vibrio parahaemolyticus) at 4 and 10°C. We demonstrated that PCR-DGGE could be used to construct growth models. This work provides a new approach to construct molecular predictive models and thereby facilitates predictive microbiology and QMRA (Quantitative Microbial Risk Assessment).
Collapse
Affiliation(s)
- C Liao
- College of Food Science and Technology, Shanghai Ocean University, Shanghai, China
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Mercante JW, Winchell JM. Current and emerging Legionella diagnostics for laboratory and outbreak investigations. Clin Microbiol Rev 2015; 28:95-133. [PMID: 25567224 PMCID: PMC4284297 DOI: 10.1128/cmr.00029-14] [Citation(s) in RCA: 213] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Legionnaires' disease (LD) is an often severe and potentially fatal form of bacterial pneumonia caused by an extensive list of Legionella species. These ubiquitous freshwater and soil inhabitants cause human respiratory disease when amplified in man-made water or cooling systems and their aerosols expose a susceptible population. Treatment of sporadic cases and rapid control of LD outbreaks benefit from swift diagnosis in concert with discriminatory bacterial typing for immediate epidemiological responses. Traditional culture and serology were instrumental in describing disease incidence early in its history; currently, diagnosis of LD relies almost solely on the urinary antigen test, which captures only the dominant species and serogroup, Legionella pneumophila serogroup 1 (Lp1). This has created a diagnostic "blind spot" for LD caused by non-Lp1 strains. This review focuses on historic, current, and emerging technologies that hold promise for increasing LD diagnostic efficiency and detection rates as part of a coherent testing regimen. The importance of cooperation between epidemiologists and laboratorians for a rapid outbreak response is also illustrated in field investigations conducted by the CDC with state and local authorities. Finally, challenges facing health care professionals, building managers, and the public health community in combating LD are highlighted, and potential solutions are discussed.
Collapse
Affiliation(s)
- Jeffrey W Mercante
- Pneumonia Response and Surveillance Laboratory, Respiratory Diseases Branch, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jonas M Winchell
- Pneumonia Response and Surveillance Laboratory, Respiratory Diseases Branch, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|
45
|
Taylor MJ, Bentham RH, Ross KE. Limitations of Using Propidium Monoazide with qPCR to Discriminate between Live and Dead Legionella in Biofilm Samples. Microbiol Insights 2014; 7:15-24. [PMID: 25288885 PMCID: PMC4167484 DOI: 10.4137/mbi.s17723] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 06/30/2014] [Accepted: 07/08/2014] [Indexed: 01/17/2023] Open
Abstract
Accurately quantifying Legionella for regulatory purposes to protect public health is essential. Real-time PCR (qPCR) has been proposed as a better method for detecting and enumerating Legionella in samples than conventional culture method. However, since qPCR amplifies any target DNA in the sample, the technique’s inability to discriminate between live and dead cells means that counts are generally significantly overestimated. Propidium monoazide (PMA) has been used successfully in qPCR to aid live/dead discrimination. We tested PMA use as a method to count only live Legionella cells in samples collected from a modified chemostat that generates environmentally comparable samples. Counts from PMA-treated samples that were pretreated with either heat or three types of disinfectants (to kill the cells) were highly variable, with the only consistent trend being the relationship between biofilm mass and numbers of Legionella cells. Two possibilities explain this result: 1. PMA treatment worked and the subsequent muted response of Legionella to disinfection treatment is a factor of biofilm/microbiological effects; although this does not account for the relationship between the amount of biofilm sampled and the viable Legionella count as determined by PMA-qPCR; or 2. PMA treatment did not work, and any measured decrease or increase in detectable Legionella is because of other factors affecting the method. This is the most likely explanation for our results, suggesting that higher concentrations of PMA might be needed to compensate for the presence of other compounds in an environmental sample or that lower amounts of biofilm need to be sampled. As PMA becomes increasingly toxic at higher concentrations and is very expensive, augmenting the method to include higher PMA concentrations is both counterproductive and cost prohibitive. Conversely, if smaller volumes of biofilm are used, the reproducibility of the method is reduced. Our results suggest that using PMA is not an appropriate method for discriminating between live and dead cells to enumerate Legionella for regulatory purposes.
