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Capuano GE, Corso D, Farina R, Pezzotti Escobar G, Screpis GA, Coniglio MA, Libertino S. Miniaturizable Chemiluminescence System for ATP Detection in Water. SENSORS (BASEL, SWITZERLAND) 2024; 24:3921. [PMID: 38931704 PMCID: PMC11207618 DOI: 10.3390/s24123921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 06/10/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
We present the design, fabrication, and testing of a low-cost, miniaturized detection system that utilizes chemiluminescence to measure the presence of adenosine triphosphate (ATP), the energy unit in biological systems, in water samples. The ATP-luciferin chemiluminescent solution was faced to a silicon photomultiplier (SiPM) for highly sensitive real-time detection. This system can detect ATP concentrations as low as 0.2 nM, with a sensitivity of 79.5 A/M. Additionally, it offers rapid response times and can measure the characteristic time required for reactant diffusion and mixing within the reaction volume, determined to be 0.3 ± 0.1 s. This corresponds to a diffusion velocity of approximately 44 ± 14 mm2/s.
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Affiliation(s)
- Giuseppe E. Capuano
- Istituto per la Microeletttronica e Microsistemi—Consiglio Nazionale delle Ricerche, VIII Strada Z.I., 5, 95121 Catania, Italy; (G.E.C.); (R.F.); (S.L.)
| | - Domenico Corso
- Istituto per la Microeletttronica e Microsistemi—Consiglio Nazionale delle Ricerche, VIII Strada Z.I., 5, 95121 Catania, Italy; (G.E.C.); (R.F.); (S.L.)
| | - Roberta Farina
- Istituto per la Microeletttronica e Microsistemi—Consiglio Nazionale delle Ricerche, VIII Strada Z.I., 5, 95121 Catania, Italy; (G.E.C.); (R.F.); (S.L.)
- Department of Chemical Sciences, University of Catania, Viale Andrea Doria 6, 95125 Catania, Italy
| | - Gianni Pezzotti Escobar
- URT “LabSens of Beyond Nano” of the Department of Physical Sciences and Technologies of Matter, National Research Council (CNR-DSFTM-ME), Viale Ferdinando Stagno D’Alcontres 31, 98166 Messina, Italy;
| | - Giuseppe A. Screpis
- Department of Medical, Surgical Sciences and Advanced Technologies, University of Catania, Via S. Sofia 78, 95123 Catania, Italy
| | - Maria Anna Coniglio
- Istituto per la Microeletttronica e Microsistemi—Consiglio Nazionale delle Ricerche, VIII Strada Z.I., 5, 95121 Catania, Italy; (G.E.C.); (R.F.); (S.L.)
- Department of Medical, Surgical Sciences and Advanced Technologies, University of Catania, Via S. Sofia 78, 95123 Catania, Italy
| | - Sebania Libertino
- Istituto per la Microeletttronica e Microsistemi—Consiglio Nazionale delle Ricerche, VIII Strada Z.I., 5, 95121 Catania, Italy; (G.E.C.); (R.F.); (S.L.)
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2
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Fasciana T, Palermo M, Arrigo I, Tricoli MR, Diquattro O, Giammanco A. Editorial: Special Issue: " Legionella pneumophila: A Microorganism with a Thousand Faces". Microorganisms 2023; 11:2392. [PMID: 37894050 PMCID: PMC10609420 DOI: 10.3390/microorganisms11102392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 10/29/2023] Open
Abstract
Legionella pneumophila is a microorganism that is able to contaminate the freshwater environment and, consequently, human-made water systems [...].
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Affiliation(s)
- Teresa Fasciana
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, 90127 Palermo, Italy;
- Legionella Reference Laboratory, University of Palermo, 90127 Palermo, Italy; (I.A.); (M.R.T.)
| | - Mario Palermo
- Sicilian Health Department, Public Health and Environmental Risks Service, 90127 Palermo, Italy;
| | - Ignazio Arrigo
- Legionella Reference Laboratory, University of Palermo, 90127 Palermo, Italy; (I.A.); (M.R.T.)
| | - Maria Rita Tricoli
- Legionella Reference Laboratory, University of Palermo, 90127 Palermo, Italy; (I.A.); (M.R.T.)
| | - Orazia Diquattro
- Laboratory of Microbiology, A. O. Ospedali Riuniti “Villa Sofia-Cervello”, 90100 Palermo, Italy;
| | - Anna Giammanco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, 90127 Palermo, Italy;
- Legionella Reference Laboratory, University of Palermo, 90127 Palermo, Italy; (I.A.); (M.R.T.)
