Environmental culturing for Legionella: Can we build a better mouse trap?

Stout, Janet E.; Yu, Victor L.

doi:10.1016/j.ajic.2010.02.002

Cited by 10 publications

(12 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some of the studies have reported positivity rate of <30 per cent (12-18.7%)2021 or even zero6. The positivity cut-off of >30 per cent has been used and confirmed by many researchers to indicate the extent of colonization by L. pneumophila in any hospital warranting active clinical surveillance of legionnaire's disease31121. Colonization in only 6.66 per cent of water outlets obtained in our study does not warrant active screening for the legionnaires’ disease in the hospitalized patients.…”

Section: Resultssupporting

confidence: 51%

“…Sampling directly the biofilms using swabs was considered better compared to water in increasing the yield of isolation34. Acid buffer treatment of samples was effective in reducing the contamination; although, it was found to be detrimental to the growth of L. pneumophila .…”

Section: Resultsmentioning

confidence: 99%

“…This index of suspicion can be raised by generating knowledge about the possible presence of the organism in the hospital water supplies and outlets3. Legionella colonization of hospital water supplies in >30 per cent of the sampled water outlets merits initiation of specialized laboratory tests for Legionella screening in all patients with hospital-acquired pneumonia3. There are only a few studies on environmental colonization by Legionella from India4567.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Environmental surveillance of Legionella pneumophila in distal water supplies of a hospital for early identification & prevention of hospital-acquired legionellosis

Jinna¹,

Gaikwad²

2018

Indian J Med Res

View full text Add to dashboard Cite

Background & objectives:Legionella pneumophila, a ubiquitous aquatic organism is found to be associated with the development of the community as well as hospital-acquired pneumonia. Diagnosing Legionella infection is difficult unless supplemented with, diagnostic laboratory testing and established evidence for its presence in the hospital environment. Hence, the present study was undertaken to screen the hospital water supplies for the presence of L. pneumophila to show its presence in the hospital environment further facilitating early diagnosis and prevention of hospital-acquired legionellosis.Methods:Water samples and swabs from the inner side of the same water taps were collected from 30 distal water outlets present in patient care areas of a tertiary care hospital. The filtrate obtained from water samples as well as swabs were inoculated directly and after acid buffer treatment on plain and selective (with polymyxin B, cycloheximide and vancomycin) buffered charcoal yeast extract medium. The colonies grown were identified using standard methods and confirmed for L. pneumophila by latex agglutination test.Results:About 6.66 per cent (2/30) distal water outlets sampled were found to be contaminated with L. pneumophila serotype 2-15. Isolation was better with swabs compared to water samples.Interpretation & conclusions:The study showed the presence of L. pneumophila colonization of hospital water outlets at low levels. Periodic water sampling and active clinical surveillance in positive areas may be done to substantiate the evidence, to confirm or reject its role as a potential nosocomial pathogen in hospital environment.

show abstract

Section: Resultssupporting

confidence: 51%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Environmental surveillance of Legionella pneumophila in distal water supplies of a hospital for early identification & prevention of hospital-acquired legionellosis

Jinna¹,

Gaikwad²

2018

Indian J Med Res

View full text Add to dashboard Cite

show abstract

“…However, our case report may help to avoid the taken-for-granted association between hospitals and all cases occurred 10 days after recovery, with the consequent negative publicity in the newspaper and television and/or lawsuits based on allegations of negligence [16]. …”

Section: Discussionmentioning

confidence: 99%

A Culture-Proven Case of Community-AcquiredLegionellaPneumonia Apparently Classified as Nosocomial: Diagnostic and Public Health Implications

Bargellini

Marchesi²,

Marchegiano³

et al. 2013

Case Reports in Medicine

View full text Add to dashboard Cite

We report a case of Legionella pneumonia in a 78-year-old patient affected by cerebellar haemangioblastoma continuously hospitalised for 24 days prior to the onset of overt symptoms. According to the established case definition, this woman should have been definitely classified as a nosocomial case (patient spending all of the ten days in hospital before onset of symptoms). Water samples from the oncology ward were negative, notably the patient's room and the oxygen bubbler, and the revision of the case history induced us to verify possible contamination in water samples collected at home. We found that the clinical strain had identical rep-PCR fingerprint of L. pneumophila serogroup 1 isolated at home. The description of this culture-proven case of Legionnaires' disease has major clinical, legal, and public health consequences as the complexity of hospitalised patients poses limitations to the rule-of-thumb surveillance definition of nosocomial pneumonia based on 2–10-day incubation period.

show abstract

“…Testing water for the presence of Legionella is the most direct means of determining whether the building water system is colonized by Legionella [9,10] and its usefulness has been discussed in multiple technical guidelines [7,11,12]. The correlation with disease risk has been well established in healthcare facilities [13][14][15][16], but risk has also been demonstrated in hotels and other commercial properties.…”

Section: Introductionmentioning

confidence: 99%

Water Quality as a Predictor of Legionella Positivity of Building Water Systems

Pierre¹,

Baron²,

Ma³

et al. 2019

Pathogens

Self Cite

View full text Add to dashboard Cite

Testing drinking water systems for the presence of Legionella colonization is a proactive approach to assess and reduce the risk of Legionnaires’ disease. Previous studies suggest that there may be a link between Legionella positivity in the hot water return line or certain water quality parameters (temperature, free chlorine residual, etc.) with distal site Legionella positivity. It has been suggested that these measurements could be used as a surrogate for testing for Legionella in building water systems. We evaluated the relationship between hot water return line Legionella positivity and other water quality parameters and Legionella colonization in premise plumbing systems by testing 269 samples from domestic cold and hot water samples in 28 buildings. The hot water return line Legionella positivity and distal site positivity only demonstrated a 77.8% concordance rate. Hot water return line Legionella positivity compared to distal site positivity had a sensitivity of 55% and a specificity of 96%. There was poor correlation and a low positive predictive value between the hot water return line and distal outlet positivity. There was no correlation between Legionella distal site positivity and total bacteria (heterotrophic plate count), pH, free chlorine, calcium, magnesium, zinc, manganese, copper, temperature, total organic carbon, or incoming cold-water chlorine concentration. These findings suggest that hot water return line Legionella positivity and other water quality parameters are not predictive of distal site positivity and should not be used alone to determine the building’s Legionella colonization rate and effectiveness of water management programs.

show abstract

Environmental culturing for Legionella: Can we build a better mouse trap?

Cited by 10 publications

References 12 publications

Environmental surveillance of Legionella pneumophila in distal water supplies of a hospital for early identification & prevention of hospital-acquired legionellosis

Environmental surveillance of Legionella pneumophila in distal water supplies of a hospital for early identification & prevention of hospital-acquired legionellosis

A Culture-Proven Case of Community-AcquiredLegionellaPneumonia Apparently Classified as Nosocomial: Diagnostic and Public Health Implications

Water Quality as a Predictor of Legionella Positivity of Building Water Systems

Contact Info

Product

Resources

About