Epidemiological investigation of a case of nosocomial Legionnaires' disease in Taiwan: implications for routine environmental surveillance

St, Chien; Jc, Hsueh; Hh, Lin; Shih, HY; Lee, TM; Rj, Ben; St, Chou; Cm, Fong; Yuan, Lin; Lr, Tseng; Cs, Chiang

doi:10.1111/j.1469-0691.2009.02890.x

Cited by 9 publications

(4 citation statements)

References 16 publications

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“…Analysis of the nucleotide sequence of the LPS biosynthesis regions for various serogroups could be adapted to the type of multiplexing described above and used to detect less common serogroups that have been associated with infection such as serogroup 3 (Chien et al, 2010). Additionally, with new knowledge of the genomes of other Legionella pathogens, such as L. longbeachae and L. micdadei , simple tests could be developed to identify multiple Legionella species using species-specific genetic targets.…”

Section: What Is the Scope For Future Molecular Detection Of Legionella?mentioning

confidence: 99%

Molecular Detection of Legionella: Moving on From mip

Yong¹,

Tan²,

Wee³

et al. 2010

Front. Microbio.

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The detection of Legionella pneumophila in environmental and clinical samples is frequently performed by PCR amplification of the mip and/or 16S rRNA genes. Combined with DNA sequencing, these two genetic loci can be used to distinguish different species of Legionella and identify L. pneumophila. However, the recent Legionella genome sequences have opened up hundreds of possibilities for the development of new molecular targets for detection and diagnosis. Ongoing comparative genomics has the potential to fine tune the identification of Legionella species and serogroups by combining specific and general genetic targets. For example, the coincident detection of LPS biosynthesis genes and virulence genes may allow the differentiation of both pathogen and serogroup without the need for nucleotide sequencing. We tested this idea using data derived from a previous genomic subtractive hybridization we performed between L. pneumophila serogroup 1 and L. micdadei. Although not yet formally tested, these targets serve as an example of how comparative genomics has the potential to improve the scope and accuracy of Legionella molecular detection if embraced by laboratories undertaking Legionella surveillance.

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Section: What Is the Scope For Future Molecular Detection Of Legionella?mentioning

confidence: 99%

Molecular Detection of Legionella: Moving on From mip

Yong¹,

Tan²,

Wee³

et al. 2010

Front. Microbio.

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“…The L. pneumophila serogroup 1 ST23 sequence type, which has been previously described in other outbreaks and sporadic community cases in Europe [18,19], was the predominant subtype identified in clinical samples. L. pneumophila serogroup 3, a serogroup notably described in nosocomial cases and immunocompromised patients [20,21], was identified in two clinical samples: one patient with idiopathic pulmonary fibrosis and another with lung cancer. isolates of an outbreak and environmental isolates when compared to the gold standard SBT method [22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

“…The outbreak of pneumonia was detected on 2 August 2 2017 when the Geneva University Hospitals (HUG) notified the Public Health Service of Geneva of eight positive Legionella urinary antigen tests from patients with pneumonia, all of whom resided in the Canton of Geneva, over the period of 28 July to 2 August. In contrast, a mean of 19.4 cases per year (range [16][17][18][19][20][21][22][23][24][25][26] were recorded in Geneva between 2012 and 2016. The HUG and the Public Health Service convened an outbreak control team on 2 August to conduct investigations and control the outbreak of Legionnaires' disease.…”

Section: Introductionmentioning

confidence: 99%

A community outbreak of Legionnaires' disease in Geneva, Switzerland, June to September 2017

et al. 2018

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PURPOSE: Eight confirmed cases of Legionnaires' disease were identified at the Geneva University Hospitals between 28 July 2017 and 02 August 2017, leading to a detailed outbreak investigation. METHODS: Legionnaires' disease cases were defined according to Swiss and European (ELDSNet) consensus guidelines. An outbreak investigation task force was put in place. Patients were interviewed, when feasible, with a standard questionnaire. A Legionella pneumophila urinary antigen test was performed in all cases. Lower respiratory tract (LRT) specimens were collected for culture, polymerase chain-reaction (PCR) assay, monoclonal antibody subtyping and sequenced-based typing (SBT). Multiple environmental samples were collected. Case geographical mapping was performed and local meteorological data were obtained. RESULTS: Thirty-four confirmed cases of Legionnaires' disease were identified between 20 June 2017 and 16 September 2017, including 28 patients living in the Canton of Geneva and 6 cases in neighbouring cantons and France. The case fatality rate was 8.8%. The urinary antigen test was positive in 32/34 (94.1%) cases. Among the 17/34 (50%) cases with available LRT specimens, 8 (47.1%) were culture/PCR positive, 5 (29.4%) were PCR positive only, and 4 (23.5%) were culture/PCR negative. Monoclonal antibody subtyping and SBT on 12 samples allowed subtype identification of 8 samples, with a predominance of L. pneumophila serogroup-1 subtype-France/Allentown ST23 among clinical isolates. A specific city area was identified as a possible outbreak epicentre in 25/34 (73.5%) cases, although molecular analysis of clinical and environmental specimens revealed heterogeneous subtypes of L. pneumophila. CONCLUSIONS:In this largest documented outbreak of Legionnaires' disease in Switzerland, we report prompt outbreak identification, leading to timely initiation of a detailed, well-orchestrated clinical and epidemiological investigation.

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“…Legionnaires' disease is known to cause hospital acquired pneumonia and may occur as part of an outbreak or sporadically [15,16]. Outbreaks are worldwi de and have been reported from India [17], Turkey [18], Italy [19] Taiwan [20,21] and Poland [22]. These outbreaks are usually due to aspiration of contaminated drinking water, but an oxygen humidifier [23] and a decorative fountain were implicated in two reports.…”

Section: History Of Hospital-acquired Legionnaires' Diseasementioning

confidence: 99%

Nosocomial Legionnaires’ Disease: Risque and Prevention

Tai¹,

Benchekroun²,

Ennaji³

et al. 2012

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In 1977, Fraser et al. described an outbreak of pneumonia among legionnaires attending a convention at a hotel in Philadelphia in 1976. Legionnaires' disease (LD) can be nosocomial, community acquired or travel related. The incidence of hospital-acquired legionellosis appears to be increasing. Colonization of water systems by Legionella spp. is ubiquitous in hospitals throughout the world. The outbreak, which later became known as legionnaires' disease, was caused by a new pleomorphic, faintly staining gram-negative bacillus, L. pneumophila, which was isolated at the Center for Disease Control from lung tissues of legionnaires who died. Risk assessment for this disease forms the basis for the institution of control measures. Detection and quantification of Legionella spp. in the environment, in particular in the hospital water distribution system is one of the cornerstones of risk assessment. This review summarizes the current state-of-the-art regarding these aspects and points out important areas which require further study. The environmental surveillance revealed that the centralized hot water distribution system of the hospital was colonized with Legionella. Methods of prevention of the organisms for eradication involved in hospital water systems.

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Epidemiological investigation of a case of nosocomial Legionnaires' disease in Taiwan: implications for routine environmental surveillance

Cited by 9 publications

References 16 publications

Molecular Detection of Legionella: Moving on From mip

Molecular Detection of Legionella: Moving on From mip

A community outbreak of Legionnaires' disease in Geneva, Switzerland, June to September 2017

Nosocomial Legionnaires’ Disease: Risque and Prevention

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