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3
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Farina C, Cacciabue E, Averara F, Ferri N, Vailati F, Del Castillo G, Serafini A, Fermi B, Doniselli N, Pezzoli F. Water Safety Plan, Monochloramine Disinfection and Extensive Environmental Sampling Effectively Control Legionella and Other Waterborne Pathogens in Nosocomial Settings: The Ten-Year Experience of an Italian Hospital. Microorganisms 2023; 11:1794. [PMID: 37512966 PMCID: PMC10384652 DOI: 10.3390/microorganisms11071794] [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: 05/24/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Legionella contamination control is crucial in healthcare settings where patients suffer an increased risk of disease and fatal outcome. To ensure an effective management of this health hazard, the accurate application of a hospital-specific Water Safety Plan (WSP), the choice of a suitable water disinfection system and an extensive monitoring program are required. Here, the ten-year experience of an Italian hospital is reported: since its commissioning, Legionellosis risk management has been entrusted to a multi-disciplinary Working Group, applying the principles of the World Health Organization's WSP. The disinfection strategy to prevent Legionella and other waterborne pathogens relies on the treatment of domestic hot water with a system ensuring the in situ production and dosage of monochloramine. An average of 250 samples/year were collected and analyzed to allow an accurate assessment of the microbiological status of water network. With the aim of increasing the monitoring sensitivity, in addition to the standard culture method, an optimized MALDI-ToF MS-based strategy was applied, allowing the identification of Legionella species and other relevant opportunistic pathogens. Data collected so far confirmed the effectiveness of this multidisciplinary approach: the fraction of positive samples never overcame 1% on a yearly basis and Legionnaires' Disease cases never occurred.
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Affiliation(s)
- Claudio Farina
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", 24127 Bergamo, Italy
| | - Eleonora Cacciabue
- Health Care Coordination Offices, ASST "Papa Giovanni XXIII", 24127 Bergamo, Italy
| | - Franca Averara
- Department of Health Care Professions, ASST "Papa Giovanni XXIII", 24127 Bergamo, Italy
| | - Nadia Ferri
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", 24127 Bergamo, Italy
| | - Francesca Vailati
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", 24127 Bergamo, Italy
| | | | | | - Beatrice Fermi
- Sanipur S.p.A., 25020 Flero, Italy
- ESCMID Study Group for Legionella Infections (ESGLI), 4001 Basel, Switzerland
| | - Nicola Doniselli
- Sanipur S.p.A., 25020 Flero, Italy
- ESCMID Study Group for Legionella Infections (ESGLI), 4001 Basel, Switzerland
| | - Fabio Pezzoli
- Health Care Coordination Offices, ASST "Papa Giovanni XXIII", 24127 Bergamo, Italy
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4
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Lombardi A, Borriello T, De Rosa E, Di Duca F, Sorrentino M, Torre I, Montuori P, Trama U, Pennino F. Environmental Monitoring of Legionella in Hospitals in the Campania Region: A 5-Year Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085526. [PMID: 37107807 PMCID: PMC10138562 DOI: 10.3390/ijerph20085526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/06/2023] [Accepted: 04/13/2023] [Indexed: 05/11/2023]
Abstract
Legionella is a pathogen that colonizes soils, freshwater, and building water systems. People who are most affected are those with immunodeficiencies, so it is necessary to monitor its presence in hospitals. The purpose of this study was to evaluate the presence of Legionella in water samples collected from hospitals in the Campania region, Southern Italy. A total of 3365 water samples were collected from January 2018 to December 2022 twice a year in hospital wards from taps and showers, tank bottoms, and air-treatment units. Microbiological analysis was conducted in accordance with the UNI EN ISO 11731:2017, and the correlations between the presence of Legionella and water temperature and residual chlorine were investigated. In total, 708 samples (21.0%) tested positive. The most represented species was L. pneumophila 2-14 (70.9%). The serogroups isolated were 1 (27.7%), 6 (24.5%), 8 (23.3%), 3 (18.9%), 5 (3.1%), and 10 (1.1%). Non-pneumophila Legionella spp. represented 1.4% of the total. Regarding temperature, the majority of Legionella positive samples were found in the temperature range of 26.0-40.9 °C. An influence of residual chlorine on the presence of the bacterium was observed, confirming that chlorine disinfection is effective for controlling contamination. The positivity for serogroups other than serogroup 1 suggested the need to continue environmental monitoring of Legionella and to focus on the clinical diagnosis of other serogroups.
