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International Journal of Environmental... Jun 2019(Lp) is the most common etiologic agent causing Legionnaires' Disease (LD). Water systems offer the best growth conditions for Lp and support its spread by producing...
BACKGROUND
(Lp) is the most common etiologic agent causing Legionnaires' Disease (LD). Water systems offer the best growth conditions for Lp and support its spread by producing aerosols. From 2015 to 2017, the Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis of Palermo monitored the presence of Lp in nine prisons in Western Sicily. During this investigation, we compared Lp isolates from environmental samples in a prison located in Palermo with isolates from two prisoners in the same prison.
METHODS
We collected 93 water samples from nine Sicilian prisons and the bronchoalveolar lavages (BALs) of two prisoners considered cases of LD. These samples were processed following the procedures described in the Italian Guidelines for the Prevention and Control of Legionellosis of 2015. Then, genotyping was performed on 19 Lp colonies (17 from water samples and 2 from clinical samples) using the Sequence-Based Typing (SBT) method, according to European Study Group for Legionella Infections (ESGLI) protocols.
RESULTS
Lp serogroup (sg) 6 was the most prevalent serogroup isolated from the prisons analyzed (40%), followed by Lp sg 1 (16%). Most of all, in four penitentiary institutions, we detected a high concentration of Lp >10 Colony Forming Unit/Liter (CFU/L). The environmental molecular investigation found the following Sequence Types (STs) in Lp sg 6: ST 93, ST 292, ST 461, ST 728, ST 1317 and ST 1362, while most of the isolates in sg 1 belonged to ST 1. We also found a new ST that has since been assigned the number 2451 in the ESGLI-SBT database. From the several Lp sg 1 colonies isolated from the two BALs, we identified ST 2451.
CONCLUSIONS
In this article, we described the results obtained from environmental and epidemiological investigations of Lp isolated from prisons in Western Sicily. Furthermore, we reported the first cluster of Legionnaires' in an Italian prison and the molecular typing of Lp sg 1 from one prison's water system and two BALs, identified the source of the contamination, and discovered a new ST.
Topics: Cluster Analysis; Environmental Monitoring; Humans; Italy; Legionella pneumophila; Legionnaires' Disease; Prevalence; Prisons; Water Microbiology
PubMed: 31212678
DOI: 10.3390/ijerph16112062 -
Acta Bio-medica : Atenei Parmensis Mar 2022In order to cope with the requirements of COVID-19 pandemic and prevent overwhelming of the healthcare systems, during 2020 social distancing measures were proposed, and...
BACKGROUND AND AIM
In order to cope with the requirements of COVID-19 pandemic and prevent overwhelming of the healthcare systems, during 2020 social distancing measures were proposed, and generalized lockdown. Aim of our study is to ascertain whether non-pharmaceutical intervention did have any impact on the epidemiology of Legionnaires' disease (LD), a respiratory infectious disease without interhuman spreading.
METHODS
Official national reports from 4 index countries in European Union (i.e. Germany, France, Italy, and Spain) were retrieved. The study included all cases notified during 2020 COVID-19 outbreak, versus the cases referred during the same period in 2019. Subgroup analyses for hospital-associated and travel-associated LD cases, as well as for lethality estimates were performed.
RESULTS
A sustained drop for incidence rate was confirmed, at EU-level (3.5 per 100,000 vs. 5.3 per 100,000) as well as in the national estimates. The decrease was particularly evident in Italy (RR 0.880, 95%CI 0.839 to 0.905), despite a transient surge in notification rates during the month of June, 2020. Subgroup analyses demonstrated a fall in travel-associated cases (-66.8% at EU level), while hospital-associated cases decreased in absolute number when compared to 2019, but where substantially stable in terms when compared to EU estimates. While Case Fatality Ratio increased in comparison with 2019, no significant trend was similarly identified in comparison to EU estimates. Conclusions. Lockdown measures have impacted on the epidemiology of LD in Europe during 2020, but some heterogeneities were identified both across the assessed countries, and the various subgroup. Even though the absolute number of total cases did substantially decrease in 2020 compared to 2019, the effect of non-pharmaceutical interventions was mostly indirect, through a reduced interaction of individuals with environments at potentially high-risk for human infections (e.g. hospitals, accommodation sites, etc.).
Topics: COVID-19; Communicable Disease Control; Humans; Legionnaires' Disease; Pandemics; Travel
PubMed: 35315385
DOI: 10.23750/abm.v93i1.12744 -
Emerging Infectious Diseases Jul 2020We describe 2 cases of healthcare-associated Legionnaires' disease in patients in France hospitalized 5 months apart in the same room. Whole-genome sequencing analyses...
