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The American Journal of Pathology Jun 1981
Review
Topics: Agglutination Tests; Antibody Specificity; Culture Media; Enzyme-Linked Immunosorbent Assay; Fluorescent Antibody Technique; Humans; Legionella; Legionnaires' Disease; Risk; Serologic Tests; Tissue Preservation; United States
PubMed: 7015873
DOI: No ID Found -
Journal of Environmental and Public... 2010In June and July 2008, two office workers were admitted to a Dublin hospital with Legionnaires' disease. Investigations showed that cooling towers in the basement car...
In June and July 2008, two office workers were admitted to a Dublin hospital with Legionnaires' disease. Investigations showed that cooling towers in the basement car park were the most likely source of infection. However, positive results from cooling tower samples by polymerase chain reaction (PCR) did not correlate with subsequent culture results. Also, many employees reported Pontiac fever-like morbidity following notification of the second case of Legionnaires' disease. In total, 54 employees attended their general practitioner or emergency department with symptoms of Legionnaires' disease or Pontiac fever. However, all laboratory tests for Legionnaires' disease or Pontiac fever were negative. In this investigation, email was used extensively for active case finding and provision of time information to employees and medical colleagues. We recommend clarification of the role of PCR in the diagnosis of legionellosis and also advocate for a specific laboratory test for the diagnosis of the milder form of legionellosis as in Pontiac fever.
Topics: Air Conditioning; Disease Outbreaks; Humans; Ireland; Legionella pneumophila; Legionnaires' Disease; Male; Middle Aged; Occupational Diseases; Polymerase Chain Reaction; Water Microbiology
PubMed: 20414339
DOI: 10.1155/2010/463926 -
Frontiers in Cellular and Infection... 2018() is an opportunistic waterborne pathogen and the causative agent for Legionnaires' disease, which is transmitted to humans via inhalation of contaminated water... (Review)
Review
() is an opportunistic waterborne pathogen and the causative agent for Legionnaires' disease, which is transmitted to humans via inhalation of contaminated water droplets. The bacterium is able to colonize a variety of man-made water systems such as cooling towers, spas, and dental lines and is widely distributed in multiple niches, including several species of protozoa In addition to survival in planktonic phase, is able to survive and persist within multi-species biofilms that cover surfaces within water systems. Biofilm formation by is advantageous for the pathogen as it leads to persistence, spread, resistance to treatments and an increase in virulence of this bacterium. Furthermore, Legionellosis outbreaks have been associated with the presence of in biofilms, even after the extensive chemical and physical treatments. In the microbial consortium-containing among other organisms, several factors either positively or negatively regulate the presence and persistence of in this bacterial community. Biofilm-forming is of a major importance to public health and have impact on the medical and industrial sectors. Indeed, prevention and removal protocols of as well as diagnosis and hospitalization of patients infected with this bacteria cost governments billions of dollars. Therefore, understanding the biological and environmental factors that contribute to persistence and physiological adaptation in biofilms can be detrimental to eradicate and prevent the transmission of . In this review, we focus on various factors that contribute to persistence of within the biofilm consortium, the advantages that the bacteria gain from surviving in biofilms, genes and gene regulation during biofilm formation and finally challenges related to biofilm resistance to biocides and treatments.
Topics: Biodiversity; Biofilms; Environment; Environmental Microbiology; Factor Analysis, Statistical; Gene Expression Profiling; Iron; Legionella pneumophila; Legionnaires' Disease; Microbial Viability; Quorum Sensing
PubMed: 29535972
DOI: 10.3389/fcimb.2018.00038 -
Internal Medicine (Tokyo, Japan) Jan 2021Legionellosis is a serious bacterial infection characterized by atypical pneumonia primarily due to infection with Legionella pneumophila, and bathing can be a potential...
Legionellosis is a serious bacterial infection characterized by atypical pneumonia primarily due to infection with Legionella pneumophila, and bathing can be a potential cause of this infection. Legionellosis was first identified in 1977, and it is caused by Gram-negative bacteria belonging to the genus Legionella. Legionellosis remains an important public health threat, particularly in Japan, where the population is rapidly aging, thereby becoming more at risk of developing severe disease and accompanying life-threatening pneumonia. The bacteria are most commonly transmitted via the inhalation of contaminated aerosols produced and broadcast via water sprays, jets or mists. Infection can also occur via the aspiration of contaminated water or ice, or through inhalation of contaminated dust. Because the signs and symptoms of Legionnaires' disease (LD), as well as radiographic imaging are similar to pneumonia caused by other pathogens, a specific diagnostic test is required, such as a urine antigen detection test. Six clinical and laboratory parameters, a high body temperature, a non-productive cough, low serum sodium and platelet counts, and high lactate dehydrogenase (LDH) and c-reactive protein concentrations can be used to reliably predict the likelihood of LD. The first choices for chemotherapy are fluoroquinolone and macrolide antibiotic drugs. The main goals of LD prevention measures are 1) the prevention of microbial growth and biofilm formation, 2) the removal of all biofilm formed on equipment and in facilities, 3) minimizing aerosol splash and spread, and 4) minimizing bacterial contamination from external sources. It is apparent that, in Japan, where hot spring (onsen) bathing is common among aged people, strict regulations need to be in place - and enforced - to ensure that all Japanese onsens and spas provide a safe environment and undertake regular, effective infection control practices.