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Affiliation(s)
- Annalisa Lombardi
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Tonia Borriello
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Elvira De Rosa
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Fabiana Di Duca
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Michele Sorrentino
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Ida Torre
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Paolo Montuori
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Ugo Trama
- General Directorate of Health, Campania Region, Centro Direzionale C3, 80143 Naples, Italy
| | - Francesca Pennino
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
- Correspondence:
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Gamage SD, Jinadatha C, Coppin JD, Kralovic SM, Bender A, Ambrose M, Decker BK, DeVries AS, Goto M, Kowalskyj O, Maistros AL, Rizzo V, Simbartl LA, Watson RJ, Roselle GA. Factors That Affect Legionella Positivity in Healthcare Building Water Systems from a Large, National Environmental Surveillance Initiative. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:11363-11373. [PMID: 35929739 DOI: 10.1021/acs.est.2c02194] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Legionella growth in healthcare building water systems can result in legionellosis, making water management programs (WMPs) important for patient safety. However, knowledge is limited on Legionella prevalence in healthcare buildings. A dataset of quarterly water testing in Veterans Health Administration (VHA) healthcare buildings was used to examine national environmental Legionella prevalence from 2015 to 2018. Bayesian hierarchical logistic regression modeling assessed factors influencing Legionella positivity. The master dataset included 201,146 water samples from 814 buildings at 168 VHA campuses. Overall Legionella positivity over the 4 years decreased from 7.2 to 5.1%, with the odds of a Legionella-positive sample being 0.94 (0.90-0.97) times the odds of a positive sample in the previous quarter for the 16 quarters of the 4 year period. Positivity varied considerably more at the medical center campus level compared to regional levels or to the building level where controls are typically applied. We found higher odds of Legionella detection in older buildings (OR 0.92 [0.86-0.98] for each more recent decade of construction), in taller buildings (OR 1.20 [1.13-1.27] for each additional floor), in hot water samples (O.R. 1.21 [1.16-1.27]), and in samples with lower residual biocide concentrations. This comprehensive healthcare building review showed reduced Legionella detection in the VHA healthcare system over time. Insights into factors associated with Legionella positivity provide information for healthcare systems implementing WMPs and for organizations setting standards and regulations.
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Affiliation(s)
- Shantini D Gamage
- National Infectious Diseases Service, Specialty Care Program Office, Veterans Health Administration, Department of Veterans Affairs (VA), Washington, D.C. 20571, United States
- Division of Infectious Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267, United States
| | - Chetan Jinadatha
- Department of Medicine, Central Texas Veterans Health Care System, Temple, Texas 76504, United States
- College of Medicine, Texas A&M University, Bryan, Texas 77807, United States
| | - John D Coppin
- Department of Research, Central Texas Veterans Health Care System, Temple, Texas 76504, United States
| | - Stephen M Kralovic
- National Infectious Diseases Service, Specialty Care Program Office, Veterans Health Administration, Department of Veterans Affairs (VA), Washington, D.C. 20571, United States
- Division of Infectious Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267, United States
- Cincinnati VA Medical Center, Cincinnati, Ohio 45220, United States
| | - Alan Bender
- Booz Allen Hamilton, McLean, Virginia 22102, United States
| | - Meredith Ambrose
- National Infectious Diseases Service, Specialty Care Program Office, Veterans Health Administration, Department of Veterans Affairs (VA), Washington, D.C. 20571, United States
| | - Brooke K Decker
- Division of Infectious Diseases, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania 15240, United States
| | - Aaron S DeVries
- Minneapolis VA Healthcare System, Minneapolis, Minnesota 55417, United States
| | - Michihiko Goto
- Iowa City VA Health Care System, Iowa City, Iowa 52246, United States
- University of Iowa Carver College of Medicine, Iowa City, Iowa 52242, United States
| | - Oleh Kowalskyj
- Office of Healthcare Engineering, Healthcare Environment and Facilities Program, Veterans Health Administration, VA, Washington, D.C. 20571, United States
