Each water outlet is a unique ecological niche for<i>Legionella pneumophila</i>

Marrie, Thomas J.; Haldane, David; Bezanson, G.; Peppard, R.

doi:10.1017/s0950268800049736

Cited by 29 publications

(15 citation statements)

References 19 publications

(13 reference statements)

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“…States et al (1989) showed the potential for Legionella growth within municipal systems, and this supports the hypothesis that public water supplies may contaminate the plumbing systems of hospitals and other large buildings. Individual water outlets in hospitals can each serve as its own ecological niche of L. pneumophila (Marrie et al, 1992). In a study of Legionella in the hot water distribution systems of Finnish apartment buildings, Zacheus and Martikainen (1994) found the highest concentrations of legionellae in the shower water.…”

Section: Environmental Sources Of Legionellosismentioning

confidence: 99%

Legionella: from environmental habitats to disease pathology, detection and control

Atlas

1999

Environmental Microbiology

210

148

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Studies on Legionella show a continuum from environment to human disease. Legionellosis is caused by Legionella species acquired from environmental sources, principally water sources such as cooling towers, where Legionella grows intracellularly in protozoa within biofilms. Aquatic biofilms, which are widespread not only in nature, but also in medical and dental devices, are ecological niches in which Legionella survives and proliferates and the ultimate sources to which outbreaks of legionellosis can be traced. Invasion and intracellular replication of L. pneumophila within protozoa in the environment play a major role in the transmission of Legionnaires' disease. Protozoa provide the habitats for the environmental survival and reproduction of Legionella species. L. pneumophila proliferates intracellularly in various species of protozoa within vacuoles studded with ribosomes, as it also does within macrophages. Growth within protozoa enhances the environmental survival capability and the pathogenicity (virulence) of Legionella. The growth requirements of Legionella, the ability of Legionella to enter a viable non‐culturable state, the association of Legionella with protozoa and the occurrence of Legionella within biofilms complicates the detection of Legionella and epidemiological investigations of legionellosis. Polymerase chain reaction (PCR) methods have been developed for the molecular detection of Legionella and used in environmental and epidemiological studies. Various physical and chemical disinfection methods have been developed to eliminate Legionella from environmental sources, but gaining control of Legionella in environmental waters, where they are protected from disinfection by growing within protozoa and biofilms, remains a challenge, and one that must be overcome in order to eliminate sporadic outbreaks of legionellosis.

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Section: Environmental Sources Of Legionellosismentioning

confidence: 99%

Legionella: from environmental habitats to disease pathology, detection and control

Atlas

1999

Environmental Microbiology

210

148

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“…Water was cultured every 2 weeks for 4 years from 20 sites throughout the hospital. 14 Of the 2200 samples, 545 (24.7%) were positive for L. pneumophila serogroup 1. During periods of hyperchlorination, 11.7% of the samples were positive compared with 41.6% when the water was not being hyperchlorinated.…”

Section: Biology and Reservoirs Of Legionella Speciesmentioning

confidence: 99%

Healthcare-Associated Atypical Pneumonia

Forgie

Marrie

2009

Semin Respir Crit Care Med

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Atypical pneumonia was first described in 1938, and over time, Mycoplasma, Legionella, and Chlamydophila were the agents commonly linked with community-associated atypical pneumonia. However, as technology has improved, so has our understanding of this clinical entity. It is now known that there are many agents linked with atypical pneumonia in the community, and many of these agents are also major causes of healthcare-associated pneumonia. This article discusses the history, epidemiology, and pathogenesis of infection; control of infection; clinical findings; diagnosis; and, where applicable, treatment of the agents of healthcare-associated atypical pneumonia. Bacterial agents include Legionella species, Mycoplasma pneumoniae, Chlamydophila species, and Coxiella burnetii. Although there are over 100 viruses that can cause respiratory tract infections, only a fraction of those have been defined in the context of healthcare-associated atypical pneumonia: adenovirus and human bocavirus (HBoV); rhinovirus; human coronaviruses (HCoV), including HCoV 229E, HCoV OC43, HCoV NL63, HCoV HKU1; members of the paramyxoviridae (parainfluenza viruses, human metapneumovirus, and respiratory syncytial virus); hantavirus; influenza; and severe acute respiratory syndrome (SARS) Co-V. Our knowledge about healthcare-associated atypical pneumonia will continue to evolve as newer pathogens are identified and as newer diagnostic modalities such as multiplex polymerase chain reaction are introduced.

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“…At hospital A, most of the isolates have contained one of the following plasmids: a 23-MDa plasmid (type II), 72-and 96-MDa plasmids (type III), and a 100-MDa plasmid (type VI). A few isolates had a 70-MDa plasmid (type IV), an 89-MDa plasmid (type V), and 58-and 103-MDa plasmids (type VII) (5). The potable water at both of these hospitals remained positive for Legionella from 1987 until the present for hospital A and until its demolition in 1996 for hospital B (where plasmidless isolates were obtained).…”

mentioning

confidence: 96%