Nosocomial <i>Legionella pneumophila</i> serogroup 5 outbreak associated with persistent colonization of a hospital water system

Perola, Outi; Kauppinen, Juha; Kusnetsov, Jaana; Heikkinen, Jari; Jokinen, C; Katila, Marja–Leena

doi:10.1034/j.1600-0463.2002.1101204.x

Cited by 35 publications

(44 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In hospitals micro-aspiration may be an important route of transmission for patients lacking normal respiratory reflexes (Yu 2000). In many outbreaks hot water systems are the most frequently involved source of infection (Meenhorst et al 1985;Berthelot et al 1998;Fields et al 2002;Perola et al 2002). Temperature is in fact one of the main factors associated with the presence of legionellae, which are able to reproduce between 20 and 45°C, and can remain viable at much higher temperatures, even up to 60°C.…”

Section: Introductionmentioning

confidence: 99%

“…Community-acquired cases of Legionella infection have, for example, been linked to exposure to water systems of hotels (Joseph et al 1996;Benin et al 2002;Fields et al 2002) where a risk is created by the intermittent use of the water and the consequent stagnation, leading to the formation of biofilms in the piping. Furthermore, the presence of L. pneumophila in hospital water supplies is a well-known risk factor for nosocomial pneumonia (Colville et al 1993;Berthelot et al 1998;Perola et al 2002); there is also evidence of a widespread diffusion of the bacteria in domestic hot water distribution systems (Stout et al 1992;Marrie et al 1994;Zacheus and Martikainen 1994).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Legionella waterline colonization: detection of Legionella species in domestic, hotel and hospital hot water systems

et al. 2005

View full text Add to dashboard Cite

Aims: An evaluation was made of the prevalence of Legionella species in hot water distribution systems in the city of Bologna (Italy) and their possible association with bacterial contamination (total counts and Pseudomonadaceae) and the chemical characteristics of the water (pH, Ca, Mg, Fe, Mn, Cu, Zn and Total Organic Carbon, TOC). Methods and Results: A total of 137 hot water samples were analysed: 59 from the same number of private apartments, 46 from 11 hotels and 32 from five hospitals, all using the same water supply. Legionella species were detected in 40AE0% of the distribution systems, L. pneumophila in 33AE3%. The highest colonization was found in the hot water systems of hospitals (93AE7% of samples positive for L. pneumophila, geometric mean: 2AE4 · 10 3 CFU l )1 ), followed by the hotels (60AE9%, geometric mean: 127AE3 CFU l )1 ) and the apartments with centralized heating (41AE9%, geometric mean: 30AE5 CFU l )1 ). The apartments with independent heating systems showed a lower level of colonization (3AE6% for Legionella species), with no evidence of L. pneumophila. Correlation analysis suggests that copper exerts an inhibiting action, while the TOC tends to favour the development of L. pneumophila. No statistically significant association was seen with Pseudomonadaceae, which were found at lower water temperatures than legionellae and in individual distribution points rather than in the whole network. Conclusions:The water recirculation system used by centralized boilers enhances the spreading of legionellae throughout the whole network, both in terms of the number of colonized sites and in terms of CFU count. Significance and Impact of the Study: Differences in Legionella colonization between types of buildings are not due to a variation in water supply but to other factors. Besides the importance of water recirculation, the study demonstrates the inhibiting action of copper and the favourable action of TOC on the development of L. pneumophila.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Legionella waterline colonization: detection of Legionella species in domestic, hotel and hospital hot water systems

et al. 2005

View full text Add to dashboard Cite

show abstract

“…In a German study of hot-water samples from 452 households, water temperature was observed to be probably the most important factor for the multiplication of legionellae (25). Furthermore, it has been observed for many outbreaks of Legionnaires' disease that hot water was the most frequent source of infection (5,11,20,29). To bridge the gap to cultivation, we isolated and characterized 15 Legionella sp.…”

Section: Discussionmentioning

confidence: 99%

High-Resolution In Situ Genotyping of Legionella pneumophila Populations in Drinking Water by Multiple-Locus Variable-Number Tandem-Repeat Analysis Using Environmental DNA

Kahlisch

Henne

Draheim

et al. 2010

Appl Environ Microbiol

View full text Add to dashboard Cite

Central to the understanding of infections by the waterborne pathogen Legionella pneumophila is its detection at the clonal level. Currently, multiple-locus variable-number tandem-repeat (VNTR) analysis (MLVA) of L. pneumophila isolates can be used as a tool for high-resolution genotyping. Since L. pneumophila is difficult to isolate, the isolation of outbreak strains often fails due to a viable but nonculturable (VBNC) state of the respective environmental population. Therefore, we developed a cultivation-independent approach to detect single clones in drinking water. This approach is based on the extraction of DNA from drinking water followed by PCR using a set of eight VNTR primer pairs necessary for MLVA genotyping of L. pneumophila. The PCR amplicons were analyzed by single-strand conformation polymorphism (SSCP) and capillary electrophoresis to obtain the respective MLVA profiles. Parallel to the high-resolution analysis, we used the same environmental DNA to quantify the number of L. pneumophila cells in drinking water using real-time PCR with 16S rRNA gene-targeted primers. We used a set of drinking water samples from a small-scale drinking water network to test our approach. With these samples we demonstrated that the developed approach was directly applicable to DNA obtained from drinking water. We were able to detect more L. pneumophila MLVA genotypes in drinking water than we could detect by isolation. Our approach could be a valuable tool to identify outbreak strains even after the outbreak has occurred and has the potential to be applied directly to clinical material.

show abstract

“…In 1995, shock heat treatment was applied at a hospital in Finland after an outbreak of Legionnaires' disease caused by Legionella pneumophila serogroup 5 (15). A shock heat treatment unit was installed after a single round of shock heat treatment had failed.…”

Section: Heat Treatmentmentioning

confidence: 99%

Forebygging av legionærsykdom i sykehus

Sarjomaa¹,

Urdahl²,

Ramsli³

et al. 2011

Tidsskriftet

View full text Add to dashboard Cite

show abstract

Nosocomial Legionella pneumophila serogroup 5 outbreak associated with persistent colonization of a hospital water system

Cited by 35 publications

References 31 publications

Legionella waterline colonization: detection of Legionella species in domestic, hotel and hospital hot water systems

Legionella waterline colonization: detection of Legionella species in domestic, hotel and hospital hot water systems

High-Resolution In Situ Genotyping of Legionella pneumophila Populations in Drinking Water by Multiple-Locus Variable-Number Tandem-Repeat Analysis Using Environmental DNA

Forebygging av legionærsykdom i sykehus

Contact Info

Product

Resources

About