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Sequence-based typing of clinical and environmental Legionella pneumophila isolates in Shenyang, China. ACTA ACUST UNITED AC 2021; 39:383-389. [PMID: 34620473 DOI: 10.1016/j.eimce.2020.06.018] [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: 02/17/2020] [Accepted: 06/04/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION We performed SBT (sequence-based typing) on clinical and environmental Legionellapneumophila isolates in Shenyang (China). We analyzed and compared the results with those obtained by PFGE (pulsed field gel electrophoresis). METHODS Twenty-two L. pneumophila isolates were collected from two patients with L. pneumophila infection, two hospitals, and 13 office buildings. There were two clinical isolates, one strain isolated from domestic tap water, another from shower water and 18 strains from cooling tower water. All these isolates were analyzed by SBT and PFGE methods. RESULTS The 22 isolates were divided into 7 types by SBT. Five isolates belonged to novel sequence types (ST2345, ST2344, ST2406, ST2407, and ST2408) and one isolate belonged to ST328. The STs were not obtained for two of the isolates. The remaining 14 isolates belonged to ST1. PFGE typing divided the 22 isolates into 14 pulsotypes. The main pulsotype was SYC, which included seven isolates. CONCLUSION Both typing methods showed that predominant clonal lines exist in the Shenyang region, with high levels of genetic polymorphisms. Five novel STs were identified, indicating a unique genetic composition of L. pneumophila strains in this region, which are significantly different from those found in other environmental water systems in the world.
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Quero S, Párraga-Niño N, Garcia-Núñez M, Pedro-Botet ML, Gavaldà L, Mateu L, Sabrià M, Mòdol JM. The impact of pipeline changes and temperature increase in a hospital historically colonised with Legionella. Sci Rep 2021; 11:1916. [PMID: 33479467 PMCID: PMC7820426 DOI: 10.1038/s41598-021-81625-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/01/2021] [Indexed: 01/25/2023] Open
Abstract
Healthcare-related Legionnaires’ disease has a devastating impact on high risk patients, with a case fatality rate of 30–50%. Legionella prevention and control in hospitals is therefore crucial. To control Legionella water colonisation in a hospital setting we evaluated the effect of pipeline improvements and temperature increase, analysing 237 samples over a 2-year period (first year: 129, second year: 108). In the first year, 25.58% of samples were positive for Legionella and 16.67% for amoeba. Assessing the distance of the points analysed from the hot water tank, the most distal points presented higher proportion of Legionella colonisation and lower temperatures (nearest points: 6.4% colonised, and temperature 61.4 °C; most distal points: 50% and temperature 59.1 °C). After the first year, the hot water system was repaired and the temperature stabilised. This led to a dramatic reduction in Legionella colonisation, which was negative in all the samples analysed; however, amoeba colonisation remained stable. This study shows the importance of keeping the temperature stable throughout the circuit, at around 60 °C. Special attention should be paid to the most distal points of the circuit; a fall in temperature at these weak points would favour the colonisation and spread of Legionella, because amoeba (the main Legionella reservoir) are not affected by temperature.
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Affiliation(s)
- S Quero
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias I Pujol, Carretera de Can Ruti, Camí de les Escoles s/n, 08916, Badalona, Barcelona, Spain. .,CIBER de Enfermedades Respiratorias, CIBERES, Av. de Monforte de Lemos, 3-5, 28029, Madrid, Spain. .,Institut d'Investigació i Innovació Parc Taulí, I3PT, Parc Taulí, 1, 08208, Sabadell, Barcelona, Spain.