| | - Angela L Maistros
- VA Capitol Health Care Network, Veterans Integrated Service Network (VISN) 5, Linthicum, Maryland 21090, United States
| | - Vincent Rizzo
- Office of Healthcare Engineering, Healthcare Environment and Facilities Program, Veterans Health Administration, VA, Washington, D.C. 20571, United States
| | - Loretta A Simbartl
- National Infectious Diseases Service, Specialty Care Program Office, Veterans Health Administration, Department of Veterans Affairs (VA), Washington, D.C. 20571, United States
| | - Richard J Watson
- Occupational Health and Safety Program Office, Veterans Health Administration, VA, Washington, D.C. 20571, United States
| | - Gary A Roselle
- National Infectious Diseases Service, Specialty Care Program Office, Veterans Health Administration, Department of Veterans Affairs (VA), Washington, D.C. 20571, United States
- Division of Infectious Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267, United States
- Cincinnati VA Medical Center, Cincinnati, Ohio 45220, United States
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6
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Filice S, Sciuto EL, Scalese S, Faro G, Libertino S, Corso D, Timpanaro RM, Laganà P, Coniglio MA. Innovative Antibiofilm Smart Surface against Legionella for Water Systems. Microorganisms 2022; 10:microorganisms10050870. [PMID: 35630315 PMCID: PMC9144790 DOI: 10.3390/microorganisms10050870] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/11/2022] [Accepted: 04/19/2022] [Indexed: 12/20/2022] Open
Abstract
Legionella pneumophila contamination of water systems is a crucial issue for public health. The pathogen is able to persist in water as free-living planktonic bacteria or to grow within biofilms that adhere to and clog filters and pipes in a water system, reducing its lifespan and, in the case of hospital buildings, increasing the risk of nosocomial infections. The implementation of water management is considered to be the main prevention measure and can be achieved from the optimization of water system architecture, notably introducing new materials and strategies to contrast Legionella biofilm proliferation and so prolong the water system functionality. In this research, we propose a new smart surface against L. pneumophila biofilm formation. This is based on an innovative type of coating consisting of a sulfonated pentablock copolymer (s-PBC, commercially named Nexar™) deposited on top of a polypropylene (PP) coupon in a sandwich filter model. The covering of PP with s-PBC results in a more hydrophilic, acid, and negatively charged surface that induces microbial physiological inhibition thereby preventing adhesion and/or proliferation attempts of L. pneumophila prior to the biofilm formation. The antibiofilm property has been investigated by a Zone of Inhibition test and an in vitro biofilm formation analysis. Filtration tests have been performed as representative of possible applications for s-PBC coating. Results are reported and discussed.
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Affiliation(s)
- Simona Filice
- Istituto per la Microelettronica e Microsistemi-Consiglio Nazionale delle Ricerche (CNR-IMM), Ottava Strada 5, 95121 Catania, Italy; (S.F.); (S.S.); (S.L.); (D.C.); (M.A.C.)
| | - Emanuele Luigi Sciuto
- Azienda Ospedaliero Universitaria Policlinico “G. Rodolico-San Marco”, Via S. Sofia 78, 95123 Catania, Italy;
- Correspondence:
| | - Silvia Scalese
- Istituto per la Microelettronica e Microsistemi-Consiglio Nazionale delle Ricerche (CNR-IMM), Ottava Strada 5, 95121 Catania, Italy; (S.F.); (S.S.); (S.L.); (D.C.); (M.A.C.)
| | - Giuseppina Faro
- Azienda Sanitaria Provinciale di Catania, Via S. Maria La Grande 5, 95124 Catania, Italy;
| | - Sebania Libertino
- Istituto per la Microelettronica e Microsistemi-Consiglio Nazionale delle Ricerche (CNR-IMM), Ottava Strada 5, 95121 Catania, Italy; (S.F.); (S.S.); (S.L.); (D.C.); (M.A.C.)
| | - Domenico Corso
- Istituto per la Microelettronica e Microsistemi-Consiglio Nazionale delle Ricerche (CNR-IMM), Ottava Strada 5, 95121 Catania, Italy; (S.F.); (S.S.); (S.L.); (D.C.); (M.A.C.)
| | - Rosario Manuel Timpanaro
- Azienda Ospedaliero Universitaria Policlinico “G. Rodolico-San Marco”, Via S. Sofia 78, 95123 Catania, Italy;
| | - Pasqualina Laganà
- Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Torre Biologica 3p, AOU ‘G. Martino’, University of Messina, Via C. Valeria, S.N.C., 98125 Messina, Italy;
| | - Maria Anna Coniglio
- Istituto per la Microelettronica e Microsistemi-Consiglio Nazionale delle Ricerche (CNR-IMM), Ottava Strada 5, 95121 Catania, Italy; (S.F.); (S.S.); (S.L.); (D.C.); (M.A.C.)
- Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis, Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, Via Sofia 87, 95123 Catania, Italy
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Brunello A, Civilini M, De Martin S, Felice A, Franchi M, Iacumin L, Saccomanno N, Vitacolonna N. Machine learning-assisted environmental surveillance of Legionella: A retrospective observational study in Friuli-Venezia Giulia region of Italy in the period 2002–2019. INFORMATICS IN MEDICINE UNLOCKED 2022. [DOI: 10.1016/j.imu.2021.100803] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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8
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Sciuto EL, Corso D, Libertino S, van der Meer JR, Faro G, Coniglio MA. A Miniaturized Microbe-Silicon-Chip Based on Bioluminescent Engineered Escherichia coli for the Evaluation of Water Quality and Safety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147580. [PMID: 34300030 PMCID: PMC8304097 DOI: 10.3390/ijerph18147580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 01/24/2023]
Abstract
Conventional high throughput methods assaying the chemical state of water and the risk of heavy metal accumulation share common constraints of long and expensive analytical procedures and dedicated laboratories due to the typical bulky instrumentation. To overcome these limitations, a miniaturized optical system for the detection and quantification of inorganic mercury (Hg2+) in water was developed. Combining the bioactivity of a light-emitting mercury-specific engineered Escherichia coli—used as sensing element—with the optical performance of small size and inexpensive Silicon Photomultiplier (SiPM)—used as detector—the system is able to detect mercury in low volumes of water down to the concentration of 1 µg L−1, which is the tolerance value indicated by the World Health Organization (WHO), providing a highly sensitive and miniaturized tool for in situ water quality analysis.
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Affiliation(s)
- Emanuele Luigi Sciuto
- Azienda Ospedaliero Universitaria Policlinico “G. Rodolico-San Marco”, Via S. Sofia 78, 95123 Catania, Italy;
| | - Domenico Corso
- Istituto per la Microelettronica e Microsistemi–Consiglio Nazionale delle Ricerche (CNR-IMM), Ottava Strada 5, 95121 Catania, Italy
- Correspondence: (D.C.); (S.L.); (M.A.C.)
| | - Sebania Libertino
- Istituto per la Microelettronica e Microsistemi–Consiglio Nazionale delle Ricerche (CNR-IMM), Ottava Strada 5, 95121 Catania, Italy
- Correspondence: (D.C.); (S.L.); (M.A.C.)
| | - Jan Roelof van der Meer
- Department of Fundamental Microbiology, Bâtiment Biophore, University of Lausanne, 1015 Lausanne, Switzerland;
| | - Giuseppina Faro
- Azienda Sanitaria Provinciale di Catania, Via S. Maria La Grande 5, 95124 Catania, Italy;
| | - Maria Anna Coniglio
- Azienda Ospedaliero Universitaria Policlinico “G. Rodolico-San Marco”, Via S. Sofia 78, 95123 Catania, Italy;
- Istituto per la Microelettronica e Microsistemi–Consiglio Nazionale delle Ricerche (CNR-IMM), Ottava Strada 5, 95121 Catania, Italy
- Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis, Catania, Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, Via Sofia 87, 95123 Catania, Italy
- Correspondence: (D.C.); (S.L.); (M.A.C.)
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9
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Pereira A, Silva AR, Melo LF. Legionella and Biofilms-Integrated Surveillance to Bridge Science and Real-Field Demands. Microorganisms 2021; 9:microorganisms9061212. [PMID: 34205095 PMCID: PMC8228026 DOI: 10.3390/microorganisms9061212] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 11/16/2022] Open
Abstract
Legionella is responsible for the life-threatening pneumonia commonly known as Legionnaires’ disease or legionellosis. Legionellosis is known to be preventable if proper measures are put into practice. Despite the efforts to improve preventive approaches, Legionella control remains one of the most challenging issues in the water treatment industry. Legionellosis incidence is on the rise and is expected to keep increasing as global challenges become a reality. This puts great emphasis on prevention, which must be grounded in strengthened Legionella management practices. Herein, an overview of field-based studies (the system as a test rig) is provided to unravel the common roots of research and the main contributions to Legionella’s understanding. The perpetuation of a water-focused monitoring approach and the importance of protozoa and biofilms will then be discussed as bottom-line questions for reliable Legionella real-field surveillance. Finally, an integrated monitoring model is proposed to study and control Legionella in water systems by combining discrete and continuous information about water and biofilm. Although the successful implementation of such a model requires a broader discussion across the scientific community and practitioners, this might be a starting point to build more consistent Legionella management strategies that can effectively mitigate legionellosis risks by reinforcing a pro-active Legionella prevention philosophy.
