Legionella pneumophila recurrently isolated in a Spanish hospital: Two years of antimicrobial resistance surveillance

Graells, Tiscar; Hernández-García, Marta; Pérez-Jové, Josefa; Guy, Lionel; Padilla, Emma

doi:10.1016/j.envres.2018.06.045

Cited by 19 publications

(11 citation statements)

References 34 publications

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“…In 8/89 (9%) of the articles, the authors used the Kirby–Bauer method and followed the protocol proposed by the CLSI ( Table S1 raw data; [ 82 , 83 ]) or older citations ( Table S1 raw data; [ 40 , 84 ]). Finally, there were 9/89 (10%) articles that applied a combination of the methods ( Table S1 raw data; [ 42 , 46 , 56 , 65 , 85 , 86 , 87 , 88 , 89 ]) and one multi-center study from Dunbar et al 2007 [ 90 ]. In the Dunbar et al [ 90 ] study, they performed an alternative Broth Microdilution method (Sensititre microtitre plates containing freeze-dried antimicrobial agents) in order to evaluate the activity of telithromycin against a worldwide L. pneumophila isolate set.…”

Section: Resultsmentioning

confidence: 99%

Antibiotic Resistance of Legionella pneumophila in Clinical and Water Isolates—A Systematic Review

Παππά

Chochlakis

Sandalakis

et al. 2020

IJERPH

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The current systematic review investigates the antibiotic susceptibility pattern of Legionella pneumophila isolates from the 1980s to the present day, deriving data from clinical and/or water samples from studies carried out all over the world. Eighty-nine papers meeting the inclusion criteria, i.e., “Legionella pneumophila” and “resistance to antibiotics”, were evaluated according to pre-defined validity criteria. Sixty articles referred to clinical isolates, and 18 articles reported water-related L. pneumophila isolates, while 11 articles included both clinical and water isolates. Several methods have been proposed as suitable for the determination of MICs, such as the E-test, broth and agar dilution, and disk diffusion methods, in vivo and in vitro, using various media. The E-test method proposed by the European Society of Clinical Microbiology and Infectious Diseases (EUCAST) seems to be the second most frequently used method overall, but it is the preferred method in the most recent publications (2000–2019) for the interpretation criteria. Erythromycin has been proved to be the preference for resistance testing over the years. However, in the last 19 years, the antibiotics ciprofloxacin (CIP), erythromycin (ERM), levofloxacin (LEV) and azithromycin (AZM) were the ones that saw an increase in their use. A decrease in the sensitivity to antibiotics was identified in approximately half of the reviewed articles.

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Section: Resultsmentioning

confidence: 99%

Antibiotic Resistance of Legionella pneumophila in Clinical and Water Isolates—A Systematic Review

Παππά

Chochlakis

Sandalakis

et al. 2020

IJERPH

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“…Several respiratory pathogens of public health importance have been shown to be reliably identified using MALDI-TOF MS. Legionella spp. was identified from environmental samples in two different hospitals in a rapid and reliable manner [37,38].…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, available databases constructed by MALDI-TOF MS users can now be accessed online for the accurate identification of certain groups of microorganisms (https://microbenet.cdc.gov/) [37,107,108].…”

Section: Discussionmentioning

confidence: 99%

Review of the impact of MALDI-TOF MS in public health and hospital hygiene, 2018

et al. 2019

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IntroductionMALDI-TOF MS represents a new technological era for microbiology laboratories. Improved sample processing and expanded databases have facilitated rapid and direct identification of microorganisms from some clinical samples. Automated analysis of protein spectra from different microbial populations is emerging as a potential tool for epidemiological studies and is expected to impact public health.AimTo demonstrate how implementation of MALDI-TOF MS has changed the way microorganisms are identified, how its applications keep increasing and its impact on public health and hospital hygiene.MethodsA review of the available literature in PubMED, published between 2009 and 2018, was carried out.ResultsOf 9,709 articles retrieved, 108 were included in the review. They show that rapid identification of a growing number of microorganisms using MALDI-TOF MS has allowed for optimisation of patient management through prompt initiation of directed antimicrobial treatment. The diagnosis of Gram-negative bacteraemia directly from blood culture pellets has positively impacted antibiotic streamlining, length of hospital stay and costs per patient. The flexibility of MALDI-TOF MS has encouraged new forms of use, such as detecting antibiotic resistance mechanisms (e.g. carbapenemases), which provides valuable information in a reduced turnaround time. MALDI-TOF MS has also been successfully applied to bacterial typing.ConclusionsMALDI-TOF MS is a powerful method for protein analysis. The increase in speed of pathogen detection enables improvement of antimicrobial therapy, infection prevention and control measures leading to positive impact on public health. For antibiotic susceptibility testing and bacterial typing, it represents a rapid alternative to time-consuming conventional techniques.

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“…Specifically, eleven studies performed membrane filtration followed by plating onto selective agar media, nine of these studies used 0.45 µm pore diameter filters and two did not specify ( Table 1 ). Of those that specifically investigated Legionella spp., two studies referenced the International Organization for Standardization (ISO) 11731—water quality enumeration of Legionella [ 31 , 36 ]. One study investigating L. pneumophila followed Italian guidelines for prevention and the control of legionellosis [ 34 ] and two studies used other culturing techniques [ 35 , 44 ].…”

Section: Resultsmentioning

confidence: 99%

“…International standards have been published for the processing of environmental water samples for organisms such as Legionella spp., P. aeruginosa and E. coli . However, of the publications reviewed in this study, only three referenced a specific ISO standard [ 31 , 36 , 43 ]. There was significant variation between sampling techniques and selective growth media used in publications that investigated water-related surfaces such as tap faucets and drain holes [ 32 , 33 , 39 , 40 , 41 , 43 , 47 , 48 , 50 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

Water as a Source of Antimicrobial Resistance and Healthcare-Associated Infections

et al. 2020

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Healthcare-associated infections (HAIs) are one of the most common patient complications, affecting 7% of patients in developed countries each year. The rise of antimicrobial resistant (AMR) bacteria has been identified as one of the biggest global health challenges, resulting in an estimated 23,000 deaths in the US annually. Environmental reservoirs for AMR bacteria such as bed rails, light switches and doorknobs have been identified in the past and addressed with infection prevention guidelines. However, water and water-related devices are often overlooked as potential sources of HAI outbreaks. This systematic review examines the role of water and water-related devices in the transmission of AMR bacteria responsible for HAIs, discussing common waterborne devices, pathogens, and surveillance strategies. AMR strains of previously described waterborne pathogens including Pseudomonas aeruginosa, Mycobacterium spp., and Legionella spp. were commonly isolated. However, methicillin-resistant Staphylococcus aureus and carbapenem-resistant Enterobacteriaceae that are not typically associated with water were also isolated. Biofilms were identified as a hot spot for the dissemination of genes responsible for survival functions. A limitation identified was a lack of consistency between environmental screening scope, isolation methodology, and antimicrobial resistance characterization. Broad universal environmental surveillance guidelines must be developed and adopted to monitor AMR pathogens, allowing prediction of future threats before waterborne infection outbreaks occur.

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Legionella pneumophila recurrently isolated in a Spanish hospital: Two years of antimicrobial resistance surveillance

Cited by 19 publications

References 34 publications

Antibiotic Resistance of Legionella pneumophila in Clinical and Water Isolates—A Systematic Review

Antibiotic Resistance of Legionella pneumophila in Clinical and Water Isolates—A Systematic Review

Review of the impact of MALDI-TOF MS in public health and hospital hygiene, 2018

Water as a Source of Antimicrobial Resistance and Healthcare-Associated Infections

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