Collapse
Affiliation(s)
- Michael J Taylor
- Health and Environment, School of the Environment, Flinders University, Adelaide, Australia
| | - Richard H Bentham
- Health and Environment, School of the Environment, Flinders University, Adelaide, Australia
| | - Kirstin E Ross
- Health and Environment, School of the Environment, Flinders University, Adelaide, Australia
| |
Collapse
|
46
|
Kao PM, Hsu BM, Hsu TK, Ji WT, Huang PH, Hsueh CJ, Chiang CS, Huang SW, Huang YL. Application of TaqMan fluorescent probe-based quantitative real-time PCR assay for the environmental survey of Legionella spp. and Legionella pneumophila in drinking water reservoirs in Taiwan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 490:416-421. [PMID: 24867705 DOI: 10.1016/j.scitotenv.2014.04.103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 04/24/2014] [Accepted: 04/25/2014] [Indexed: 06/03/2023]
Abstract
In this study, TaqMan fluorescent quantitative real-time PCR was performed to quantify Legionella species in reservoirs. Water samples were collected from 19 main reservoirs in Taiwan, and 12 (63.2%) were found to contain Legionella spp. The identified species included uncultured Legionella spp., L. pneumophila, L. jordanis, and L. drancourtii. The concentrations of Legionella spp. and L. pneumophila in the water samples were in the range of 1.8×10(2)-2.6×10(3) and 1.6×10(2)-2.4×10(2) cells/L, respectively. The presence and absence of Legionella spp. in the reservoir differed significantly in pH values. These results highlight the importance that L. pneumophila, L. jordanis, and L. drancourtii are potential pathogens in the reservoirs. The presence of L. pneumophila in reservoirs may be a potential public health concern that must be further examined.
Collapse
Affiliation(s)
- Po-Min Kao
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi, Taiwan, ROC
| | - Bing-Mu Hsu
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi, Taiwan, ROC.
| | - Tsui-Kang Hsu
- Department of Ophthalmology, Cheng Hsin General Hospital, Taipei, Taiwan, ROC
| | - Wen-Tsai Ji
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi, Taiwan, ROC
| | - Po-Hsiang Huang
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi, Taiwan, ROC
| | - Chih-Jen Hsueh
- Department of Otorhinolaryngology, Cheng Hsin General Hospital, Taipei, Taiwan, ROC
| | - Chuen-Sheue Chiang
- Research and Diagnostic Center, Centers for Disease Control, Taiwan, ROC
| | - Shih-Wei Huang
- Center for General Education, Cheng-Shiu University, Kaohsiung, Taiwan, ROC
| | - Yu-Li Huang
- Department of Safety Health and Environmental Engineering, National Kaohsiung First University of Science and Technology, Kaohsiung, Taiwan, ROC
| |
Collapse
|
47
|
Abstract
Legionella spp. are the causative agent of Legionnaire's disease and an opportunistic pathogen of significant public health concern. Identification and quantification from environmental sources is crucial for identifying outbreak origins and providing sufficient information for risk assessment and disease prevention. Currently there are a range of methods for Legionella spp. quantification from environmental sources, but the two most widely used and accepted are culture and real-time polymerase chain reaction (qPCR). This paper provides a review of these two methods and outlines their advantages and limitations. Studies from the last 10 years which have concurrently used culture and qPCR to quantify Legionella spp. from environmental sources have been compiled. 26/28 studies detected Legionella at a higher rate using qPCR compared to culture, whilst only one study detected equivalent levels of Legionella spp. using both qPCR and culture. Aggregating the environmental samples from all 28 studies, 2856/3967 (72%) tested positive for the presence of Legionella spp. using qPCR and 1331/3967 (34%) using culture. The lack of correlation between methods highlights the need to develop an acceptable standardized method for quantification that is sufficient for risk assessment and management of this human pathogen.
Collapse
Affiliation(s)
- Harriet Whiley
- a Department of Health and the Environment , Flinders University , Adelaide , Australia
| | - Michael Taylor
- a Department of Health and the Environment , Flinders University , Adelaide , Australia
| |
Collapse
|
48
|
Wang S, Huang J, Yang Y, Hui Y, Ge Y, Larssen T, Yu G, Deng S, Wang B, Harman C. First report of a Chinese PFOS alternative overlooked for 30 years: its toxicity, persistence, and presence in the environment. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2013; 47:10117-28. [PMID: 23952109 DOI: 10.1021/es402455r] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
This is the first report on the environmental occurrence of a chlorinated polyfluorinated ether sulfonate (locally called F-53B, C8ClF16O4SK). It has been widely applied as a mist suppressant by the chrome plating industry in China for decades but has evaded the attention of environmental research and regulation. In this study, F-53B was found in high concentrations (43-78 and 65-112 μg/L for the effluent and influent, respectively) in wastewater from the chrome plating industry in the city of Wenzhou, China. F-53B was not successfully removed by the wastewater treatments in place. Consequently, it was detected in surface water that receives the treated wastewater at similar levels to PFOS (ca. 10-50 ng/L) and the concentration decreased with the increasing distance from the wastewater discharge point along the river. Initial data presented here suggest that F-53B is moderately toxic (Zebrafish LC50-96 h 15.5 mg/L) and is as resistant to degradation as PFOS. While current usage is limited to the chrome plating industry, the increasing demand for PFOS alternatives in other sectors may result in expanded usage. Collectively, the results of this work call for future assessments on the effects of this overlooked contaminant and its presence and fate in the environment.