| | - N Párraga-Niño
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias I Pujol, Carretera de Can Ruti, Camí de les Escoles s/n, 08916, Badalona, Barcelona, Spain
| | - M Garcia-Núñez
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias I Pujol, Carretera de Can Ruti, Camí de les Escoles s/n, 08916, Badalona, Barcelona, Spain.,CIBER de Enfermedades Respiratorias, CIBERES, Av. de Monforte de Lemos, 3-5, 28029, Madrid, Spain.,Institut d'Investigació i Innovació Parc Taulí, I3PT, Parc Taulí, 1, 08208, Sabadell, Barcelona, Spain
| | - M L Pedro-Botet
- CIBER de Enfermedades Respiratorias, CIBERES, Av. de Monforte de Lemos, 3-5, 28029, Madrid, Spain.,Hospital Universitari Germans Trias i Pujol, Carretera de Canyet, s/n, 08916, Badalona, Barcelona, Spain
| | - L Gavaldà
- Hospital Universitari de Bellvitge-IDIBELL, Feixa Llarga, s/n., 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - L Mateu
- Hospital Universitari Germans Trias i Pujol, Carretera de Canyet, s/n, 08916, Badalona, Barcelona, Spain
| | - M Sabrià
- CIBER de Enfermedades Respiratorias, CIBERES, Av. de Monforte de Lemos, 3-5, 28029, Madrid, Spain.,Hospital Universitari Germans Trias i Pujol, Carretera de Canyet, s/n, 08916, Badalona, Barcelona, Spain
| | - J M Mòdol
- Hospital Universitari Germans Trias i Pujol, Carretera de Canyet, s/n, 08916, Badalona, Barcelona, Spain
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Jiang L, Zhao S, Cai X, Mu D, Zhang X, Kang J, Zhao L, Chen Y. Sequence-based typing of clinical and environmental Legionella pneumophila isolates in Shenyang, China. Enferm Infecc Microbiol Clin 2020; 39:S0213-005X(20)30243-3. [PMID: 32718496 DOI: 10.1016/j.eimc.2020.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/29/2020] [Accepted: 06/04/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION We performed SBT (sequence-based typing) on clinical and environmental Legionellapneumophila isolates in Shenyang (China). We analyzed and compared the results with those obtained by PFGE (pulsed field gel electrophoresis). METHODS Twenty-two L. pneumophila isolates were collected from two patients with L. pneumophila infection, two hospitals, and 13 office buildings. There were two clinical isolates, one strain isolated from domestic tap water, another from shower water and 18 strains from cooling tower water. All these isolates were analyzed by SBT and PFGE methods. RESULTS The 22 isolates were divided into 7 types by SBT. Five isolates belonged to novel sequence types (ST2345, ST2344, ST2406, ST2407, and ST2408) and one isolate belonged to ST328. The STs were not obtained for two of the isolates. The remaining 14 isolates belonged to ST1. PFGE typing divided the 22 isolates into 14 pulsotypes. The main pulsotype was SYC, which included seven isolates. CONCLUSION Both typing methods showed that predominant clonal lines exist in the Shenyang region, with high levels of genetic polymorphisms. Five novel STs were identified, indicating a unique genetic composition of L. pneumophila strains in this region, which are significantly different from those found in other environmental water systems in the world.
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Affiliation(s)
- Luxi Jiang
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Department of Respiratory Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Sihong Zhao
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Department of Respiratory Medicine, the First Hospital of Shijiazhuang, Hebei, China
| | - Xu Cai
- Institute of Respiratory Disease, The First Hospital of China Medical University, Shenyang, China
| | - Deguang Mu
- Department of Respiratory Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Xianghua Zhang
- Department of Respiratory Medicine, the First Hospital of Shijiazhuang, Hebei, China
| | - Jian Kang
- Institute of Respiratory Disease, The First Hospital of China Medical University, Shenyang, China
| | - Li Zhao
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yu Chen
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
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Quero S, Párraga-Niño N, Sabria M, Barrabeig I, Sala MR, Jané M, Mateu L, Sopena N, Pedro-Botet ML, Garcia-Nuñez M. Legionella SBT applied directly to respiratory samples as a rapid molecular epidemiological tool. Sci Rep 2019; 9:623. [PMID: 30679570 PMCID: PMC6346096 DOI: 10.1038/s41598-018-36924-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/29/2018] [Indexed: 11/09/2022] Open
Abstract
Legionnaires' disease (LD) is an atypical pneumonia caused by the inhalation of Legionella. The methods used for the diagnosis of LD are direct culture of respiratory samples and urinary antigen detection. However, the sensitivity of culture is low, and the urinary antigen test is specific only for L. pneumophila sg1. Moreover, as no isolates are obtained, epidemiological studies cannot be performed. The implementation of Nested-sequence-based typing (Nested-SBT) makes it possible to carry out epidemiological studies while also confirming LD, especially in cases caused by non-sg 1. Sixty-two respiratory samples from patients with Legionella clinically confirmed by positive urinary antigen tests were cultured and tested by Nested-SBT, following the European Study Group for Legionella Infections (ESGLI) protocol. Only 2/62 (3.2%) respiratory samples were culture-positive. Amplification and sequencing of Nested-SBT genes were successfully performed in 57/62 samples (91.9%). The seven target genes were characterised in 39/57 (68.4%) respiratory samples, and the complete sequence type (ST) was obtained. The mip gene was the most frequently amplified and sequenced. Nested-SBT is a useful method for epidemiological studies in culture-negative samples, achieving a 28.7-fold improvement over the results of culture studies and reducing the time needed to obtain molecular epidemiological results.