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10
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Sciuto EL, Laganà P, Filice S, Scalese S, Libertino S, Corso D, Faro G, Coniglio MA. Environmental Management of Legionella in Domestic Water Systems: Consolidated and Innovative Approaches for Disinfection Methods and Risk Assessment. Microorganisms 2021; 9:577. [PMID: 33799845 PMCID: PMC8001549 DOI: 10.3390/microorganisms9030577] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 12/31/2022] Open
Abstract
Legionella is able to remain in water as free-living planktonic bacteria or to grow within biofilms that adhere to the pipes. It is also able to enter amoebas or to switch into a viable but not culturable (VBNC) state, which contributes to its resistance to harsh conditions and hinders its detection in water. Factors regulating Legionella growth, such as environmental conditions, type and concentration of available organic and inorganic nutrients, presence of protozoa, spatial location of microorganisms, metal plumbing components, and associated corrosion products are important for Legionella survival and growth. Finally, water treatment and distribution conditions may affect each of these factors. A deeper comprehension of Legionella interactions in water distribution systems with the environmental conditions is needed for better control of the colonization. To this purpose, the implementation of water management plans is the main prevention measure against Legionella. A water management program requires coordination among building managers, health care providers, and Public Health professionals. The review reports a comprehensive view of the state of the art and the promising perspectives of both monitoring and disinfection methods against Legionella in water, focusing on the main current challenges concerning the Public Health sector.
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Affiliation(s)
- Emanuele Luigi Sciuto
- Azienda Ospedaliero Universitaria Policlinico “G. Rodolico-San Marco”, Via Sofia 78, 95123 Catania, Italy;
| | - Pasqualina Laganà
- Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis, Messina, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Torre Biologica 3p, AOU ‘G. Martino, Via C. Valeria, s.n.c., 98125 Messina, Italy;
| | - Simona Filice
- Istituto per la Microelettronica e Microsistemi–Consiglio Nazionale delle Ricerche (CNR-IMM), Ottava Strada 5, 95121 Catania, Italy; (S.F.); (S.S.); (S.L.); (D.C.)
| | - Silvia Scalese
- Istituto per la Microelettronica e Microsistemi–Consiglio Nazionale delle Ricerche (CNR-IMM), Ottava Strada 5, 95121 Catania, Italy; (S.F.); (S.S.); (S.L.); (D.C.)
| | - Sebania Libertino
- Istituto per la Microelettronica e Microsistemi–Consiglio Nazionale delle Ricerche (CNR-IMM), Ottava Strada 5, 95121 Catania, Italy; (S.F.); (S.S.); (S.L.); (D.C.)
| | - Domenico Corso
- Istituto per la Microelettronica e Microsistemi–Consiglio Nazionale delle Ricerche (CNR-IMM), Ottava Strada 5, 95121 Catania, Italy; (S.F.); (S.S.); (S.L.); (D.C.)
| | - Giuseppina Faro
- Azienda Sanitaria Provinciale di Catania, Via S. Maria La Grande 5, 95124 Catania, Italy;
| | - Maria Anna Coniglio
- Azienda Ospedaliero Universitaria Policlinico “G. Rodolico-San Marco”, Via Sofia 78, 95123 Catania, Italy;
- Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis, Catania, Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, Via Sofia 87, 95123 Catania, Italy
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11
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Chambers ST, Slow S, Scott-Thomas A, Murdoch DR. Legionellosis Caused by Non- Legionella pneumophila Species, with a Focus on Legionella longbeachae. Microorganisms 2021; 9:291. [PMID: 33572638 PMCID: PMC7910863 DOI: 10.3390/microorganisms9020291] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/23/2021] [Accepted: 01/26/2021] [Indexed: 12/13/2022] Open
Abstract
Although known as causes of community-acquired pneumonia and Pontiac fever, the global burden of infection caused by Legionella species other than Legionella pneumophila is under-recognised. Non-L. pneumophila legionellae have a worldwide distribution, although common testing strategies for legionellosis favour detection of L. pneumophila over other Legionella species, leading to an inherent diagnostic bias and under-detection of cases. When systematically tested for in Australia and New Zealand, L. longbeachae was shown to be a leading cause of community-acquired pneumonia. Exposure to potting soils and compost is a particular risk for infection from L. longbeachae, and L. longbeachae may be better adapted to soil and composting plant material than other Legionella species. It is possible that the high rate of L. longbeachae reported in Australia and New Zealand is related to the composition of commercial potting soils which, unlike European products, contain pine bark and sawdust. Genetic studies have demonstrated that the Legionella genomes are highly plastic, with areas of the chromosome showing high levels of recombination as well as horizontal gene transfer both within and between species via plasmids. This, combined with various secretion systems and extensive effector repertoires that enable the bacterium to hijack host cell functions and resources, is instrumental in shaping its pathogenesis, survival and growth. Prevention of legionellosis is hampered by surveillance systems that are compromised by ascertainment bias, which limits commitment to an effective public health response. Current prevention strategies in Australia and New Zealand are directed at individual gardeners who use potting soils and compost. This consists of advice to avoid aerosols generated by the use of potting soils and use masks and gloves, but there is little evidence that this is effective. There is a need to better understand the epidemiology of L. longbeachae and other Legionella species in order to develop effective treatment and preventative strategies globally.