We describe 2 cases of healthcare-associated Legionnaires' disease in patients in France hospitalized 5 months apart in the same room. Whole-genome sequencing analyses showed that clinical isolates from the patients and isolates from the room's toilet clustered together. Toilet contamination by Legionella pneumophila could lead to a risk for exposure through flushing.
Topics: Bathroom Equipment; Cross Infection; France; Humans; Legionella pneumophila; Legionnaires' Disease
PubMed: 32568063
DOI: 10.3201/eid2607.190941 -
Emerging Infectious Diseases Nov 2021Both Legionella pneumophila and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause pneumonia. L. pneumophila is acquired from water sources,...
Both Legionella pneumophila and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause pneumonia. L. pneumophila is acquired from water sources, sometimes in healthcare settings. We report 2 fatal cases of L. pneumophila and SARS-CoV-2 co-infection in England. Clinicians should be aware of possible L. pneumophila infections among SARS-CoV-2 patients.
Topics: COVID-19; Coinfection; Humans; Legionella pneumophila; Legionnaires' Disease; SARS-CoV-2
PubMed: 34670660
DOI: 10.3201/eid2711.204121 -
Frontiers in Cellular and Infection... 2017FIH-mediated post-translational modification through asparaginyl hydroxylation of eukaryotic proteins impacts regulation of protein-protein interaction. We have...
FIH-mediated post-translational modification through asparaginyl hydroxylation of eukaryotic proteins impacts regulation of protein-protein interaction. We have identified the FIH recognition motif in 11 translocated effectors, YopM of , IpaH4.5 of and an ankyrin protein of . Mass spectrometry analyses of the AnkB and AnkH effectors of confirm their asparaginyl hydroxylation. Consistent with localization of the AnkB effector to the -containing vacuole (LCV) membrane and its modification by FIH, our data show that FIH and its two interacting proteins, Mint3 and MT1-MMP are acquired by the LCV in a Dot/Icm type IV secretion-dependent manner. Chemical inhibition or RNAi-mediated knockdown of FIH promotes LCV-lysosomes fusion, diminishes decoration of the LCV with polyubiquitinated proteins, and abolishes intra-vacuolar replication of . These data show acquisition of the host FIH by a pathogen-containing vacuole and that asparaginyl-hydroxylation of translocated effectors is indispensable for their function.
Topics: Amino Acid Motifs; Asparagine; Bacterial Proteins; Cell Line; Consensus Sequence; Gene Expression Regulation, Bacterial; Host-Pathogen Interactions; Humans; Hydroxylation; Legionella pneumophila; Legionnaires' Disease; Microbial Viability; Mixed Function Oxygenases; Mutation; Protein Processing, Post-Translational; Protein Transport; Repressor Proteins; Ubiquitin
PubMed: 28321389
DOI: 10.3389/fcimb.2017.00054 -
JAMA Network Open Jun 2018
Topics: Cross Infection; Health Facilities; Healthcare-Associated Pneumonia; Humans; Legionnaires' Disease; United States; Veterans
PubMed: 30646069
DOI: 10.1001/jamanetworkopen.2018.0232 -
Pulmonology 2019
Topics: Anti-Bacterial Agents; Antiviral Agents; Humans; Legionella pneumophila; Legionnaires' Disease; Magnetic Resonance Imaging; Male; Meningoencephalitis; Meropenem; Middle Aged; Treatment Outcome
PubMed: 30782478
DOI: 10.1016/j.pulmoe.2018.12.006 -
American Journal of Physiology. Lung... Mar 2023is the main etiological agent of Legionnaires' disease, a severe bacterial pneumonia. is initially engulfed by alveolar macrophages (AMs) and subvert normal cellular...
is the main etiological agent of Legionnaires' disease, a severe bacterial pneumonia. is initially engulfed by alveolar macrophages (AMs) and subvert normal cellular functions to establish a replicative vacuole. Cigarette smokers are particularly susceptible to developing Legionnaires' disease and other pulmonary infections; however, little is known about the cellular mechanisms underlying this susceptibility. To investigate this, we used a mouse model of acute cigarette smoke exposure to examine the immune response to cigarette smoke and subsequent infection. Contrary to previous reports, we show that cigarette smoke exposure alone causes a significant depletion of AMs using enzymatic digestion to extract cells, or via imaging intact lung lobes by light-sheet microscopy. Furthermore, treatment of mice deficient in specific types of cell death with smoke suggests that NLRP3-driven pyroptosis is a contributor to smoke-induced death of AMs. After infection, smoke-exposed mice displayed increased pulmonary loads and developed more severe disease compared with air-exposed controls. We tested if depletion of AMs was related to this phenotype by directly depleting them with clodronate liposomes and found that this also resulted in increased loads. In summary, our results showed that cigarette smoke depleted AMs from the lung and that this likely contributed to more severe Legionnaires' disease. Furthermore, the role of AMs in infection is more nuanced than simply providing a replicative niche, and our studies suggest they play a major role in bacterial clearance.
