A Legionellosis Case Due to Contaminated Spa Water and Confirmed by Genomic Identification in Taiwan

Su, Hsun-Pi; Tseng, Lei-Ron; Tzeng, Shin-Chan; Chou, Chen-Ying; Chung, Tung-Ching

doi:10.1111/j.1348-0421.2006.tb03803.x

Cited by 13 publications

(11 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Transmission of bacteria from the environment to humans occurs via inhalation or aspiration of Legionella-containing aerosols (7,8). Cooling towers (9,10), hot springs (11,12), and potable water systems (13,14) in large facilities, hotels, hospitals, and public baths that are contaminated with Legionella are the implicated sources of outbreaks and sporadic cases of Legionnaires' disease.…”

mentioning

confidence: 99%

Distribution of Sequence-Based Types of Legionella pneumophila Serogroup 1 Strains Isolated from Cooling Towers, Hot Springs, and Potable Water Systems in China

Qin

Zhou

Ren

et al. 2014

Appl Environ Microbiol

View full text Add to dashboard Cite

bLegionella pneumophila serogroup 1 causes Legionnaires' disease. Water systems contaminated with Legionella are the implicated sources of Legionnaires' disease. This study analyzed L. pneumophila serogroup 1 strains in China using sequence-based typing. Strains were isolated from cooling towers (n ‫؍‬ 96), hot springs (n ‫؍‬ 42), and potable water systems (n ‫؍‬ 26). Isolates from cooling towers, hot springs, and potable water systems were divided into 25 sequence types (STs; index of discrimination [IOD], 0.711), 19 STs (IOD, 0.934), and 3 STs (IOD, 0.151), respectively. The genetic variation among the potable water isolates was lower than that among cooling tower and hot spring isolates. ST1 was the predominant type, accounting for 49.4% of analyzed strains (n ‫؍‬ 81), followed by ST154. With the exception of two strains, all potable water isolates (92.3%) belonged to ST1. In contrast, 53.1% (51/96) and only 14.3% (6/42) of cooling tower and hot spring, respectively, isolates belonged to ST1. There were differences in the distributions of clone groups among the water sources. The comparisons among L. pneumophila strains isolated in China, Japan, and South Korea revealed that similar clones (ST1 complex and ST154 complex) exist in these countries. In conclusion, in China, STs had several unique allelic profiles, and ST1 was the most prevalent sequence type of environmental L. pneumophila serogroup 1 isolates, similar to its prevalence in Japan and South Korea. Bacteria of the genus Legionella, widely present in water, contribute to human diseases. To date, more than 50 Legionella species have been characterized, and 25 species are known to cause human disease (1, 2). Legionella was first reported as a pathogen following a pneumonia outbreak in 1976 (3). Since then, several community-, hospital-, and travel-associated Legionella outbreaks have been reported. The most severe form of pneumonia caused by Legionella is known as Legionnaires' disease; however, there is also a milder, flu-like form known as Pontiac fever (4). Legionella pneumophila is responsible for approximately 90% of human infections (5). L. pneumophila is divided into 15 serogroups, of which serogroup 1 is the most prevalent disease-causing variant. Few outbreaks by other Legionella species have been reported (5, 6). Transmission of bacteria from the environment to humans occurs via inhalation or aspiration of Legionella-containing aerosols (7,8). Cooling towers (9, 10), hot springs (11, 12), and potable water systems (13, 14) in large facilities, hotels, hospitals, and public baths that are contaminated with Legionella are the implicated sources of outbreaks and sporadic cases of Legionnaires' disease.The water systems of several countries are highly contaminated with Legionella. In our previous study that compared the efficacy of different Legionella detection methods, we isolated Legionella at rates of 26.39%, 54.44%, and 18.94% from cooling towers, hot springs, and piped water systems, respectively, with Legionella concentrations of Ͼ1,000 C...

show abstract

mentioning

confidence: 99%

Distribution of Sequence-Based Types of Legionella pneumophila Serogroup 1 Strains Isolated from Cooling Towers, Hot Springs, and Potable Water Systems in China

Qin

Zhou

Ren

et al. 2014

Appl Environ Microbiol

View full text Add to dashboard Cite

show abstract

“…Potable water systems (14,26), spa water (28), and cooling towers (7,13) are among the sources implicated in outbreaks of Legionnaires' disease. Transmission of bacteria from the environment to humans occurs via inhalation or aspiration of Legionella-containing aerosols (3,5).…”

mentioning

confidence: 99%

Optimization of Pulsed-Field Gel Electrophoresis forLegionella pneumophilaSubtyping