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Affiliation(s)
- Sara Quero
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
| | - Noemí Párraga-Niño
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Miquel Sabria
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. .,CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain. .,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
| | - Irene Barrabeig
- Vigilància Epidemiològica i Resposta a Emergències de Salut Pública, Agencia de Salut Pública de Catalunya, Barcelona, Spain
| | - Maria Rosa Sala
- Vigilància Epidemiològica i Resposta a Emergències de Salut Pública, Agencia de Salut Pública de Catalunya, Barcelona, Spain
| | - Mireia Jané
- Vigilància Epidemiològica i Resposta a Emergències de Salut Pública, Agencia de Salut Pública de Catalunya, Barcelona, Spain
| | - Lourdes Mateu
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain.,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Nieves Sopena
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain.,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Maria Luisa Pedro-Botet
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain.,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Marian Garcia-Nuñez
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. .,CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain. .,Hospital Universitari Parc Taulí, Sabadell, Spain.
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Graells T, Hernández-García M, Pérez-Jové J, Guy L, Padilla E. Legionella pneumophila recurrently isolated in a Spanish hospital: Two years of antimicrobial resistance surveillance. ENVIRONMENTAL RESEARCH 2018; 166:638-646. [PMID: 29982152 DOI: 10.1016/j.envres.2018.06.045] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/19/2018] [Accepted: 06/21/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The aim of this study was to monitor the spread, persistence and antibiotic resistance patterns of Legionella spp. strains found in a hospital water distribution system. These environmental studies are intended to help detect the presence of antibiotic resistant strains before they infect patients. METHODS Antimicrobial surveillance tests were performed at 27 different sampling points of the water network of a large Spanish hospital over two years. Water samples were screened for Legionella according to ISO 11731:2007. Legionella spp. isolates were identified by serotyping and by mass spectrometry (MALDI-ToF). Epidemiological molecular typing was done by Pulse-Field Gel Electrophoresis (PFGE) and by Sequence-Based Typing (SBT). Antibiotic susceptibility tests were performed using disk diffusion and ETEST®. RESULTS Legionella spp. were recurrently isolated for 2 years. All isolates belonged the same group, L. pneumophila serogroups 2-14. Isolates were all attributed by SBT to sequence type (ST) ST328, although PFGE revealed 5 different patterns. No significant change in antibiotic susceptibility could be observed for this study period, irrespectively of the method used. CONCLUSION Colonization of water systems by Legionella spp. is still occurring, although all the prevention rules were strictly followed. Antibiotic resistance monitoring may help us to find resistance in bacteria with environmental reservoirs but difficult to isolate from patients. The knowledge of the antibiotic susceptibility in environmental strains may help us to predict changes in clinical strains. This study might also help reconsidering Legionnaires' disease (LD) diagnostic methods. L. pneumophila serogroups 2-14 present all along the time of the investigation in the water distribution system can cause LD. However, they may not be detected by routine urine tests run on patients, thereby missing an ongoing LD infection.
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Affiliation(s)
- Tiscar Graells
- Departament de Microbiologia, CATLAB Centre Analítiques AIE, Viladecavalls, Barcelona, Spain; Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden; Division of Microsystems Technology, Department of Engineering Sciences, Uppsala University, Uppsala, Sweden; Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona (UAB), Spain.
| | - Marta Hernández-García
- Servicio de Microbiología. Hospital Universitario Ramón y Cajal e Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain
| | - Josefa Pérez-Jové
- Departament de Microbiologia, CATLAB Centre Analítiques AIE, Viladecavalls, Barcelona, Spain
| | - Lionel Guy
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Emma Padilla
- Departament de Microbiologia, CATLAB Centre Analítiques AIE, Viladecavalls, Barcelona, Spain; Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona (UAB), Spain
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Population structure of Environmental and Clinical Legionella pneumophila isolates in Catalonia. Sci Rep 2018; 8:6241. [PMID: 29674708 PMCID: PMC5908911 DOI: 10.1038/s41598-018-24708-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 04/09/2018] [Indexed: 11/13/2022] Open
Abstract
Legionella is the causative agent of Legionnaires’ disease (LD). In Spain, Catalonia is the region with the highest incidence of LD cases. The characterisation of clinical and environmental isolates using molecular epidemiology techniques provides epidemiological data for a specific geographic region and makes it possible to carry out phylogenetic and population-based analyses. The aim of this study was to describe and compare environmental and clinical isolates of Legionella pneumophila in Catalonia using sequence-based typing and monoclonal antibody subgrouping. A total of 528 isolates were characterised. For data analysis, the isolates were filtered to reduce redundancies, and 266 isolates (109 clinical and 157 environmental) were finally included. Thirty-two per cent of the clinical isolates were ST23, ST37 and ST1 while 40% of the environmental isolates were ST284 and ST1. Although the index of diversity was higher in clinical than in environmental ST isolates, we observed that clinical STs were similar to those recorded in other regions but that environmental STs were more confined to particular study areas. This observation supports the idea that only certain STs trigger cases or outbreaks in humans. Therefore, comparison of the genomes of clinical and environmental isolates could provide important information about the traits that favour infection or environmental persistence.