Topics: Mice; Animals; Legionella pneumophila; Macrophages, Alveolar; Legionnaires' Disease; Cigarette Smoking; Lung
PubMed: 36719079
DOI: 10.1152/ajplung.00268.2022 -
BMC Infectious Diseases Sep 2018Legionellosis is a well-known cause of pneumonia. Primary cutaneous and subcutaneous infection caused by Legionella pneumophila is rare and the diagnosis is challenging. (Review)
Review
BACKGROUND
Legionellosis is a well-known cause of pneumonia. Primary cutaneous and subcutaneous infection caused by Legionella pneumophila is rare and the diagnosis is challenging.
CASE PRESENTATION
A 38-year-old Thai woman with systemic lupus erythematosus and myasthenia gravis treated with prednisolone and azathioprine presented to our hospital with low-grade fever, diarrhea, and indurated skin lesions on both thighs. Initial examination showed plaques on both inner thighs. Magnetic resonance imaging showed myositis and swelling of the skin and subcutaneous tissue. Diagnosis of panniculitis due to L. pneumophila was carried out by histopathology, Gram stain, and 16S rRNA gene sequencing method of tissue biopsy from multiple sites on both thighs. Myocarditis was diagnosed by echocardiography. The final diagnosis was disseminated extrapulmonary legionellosis. Treatment comprised intravenous azithromycin for 3 weeks and the skin lesions, myositis and myocarditis resolved. Oral azithromycin and ciprofloxacin were continued for 3 months to ensure eradication of the organism. The patient's overall condition improved.
CONCLUSIONS
To our knowledge, we report the first case of L. pneumophila infection manifesting with panniculitis, possible myositis, and myocarditis in the absence of pneumonia. The diagnosis of extrapulmonary Legionella infection is difficult, especially in the absence of pneumonia. A high index of suspicion and appropriate culture with special media or molecular testing are required. Initiation of appropriate treatment is critical because delaying therapy was associated with progressive infection in our patient.
Topics: Adult; Female; Humans; Legionella pneumophila; Legionnaires' Disease; Lupus Erythematosus, Systemic; Panniculitis; Skin Diseases, Bacterial
PubMed: 30223775
DOI: 10.1186/s12879-018-3378-0 -
Journal of Public Health Management and... 2017The incidence of legionellosis has sharply increased in the United States as a result of contaminated water systems. Jurisdictions across the country are considering...
CONTEXT
The incidence of legionellosis has sharply increased in the United States as a result of contaminated water systems. Jurisdictions across the country are considering whether to develop and implement regulations to protect individuals against Legionnaires' disease with its associated high morbidity and mortality.
OBJECTIVE
This article sheds light on the implementation and effectiveness of a 2005 citywide Legionella testing mandate of multifamily housing cooling towers in Garland, Texas. This ordinance has been in place for more than 10 years and represents the first of its kind in the United States to mandate routine testing of cooling towers for Legionella in multifamily housing.
DESIGN, SETTING, AND POPULATION
We utilized a mix of both qualitative and quantitative methods to explore the development, adoption, and implementation of the ordinance. Phone interviews were conducted with individuals from the City of Garland Health Department and apartment managers. Quantitative data included public health surveillance data on legionellosis.
MAIN OUTCOME MEASURES
Barriers and facilitators of implementation, number and percentage of cooling towers from multifamily housing units that tested positive for Legionella by year, and number of legionellosis cases by year in Garland, Texas.
RESULTS
Study outcomes highlight key themes that facilitated the successful implementation of the Legionella testing mandate, including the importance of timing, leadership support, stakeholder engagement, and education and outreach. The number of contaminated cooling towers was reduced over time.
CONCLUSION
Mandatory monitoring for legionella in a local jurisdiction may result in reduced risk of legionellosis from cooling towers through raising awareness and education of building owners and managers about the need to prevent, detect, and remediate legionella contamination in their building water systems. Garland, Texas, broke new ground in the United States in moving toward primary prevention of legionellosis. The ordinance may be useful both in serving to educate and increase awareness about the need for Legionella prevention and to monitor effectiveness of maintenance procedures.
Topics: Disease Outbreaks; Drinking Water; Housing; Humans; Incidence; Legionella; Legionnaires' Disease; Population Surveillance; Public Health; Qualitative Research; Texas
PubMed: 28141673
DOI: 10.1097/PHH.0000000000000518