Zhou

Ren

Zhu

et al. 2010

Appl Environ Microbiol

View full text Add to dashboard Cite

A total of 32 strains of Legionella pneumophila were used to optimize pulsed-field gel electrophoresis (PFGE) for subtyping of L. pneumophila. Twenty-six isolates of L. pneumophila with various origins and 11 isolates from five different water systems were used as the panels. For optimization of electrophoretic parameters (EPs) of SfiI PFGE, 26 isolates were analyzed with SfiI digestion, using four EPs yielding the same D value. The EP of a switch time of 5 to 50 s for 21 h had the smallest similarity coefficients and was declared the optimal EP for SfiI PFGE of L. pneumophila. By software analysis and pilot study, AscI was chosen as another PFGE enzyme. AscI PFGE could cluster the isolates from each water system into the same or very similar patterns and had a high degree of typing concordance with other molecular methods. In evaluating the discriminatory power of AscI with the panel of 26 isolates, AscI PFGE gave one single pattern and a D value of 100%. AscI PFGE had a high discriminatory power and a high degree of consistency with epidemiological data and other molecular typing methods for L. pneumophila subtyping, and hence, AscI could be used as a restriction enzyme in PFGE subtyping of L. pneumophila.Legionella pneumophila is an environmental organism that can cause disease in humans and is increasingly recognized as an important pathogen causing nosocomial pneumonia. Potable water systems (14, 26), spa water (28), and cooling towers (7, 13) are among the sources implicated in outbreaks of Legionnaires' disease. Transmission of bacteria from the environment to humans occurs via inhalation or aspiration of Legionella-containing aerosols (3, 5). Strain differentiation is necessary for the identification of sources of contamination and determination of routes of transmission; this could in turn enable us to more accurately detect outbreaks and limit the spread of L. pneumophila infections. A variety of subtyping techniques have been used to identify and characterize L. pneumophila strains, including monoclonal antibody (MAb) analysis (16,19), ribotyping (4), amplified fragment length polymorphism (AFLP) analysis (9, 22), PCR-based methods (15, 24), sequence-based typing (SBT) (9, 16), and pulsedfield gel electrophoresis (PFGE) (1,6).Preliminary reports demonstrated that PFGE is a highly discriminative epidemiological marker for subtyping of L. pneumophila (6,11,23,25), and a number of L. pneumophila PFGE protocols have been described in the literature (1, 2, 4, 14); however, most laboratories that use PFGE to subtype L. pneumophila cannot compare their results because the protocols differ from each other in critical parameters, such as the restriction enzymes and electrophoresis conditions used to generate the DNA fingerprints. To enhance our ability to monitor this pathogen, there is an urgent need for a standardized L. pneumophila PFGE protocol which can readily be implemented in different laboratories for information interpretation.An optimal PFGE protocol produces a suitable number of restriction fragmen...

show abstract

“…We therefore found very few formal reports which might give an understanding of the distribution of L. pneumophila SG 2 in Legionella pneumonia patients, potable water, and spa facilities. 10 In our literature search, this was only the second case of Legionella pneumonia caused by L. pneumophila SG 2 in Japan. The fi rst was a case that had been reported by Tomioka et al in 1990.…”

Section: Discussionmentioning

confidence: 88%

“…However, the time of using the public baths in this case was within the incubation period of Legionnaires' disease, usually 2-10 days. 15 There are also two reports of L. pneumophila SG 2 having been isolated from the water samples of public baths, namely a spa center in Taiwan, 10 and whirlpool baths in Okinawa. 16 Therefore, we consider that the history of using public baths might be associated with the development of the infection in this case.…”

Section: Discussionmentioning

confidence: 99%

Legionella pneumonia caused by Legionella pneumophila serogroup 2: second case report in Japan

Furugen

Koide

Baba

et al. 2008

Journal of Infection and Chemotherapy

View full text Add to dashboard Cite

A Legionellosis Case Due to Contaminated Spa Water and Confirmed by Genomic Identification in Taiwan

Cited by 13 publications

References 26 publications

Distribution of Sequence-Based Types of Legionella pneumophila Serogroup 1 Strains Isolated from Cooling Towers, Hot Springs, and Potable Water Systems in China

Distribution of Sequence-Based Types of Legionella pneumophila Serogroup 1 Strains Isolated from Cooling Towers, Hot Springs, and Potable Water Systems in China

Optimization of Pulsed-Field Gel Electrophoresis forLegionella pneumophilaSubtyping

Legionella pneumonia caused by Legionella pneumophila serogroup 2: second case report in Japan

Contact Info

Product

Resources

About