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Tarabay J, Varkey JB. The potential risks of Legionella arising from ligature-resistant fixtures. Am J Infect Control 2024; 52:344-348. [PMID: 37604209 DOI: 10.1016/j.ajic.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 08/23/2023]
Abstract
To provide a safe environment, behavioral health settings must adhere to "ligature-resistant" protocols for patients at risk of harm to themselves or others. However, certain bathroom ligature-resistant fixtures alter environmental controls, such as sinks and showerheads, and increase the risk of water-borne pathogens due to low water output settings, highlighting the importance of an interdisciplinary water management program. We describe how ligature-resistant water fixtures may have been associated with a possible case of hospital-associated Legionellosis.
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Affiliation(s)
- Jessica Tarabay
- Department of Quality and Infection Prevention, Emory University Hospital, Emory Healthcare, Atlanta, GA.
| | - Jay B Varkey
- Department of Quality and Infection Prevention, Emory University Hospital, Emory Healthcare, Atlanta, GA; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA
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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).
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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
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Scheithauer L, Karagöz MS, Mayer BE, Steinert M. Protein sociology of ProA, Mip and other secreted virulence factors at the Legionella pneumophila surface. Front Cell Infect Microbiol 2023; 13:1140688. [PMID: 36936764 PMCID: PMC10017501 DOI: 10.3389/fcimb.2023.1140688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/17/2023] [Indexed: 03/06/2023] Open
Abstract
The pathogenicity of L. pneumophila, the causative agent of Legionnaires' disease, depends on an arsenal of interacting proteins. Here we describe how surface-associated and secreted virulence factors of this pathogen interact with each other or target extra- and intracellular host proteins resulting in host cell manipulation and tissue colonization. Since progress of computational methods like AlphaFold, molecular dynamics simulation, and docking allows to predict, analyze and evaluate experimental proteomic and interactomic data, we describe how the combination of these approaches generated new insights into the multifaceted "protein sociology" of the zinc metalloprotease ProA and the peptidyl-prolyl cis/trans isomerase Mip (macrophage infectivity potentiator). Both virulence factors of L. pneumophila interact with numerous proteins including bacterial flagellin (FlaA) and host collagen, and play important roles in virulence regulation, host tissue degradation and immune evasion. The recent progress in protein-ligand analyses of virulence factors suggests that machine learning will also have a beneficial impact in early stages of drug discovery.
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Affiliation(s)
- Lina Scheithauer
- Institut für Mikrobiologie, Technische Universität Braunschweig, Braunschweig, Germany
| | - Mustafa Safa Karagöz
- Institut für Mikrobiologie, Technische Universität Braunschweig, Braunschweig, Germany
| | - Benjamin E. Mayer
- Computational Biology & Simulation, Technische Universität Darmstadt, Darmstadt, Germany
| | - Michael Steinert
- Institut für Mikrobiologie, Technische Universität Braunschweig, Braunschweig, Germany
- *Correspondence: Michael Steinert,
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Molina JJ, Bennassar M, Palacio E, Crespi S. Impact of prolonged hotel closures during the COVID-19 pandemic on Legionella infection risks. Front Microbiol 2023; 14:1136668. [PMID: 36910223 PMCID: PMC9998907 DOI: 10.3389/fmicb.2023.1136668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/10/2023] [Indexed: 03/14/2023] Open
Abstract
In general, it is accepted that water stagnation and lack or poor maintenance in buildings are risk factors for Legionella growth. Then, in theory, the prolonged hotel closures due to the COVID-19 pandemic may have increased the risk of Legionella infections. However, there are very few field studies comparing the level of Legionella colonization in buildings before the pandemic and the new situation created after the lockdown. The objective of this study was to analyze these differences in a group of hotels that experienced prolonged closures in 2020 due to the COVID-19 pandemic. We have studied the Legionella spp. results, analyzed by standard culture, from the domestic water distribution systems of 73 hotels that experienced closures (from 1 to >4 months) during 2020, immediately after the reopening. The results were compared with those obtained in similar samplings of 2019. For the comparative analysis, we divided the hotels in two groups: Group A that have suffered closures for ≤3 months and Group B that remained closed for more than 3 months, both in relation to the opening period of 2019. In the Group B (36 sites), the frequency of positive samples in the hot water system increased from 6.7% in 2019 to 14.0% in 2020 (p < 0.05). In the Group A (37 sites), no significant differences were observed. No statistically significant differences were observed in terms of positive sites (defined as hotels with at least 1 positive sample), Legionella spp. concentrations and prevalence of Legionella pneumophila sg1 between the samplings of the two periods studied. The results suggest that hotels that suffered the longest prolonged closures (> 3 months) could have carried a higher risk of exposure to Legionella in the domestic hot water system. These findings highlight the importance of adequate preopening cleaning and disinfection procedures for hotel water systems, and the convenience of considering the most effective disinfection methods especially for hot water systems and after prolonged closure periods.
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Affiliation(s)
- Jhon J Molina
- Environmental Health and Laboratory Services, Biolinea Int., Palma, Spain.,Environmental Analytical Chemistry Laboratory, Department of Chemistry, University of the Balearic Islands, Palma, Spain
| | | | - Edwin Palacio
- Environmental Analytical Chemistry Laboratory, Department of Chemistry, University of the Balearic Islands, Palma, Spain
| | - Sebastian Crespi
- Environmental Health and Laboratory Services, Biolinea Int., Palma, Spain
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