Collapse
Affiliation(s)
- Siwen Wang
- State Key Joint Laboratory of Environment Simulation and Pollution Control (SKJLESPC), School of Environment, POPs Research Centre, Tsinghua University , Beijing 100084, P.R. China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Kao PM, Tung MC, Hsu BM, Chiu YC, She CY, Shen SM, Huang YL, Huang WC. Identification and quantitative detection of Legionella spp. in various aquatic environments by real-time PCR assay. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2013; 20:6128-6137. [PMID: 23536272 DOI: 10.1007/s11356-013-1534-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 01/29/2013] [Indexed: 06/02/2023]
Abstract
In this study, a SYBR green quantitative real-time PCR was developed to quantify and detect the Legionella spp. in various environmental water samples. The water samples were taken from watershed, water treatment plant, and thermal spring area in Taiwan. Legionella was detected in 13.6 % (24/176), and the detection rate for river water, raw drinking water, and thermal spring water was 10, 21.4, and 16.6 %, respectively. Using real-time PCR, concentration of Legionella spp. in detected samples ranged between 9.75 × 10(4) and 3.47 × 10(5) cells/L in river water, 6.92 × 10(4) and 4.29 × 10(5) cells/L in raw drinking water, and 5.71 × 10(4) and 2.12 × 10(6) cells/L for thermal spring water samples. The identified species included Legionella pneumophila (20.8 %), Legionella jordanis (4.2 %), Legionella nautarum (4.2 %), Legionella sp. (4.2 %), and uncultured Legionella sp. (66.6 %). The presence of L. pneumophila in aquatic environments suggested a potential public health threat that must be further examined.
Collapse
Affiliation(s)
- Po-Min Kao
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi, Taiwan, Republic of China
| | | | | | | | | | | | | | | |
Collapse
|
50
|
Leskinen SD, Kearns EA, Jones WL, Miller RS, Bevitas CR, Kingsley MT, Brigmon RL, Lim DV. Automated dead-end ultrafiltration of large volume water samples to enable detection of low-level targets and reduce sample variability. J Appl Microbiol 2012; 113:351-60. [PMID: 22607480 DOI: 10.1111/j.1365-2672.2012.05345.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 04/30/2012] [Accepted: 05/15/2012] [Indexed: 12/14/2022]
Abstract
AIMS A Portable Multi-use Automated Concentration System (PMACS) concentrates micro-organisms from large volumes of water through automated dead-end ultrafiltration and backflushing. The ability to detect microbial targets from ground, surface and cooling tower waters collected using standard methods was compared with samples from the PMACS in this study. METHODS AND RESULTS PMACS (100 l) and standard grab samples (100-500 ml) were collected from sites in Florida and South Carolina, USA. Samples were analysed for the presence of faecal indicator bacteria (FIB; ground and surface water) or Legionella pneumophila (Lp; cooling tower water). FIB were enumerated by growth on selective media following membrane filtration or in IDEXX defined substrate media. Lp cells were detected by direct fluorescence immunoassay using FITC-labelled monoclonal antibodies targeting serogroups 1, 2, 4 and 6. FIB were found in PMACS samples from ground and surface waters when their concentrations were below detection limits in grab samples. The concentrations of Lp in cooling tower samples collected over 5 months were more consistent in PMACS samples than grab samples. CONCLUSIONS These data demonstrate that PMACS concentration is advantageous for water monitoring. FIB were detected in PMACS samples when their concentrations were below the detection limits of the standard methods used. PMACS processing provided more representative samples of cooling tower waters reducing sample variability during long-term monitoring. SIGNIFICANCE AND IMPACT OF THE STUDY This study highlights the utility of PMACS processing for enhanced monitoring of water for low-level microbial targets and for reducing sample variability in long-term monitoring programmes.
Collapse
Affiliation(s)
- S D Leskinen
- Department of Cell Biology, Microbiology and Molecular Biology, University of South Florida, Tampa, FL 33620-7115, USA.
| | | | | | | | | | | | | | | |
Collapse
|