<i>Legionella pneumophila</i> in a hospital water system following a nosocomial outbreak: prevalence, monoclonal antibody subgrouping and effect of control measures

Ribeiro, C. D.; Burge, S. H.; Palmer, S.R.; Tobin, J. O'h.; Watkins, I. D.

doi:10.1017/s0950268800062002

Cited by 27 publications

(12 citation statements)

References 10 publications

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“…In another hospital, changing washers did not eradicate Legionella. 104 Although these approved materials may not promote the growth of Legionella , biofilms will eventually develop on most plumbing materials. Legionella will even colonize biofilms on surfaces of copper, a substance known to inhibit Legionella 's growth 6 …”

Section: Unvalidated Eradication Methodsmentioning

confidence: 99%

Legionella in water distribution systems

Yuan¹,

Vidić²,

Stout³

et al. 1998

Journal AWWA

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Regular culturing of distribution system samples is the key to successful disinfection. Legionnaires' disease arises from the presence of Legionella in water systems. Legionella can be found within biofilms throughout the entire water distribution system. Control measures such as copper‐silver ionization, superheat‐and‐flush procedures, ultraviolet light, instantaneous heating systems, and hyperchlorination have been applied with variable success. Specific approaches, advantages, disadvantages, and costs of each method are reviewed. Many approaches commonly recommended by public health authorities have not been scientifically validated. Results from routine environmental surveillance cultures for Legionella are the critical component for rational decision‐making.

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Section: Unvalidated Eradication Methodsmentioning

confidence: 99%

Legionella in water distribution systems

Yuan¹,

Vidić²,

Stout³

et al. 1998

Journal AWWA

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“…Legionella pneumophila is the causative agent of Legionnaires' disease, a severe pneumonia, and the nonpneumonic syndrome Pontiac fever (28). It is known that legionellae are ubiquitous in water environments (5,7,10,13,18,19,25). They have been isolated from warm water taps and faucets, humidifiers, warm water tanks, cooling towers, dental units, and other warm water reservoirs.…”

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confidence: 99%

“…In this way epidemiological linkage between water systems and patients has been established for L. pneumophila serogroup 1. It has been documented that in plumbing fixtures various Legionella species, serogroups, and subgroups can exist (2,5,16,18,19,21,23,25). Factors which influence appearance and disappearance of defined subtypes are not understood.…”

mentioning

confidence: 99%

Analysis of Legionella pneumophila serogroup 6 strains isolated from a hospital warm water supply over a three-year period by using genomic long-range mapping techniques and monoclonal antibodies

Lück

Bender

Ott

et al. 1991

Appl Environ Microbiol

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Over a period of 3 years, Legionella pneumophila serogroup 6 strains were isolated from warm water outlets and dental units in the Dental Faculty and from the Surgery and Internal Medicine Clinics at the University * Corresponding author. serogroup 6 strains isolated during a 3-year surveillance from a water system at the School of Medicine in Dresden, Germany. MATERIALS AND METHODS Water samples. After at least 16 h of stagnation, 0.3to 0.5-liter water samples were collected from dental units and warm water taps in the Faculty of Dentistry, School of Medicine in Dresden over a 3-year period. In the Internal Medicine Clinic, Surgery Clinic, and the bacteriological unit, warm water specimens from taps and faucets were sampled once in the same manner. The four facilities mentioned above are separate buildings, connected with a ring pipe warm water system. This water system is fed by two separate hot water tanks, which were employed one after the other. The temperature in these tanks was adjusted to between 56 and 58°C. During this study, no measures for eliminating legionellae such as superheating to 70°C or chlorination were made. The water temperature in the warm water system ranged from 30 to 50°C at the time of water collection. Legionella strains and culture conditions. Water samples were concentrated by centrifugation at 5,500 x g for 30 min. Legionellae were isolated on ACES [N-(2-acetamido)-2aminoethanesulfonic acid]-buffered charcoal-yeast extract (BCYE) agar medium (4, 8) supplemented with 0.1% ox-ketoglutarate (Sigma Corp.

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“…No source of exposure was identified at that time, but serologically indistinguishable L. pneumophilia serogroup 1 strains were obtained from clinical and potable water samples. 8,9 Following the initial case in the present study, the water system of the CICU was isolated from the hospital system and hyperchlorination with chlorine dioxide was undertaken.…”

Section: Methodsmentioning

confidence: 99%