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Affiliation(s)
- Stephen T. Chambers
- Department of Pathology and Biomedical Science, University of Otago, Christchurch 8011, New Zealand; (S.S.); (A.S.-T.); (D.R.M.)
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12
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Marchesi I, Paduano S, Frezza G, Sircana L, Vecchi E, Zuccarello P, Oliveri Conti G, Ferrante M, Borella P, Bargellini A. Safety and Effectiveness of Monochloramine Treatment for Disinfecting Hospital Water Networks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176116. [PMID: 32842654 PMCID: PMC7503937 DOI: 10.3390/ijerph17176116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/12/2020] [Accepted: 08/20/2020] [Indexed: 11/16/2022]
Abstract
The formation of potentially carcinogenic N-nitrosamines, associated with monochloramine, requires further research due to the growing interest in using this biocide for the secondary disinfection of water in public and private buildings. The aim of our study was to evaluate the possible formation of N-nitrosamines and other toxic disinfection by-products (DBPs) in hospital hot water networks treated with monochloramine. The effectiveness of this biocide in controlling Legionella spp. contamination was also verified. For this purpose, four different monochloramine-treated networks, in terms of the duration of treatment and method of biocide injection, were investigated. Untreated hot water, municipal cold water and, limited to N-nitrosamines analysis, hot water treated with chlorine dioxide were analyzed for comparison. Legionella spp. contamination was successfully controlled without any formation of N-nitrosamines. No nitrification or formation of the regulated DBPs, such as chlorites and trihalomethanes, occurred in monochloramine-treated water networks. However, a stable formulation of hypochlorite, its frequent replacement with a fresh product, and the routine monitoring of free ammonia are recommended to ensure a proper disinfection. Our study confirms that monochloramine may be proposed as an effective and safe strategy for the continuous disinfection of building plumbing systems, preventing vulnerable individuals from being exposed to legionellae and dangerous DBPs.
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Affiliation(s)
- Isabella Marchesi
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (S.P.); (G.F.); (P.B.); (A.B.)
- Correspondence: ; Tel.: +39-059-2055460
| | - Stefania Paduano
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (S.P.); (G.F.); (P.B.); (A.B.)
| | - Giuseppina Frezza
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (S.P.); (G.F.); (P.B.); (A.B.)
| | - Luca Sircana
- University Hospital Policlinico of Modena, Largo del Pozzo 71, 41124 Modena, Italy; (L.S.); (E.V.)
| | - Elena Vecchi
- University Hospital Policlinico of Modena, Largo del Pozzo 71, 41124 Modena, Italy; (L.S.); (E.V.)
| | - Pietro Zuccarello
- Environmental and Food Hygiene Laboratory (LIAA), Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy; (P.Z.); (G.O.C.); (M.F.)
| | - Gea Oliveri Conti
- Environmental and Food Hygiene Laboratory (LIAA), Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy; (P.Z.); (G.O.C.); (M.F.)
| | - Margherita Ferrante
- Environmental and Food Hygiene Laboratory (LIAA), Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy; (P.Z.); (G.O.C.); (M.F.)
| | - Paola Borella
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (S.P.); (G.F.); (P.B.); (A.B.)
| | - Annalisa Bargellini
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (S.P.); (G.F.); (P.B.); (A.B.)
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13
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Paduano S, Marchesi I, Casali ME, Valeriani F, Frezza G, Vecchi E, Sircana L, Romano Spica V, Borella P, Bargellini A. Characterisation of Microbial Community Associated with Different Disinfection Treatments in Hospital hot Water Networks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2158. [PMID: 32213901 PMCID: PMC7143765 DOI: 10.3390/ijerph17062158] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/20/2020] [Accepted: 03/22/2020] [Indexed: 12/16/2022]
Abstract
Many disinfection treatments can be adopted for controlling opportunistic pathogens in hospital water networks in order to reduce infection risk for immunocompromised patients. Each method has limits and strengths and it could determine modifications on bacterial community. The aim of our investigation was to study under real-life conditions the microbial community associated with different chemical (monochloramine, hydrogen peroxide, chlorine dioxide) and non-chemical (hyperthermia) treatments, continuously applied since many years in four hot water networks of the same hospital. Municipal cold water, untreated secondary, and treated hot water were analysed for microbiome characterization by 16S amplicon sequencing. Cold waters had a common microbial profile at genera level. The hot water bacterial profiles differed according to treatment. Our results confirm the effectiveness of disinfection strategies in our hospital for controlling potential pathogens such as Legionella, as the investigated genera containing opportunistic pathogens were absent or had relative abundances ≤1%, except for non-tuberculous mycobacteria, Sphingomonas, Ochrobactrum and Brevundimonas. Monitoring the microbial complexity of healthcare water networks through 16S amplicon sequencing is an innovative and effective approach useful for Public Health purpose in order to verify possible modifications of microbiota associated with disinfection treatments.