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Pérez-Cataluña A, Tapiol J, Benavent C, Sarvisé C, Gómez F, Martínez B, Terron-Puig M, Recio G, Vilanova A, Pujol I, Ballester F, Rezusta A, Figueras MJ. Antimicrobial susceptibility, virulence potential and sequence types associated with Arcobacter strains recovered from human faeces. J Med Microbiol 2017; 66:1736-1743. [PMID: 29120301 DOI: 10.1099/jmm.0.000638] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The genus Arcobacter includes bacteria that are considered emergent pathogens because they can produce infections in humans and animals. The most common symptoms are bloody and non-bloody persistent diarrhea but cases with abdominal cramps without diarrhea or asymptomatic cases have also been described as well as cases with bacteremia. The objective was to characterize Arcobacter clinical strains isolated from the faeces of patients from three Spanish hospitals. METHODOLOGY We have characterized 28 clinical strains (27 of A. butzleri and one of A. cryaerophilus) isolated from faeces, analysing their epidemiological relationship using the multilocus sequence typing (MLST) approach and screening them for their antibiotic susceptibility and for the presence of virulence genes.Results/Key findings. Typing results showed that only one of the 28 identified sequence types (i.e. ST 2) was already present in the MLST database. The other 27 STs constituted new records because they included new alleles for five of the seven genes or new combinations of known alleles of the seven genes. All strains were positive for the ciaB virulence gene and sensitive to tetracycline. However, 7.4 % of the A. butzleri and A. cryaerophilus strains showed resistance to ciprofloxacin. CONCLUSION The fact that epidemiological unrelated strains show the same ST indicates that other techniques with higher resolution should be developed to effectively recognize the infection source. Resistance to ciprofloxacin, one of the antibiotics recommended for the treatment of Arcobacter intestinal infections, demonstrated in 10.7 % of the strains, indicates the importance of selecting the most appropriate effective treatment.
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Affiliation(s)
- Alba Pérez-Cataluña
- Unitat de Microbiología, Departament de Ciències Mèdiques Bàsiques, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain
| | | | | | | | | | | | | | - Gemma Recio
- Hospital Universitari Joan XXIII, Tarragona, Spain
| | | | | | | | | | - María Jose Figueras
- Unitat de Microbiología, Departament de Ciències Mèdiques Bàsiques, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain
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Differential Proteome Between Patient-Related and Non-related Environmental Isolates of Legionella pneumophila. Curr Microbiol 2017; 74:344-355. [PMID: 28138785 DOI: 10.1007/s00284-017-1198-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 01/11/2017] [Indexed: 10/20/2022]
Abstract
Molecular epidemiologic studies of Legionella have shown different molecular types coexisting in the same environment, with only one having the ability to trigger an outbreak. We therefore studied the proteome of isolates of these different molecular types in search of the proteins responsible for infection. In this study, we performed a differential proteomic analysis between patient-related and non-patient-related environmental isolates using two-dimensional difference gel electrophoresis (2D-DIGE) combined with mass spectrometry. Sixty-three spots were observed as being different between the two groups; 31 spots were identified corresponding to 23 different proteins. Patient-related isolates overexpressed proteins associated with metabolism, with enzymes of the tricarboxylic acid cycle and the degradation pathways being the most abundant proteins identified. However, the largest group of non-patient-related proteins was associated with stress response. Furthermore, the MOMP protein was located in different spots depending on their patient-related or non-patient-related origin, suggesting different post-translational modifications. According to these results, different bacterial adaptation pathways are activated in stress conditions which influence their ability to produce infection.
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