Topics: Aged; Humans; Japan; Legionella; Legionella pneumophila; Legionellosis; Legionnaires' Disease; Water Microbiology
PubMed: 32727982
DOI: 10.2169/internalmedicine.4852-20 -
Archivum Immunologiae Et Therapiae... 2009The Legionellae are Gram-negative bacteria able to survive and replicate in a wide range of protozoan hosts in natural environments, but they also occur in man-made... (Review)
Review
The Legionellae are Gram-negative bacteria able to survive and replicate in a wide range of protozoan hosts in natural environments, but they also occur in man-made aquatic systems, which are the major source of infection. After transmission to humans via aerosols, Legionella spp. can cause pneumonia (Legionnaires' disease) or influenza-like respiratory infections (Pontiac fever). In children, Legionnaires' disease is uncommon and is mainly diagnosed in children with immunosuppression. The clinical picture of Legionella pneumonia does not allow differentiation from pneumonia caused by others pathogens. The key to diagnosis is performing appropriate microbiological testing. The clinical presentation and the natural course of Legionnaires' disease in children are not clear due to an insufficient number of samples, but morbidity and mortality caused by this infection are extremely high. The mortality rate for legionellosis depends on the promptness of an appropriate antibiotic therapy. Fluoroquinolones are the most efficacious drugs against Legionella. A combination of these drugs with macrolides seems to be promising in the treatment of immunosuppressed patients and individuals with severe legionellosis. Although all Legionella species are considered potentially pathogenic for humans, Legionella pneumophila is the etiological agent responsible for most reported cases of community-acquired and nosocomial legionellosis.
Topics: Aerosols; Animals; Diagnosis, Differential; Disease Transmission, Infectious; Drug Therapy, Combination; Fever; Fluoroquinolones; Humans; Legionellaceae; Legionnaires' Disease; Macrolides; Pneumonia; Virulence
PubMed: 19578813
DOI: 10.1007/s00005-009-0035-8 -
Current Opinion in Infectious Diseases Aug 2013The aim is to discuss the epidemiology of infections that arise from contaminated water in healthcare settings, including Legionnaires' disease, other Gram-negative... (Review)
Review
PURPOSE OF REVIEW
The aim is to discuss the epidemiology of infections that arise from contaminated water in healthcare settings, including Legionnaires' disease, other Gram-negative pathogens, nontuberculous mycobacteria, and fungi.
RECENT FINDINGS
Legionella can colonize a hospital water system and infect patients despite use of preventive disinfectants. Evidence-based measures are available for secondary prevention. Vulnerable patients can develop healthcare-associated infections with waterborne organisms that are transmitted by colonization of plumbing systems, including sinks and their fixtures. Room humidifiers and decorative fountains have been implicated in serious outbreaks, and pose unwarranted risks in healthcare settings.
SUMMARY
Design of hospital plumbing must be purposeful and thoughtful to avoid the features that foster growth and dissemination of Legionella and other pathogens. Exposure of patients who have central venous catheters and other invasive devices to tap water poses a risk for infection with waterborne pathogens. Healthcare facilities must conduct aggressive clinical surveillance for Legionnaires' disease and other waterborne infections in order to detect and remediate an outbreak promptly. Hand hygiene is the most important measure to prevent transmission of other Gram-negative waterborne pathogens in the healthcare setting.
Topics: Bacterial Infections; Disease Reservoirs; Drinking Water; Hospitals; Humans; Legionnaires' Disease; Mycoses; Protozoan Infections; Water Supply
PubMed: 23806897
DOI: 10.1097/QCO.0b013e3283630adf -
British Medical Journal Jan 1978
Topics: Adult; Aged; Disease Outbreaks; Fluorescent Antibody Technique; Humans; Legionnaires' Disease; Middle Aged; Pennsylvania; Respiratory Tract Infections
PubMed: 339988
DOI: No ID Found -
British Medical Journal Jul 1979
Topics: Humans; Legionnaires' Disease
PubMed: 466325
DOI: No ID Found -
Medecine Sciences : M/S 2012Legionella is the causative agent of Legionnaires' disease, a severe form of pneumonia. Detection of Legionella pneumophila serogroup 1 antigen in urine samples has... (Review)
Review
Legionella is the causative agent of Legionnaires' disease, a severe form of pneumonia. Detection of Legionella pneumophila serogroup 1 antigen in urine samples has shortened the delay of diagnosis and subsequent treatment initiation resulting in decreased mortality. Improved surveillance of potable water system reinforces the community prevention. In France, the National Reference Center for Legionella collects the strains responsible for sporadic or epidemic cases and crosslinks the data including epidemiological pattern, clinical presentation, and genetic analysis of the strains. Regarding host-pathogen interactions, major advances have been made recently in the understanding of L. pneumophila ability to subvert the host intracellular trafficking and the innate immune response leading to infection control.
Topics: Host-Pathogen Interactions; Humans; Legionella pneumophila; Legionnaires' Disease; Models, Biological; Population Surveillance
PubMed: 22805141
DOI: 10.1051/medsci/2012286018 -
British Medical Journal (Clinical... Aug 1983
Topics: Humans; Legionella; Legionnaires' Disease; Water Microbiology
PubMed: 6411164
DOI: 10.1136/bmj.287.6390.443