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Affiliation(s)
- Stefania Paduano
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.P.); (I.M.); (M.E.C.); (G.F.); (P.B.)
| | - Isabella Marchesi
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.P.); (I.M.); (M.E.C.); (G.F.); (P.B.)
| | - Maria Elisabetta Casali
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.P.); (I.M.); (M.E.C.); (G.F.); (P.B.)
- University Hospital Policlinico of Modena, 41124 Modena, Italy; (E.V.); (L.S.)
| | - Federica Valeriani
- Department of Movement, Human and Health Sciences, Public Health Unit, University of Rome ‘Foro Italico’, 00135 Rome, Italy; (F.V.); (V.R.S.)
| | - Giuseppina Frezza
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.P.); (I.M.); (M.E.C.); (G.F.); (P.B.)
| | - Elena Vecchi
- University Hospital Policlinico of Modena, 41124 Modena, Italy; (E.V.); (L.S.)
| | - Luca Sircana
- University Hospital Policlinico of Modena, 41124 Modena, Italy; (E.V.); (L.S.)
| | - Vincenzo Romano Spica
- Department of Movement, Human and Health Sciences, Public Health Unit, University of Rome ‘Foro Italico’, 00135 Rome, Italy; (F.V.); (V.R.S.)
| | - Paola Borella
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.P.); (I.M.); (M.E.C.); (G.F.); (P.B.)
| | - Annalisa Bargellini
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.P.); (I.M.); (M.E.C.); (G.F.); (P.B.)
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14
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Fuochi V, Coniglio MA, Laghi L, Rescifina A, Caruso M, Stivala A, Furneri PM. Metabolic Characterization of Supernatants Produced by Lactobacillus spp. With in vitro Anti- Legionella Activity. Front Microbiol 2019; 10:1403. [PMID: 31293545 PMCID: PMC6606692 DOI: 10.3389/fmicb.2019.01403] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 06/04/2019] [Indexed: 12/28/2022] Open
Abstract
Legionella pneumophila is an organism of public health interest for its presence in water supply systems and other humid thermal habitats. In this study, ten cell-free supernatants produced by Lactobacillus strains were evaluated for their ability to inhibit L. pneumophila strains isolated from hot tap water. Production of antimicrobial substances by Lactobacillus strains were assessed by agar well diffusion test on BCYE agar plates pre-inoculated with L. pneumophila. Cell-free supernatants (CFS) showed antimicrobial activity against all Legionella strains tested: L. rhamnosus and L. salivarius showed the highest activity. By means of a proton-based nuclear magnetic resonance (1H-NMR) spectroscopy, we detected and quantified the Lactobacillus metabolites of these CFSs, so to gain information about which metabolic pathway was likely to be connected to the observed inhibition activity. A panel of metabolites with variations in concentration were revealed, but considerable differences among inter-species were not showed as reported in a similar work by Foschi et al. (2018). More than fifty molecules belonging mainly to the groups of amino acids, organic acids, monosaccharides, ketones, and alcohols were identified in the metabolome. Significant differences were recorded comparing the metabolites found in the supernatants of strains grown in MRS with glycerol and the same strains grown in MRS without supplements. Indeed, pathway analysis revealed that glycine, serine and threonine, pyruvate, and sulfur metabolic pathways had a higher impact when strains were grown in MRS medium with a supplement such as glycerol. Among the metabolites identified, many were amino acids, suggesting the possible presence of bacteriocins which could be linked to the anti-Legionella activity shown by cell-free supernatants.
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Affiliation(s)
- Virginia Fuochi
- Department of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, Catania, Italy
| | - Maria Anna Coniglio
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Luca Laghi
- Centre of Foodomics, Department of Agro-Food Science and Technology, University of Bologna, Bologna, Italy
| | | | - Massimo Caruso
- Department of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, Catania, Italy.,Department of Clinical and Experimental Medicine (MEDCLIN), University of Catania, Catania, Italy
| | - Aldo Stivala
- Department of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, Catania, Italy
| | - Pio Maria Furneri
- Department of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, Catania, Italy
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