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Annals of Agricultural and... Dec 2023Legionella bacteria are commonly found in natural aquatic environments such as rivers, lakes, ponds and hot springs. Legionella infection occurs through the inhalation...
INTRODUCTION AND OBJECTIVE
Legionella bacteria are commonly found in natural aquatic environments such as rivers, lakes, ponds and hot springs. Legionella infection occurs through the inhalation of water-air aerosol generated, for example, by showers or hot tubs. The most common species responsible for infection is Legionella pneumophila, which can cause Pontiac fever, and Legionnaires' disease, as well as a rare extrapulmonary form. The aim of the study's is to assess the susceptibility of Legionella pneumophila bacteria isolated from water systems of public buildings in Poland to antibiotics and chemotherapeutic agents used in the treatment of Legionellosis pneumonia.
MATERIAL AND METHODS
A total of 100 L. pneumophila strains isolated from public buildings, such as hospitals and water recreation facilities, were used for the study. The drug sensitivity of the following antibiotics was determined: erythromycin, azithromycin, ciprofloxacin, levofloxacin, rifampicin, trimethoprim-sulfamethoxazole and tetracycline. Mean MIC50 and MIC90 values were read using accepted standards.
RESULTS
The highest mean MIC value was obtained for tetracycline 6,130+/-0,353 μg/ml (with a range from 1,500 μg/ml to 16,000 μg/ml. In contrast, the lowest MIC was recorded with rifampicin: 0.020+/-0.037 μg/ml (with a range from 0.016 μg/ml to 0.380 μg/ml).
CONCLUSIONS
The lowest biocidal concentration was found for levofloxacin, the highest for tetracycline. The highest MIC50 and MIC90 values were found for tetracycline and the lowest for rifampicin. The highest biocidal values were found for azithromycin and the lowest for tetracycline.
Topics: Humans; Anti-Bacterial Agents; Legionella pneumophila; Rifampin; Levofloxacin; Azithromycin; Poland; Legionnaires' Disease; Tetracycline; Water; Legionella; Microbial Sensitivity Tests
PubMed: 38153060
DOI: 10.26444/aaem/167934 -
Journal of Travel Medicine 2015Travel-associated Legionnaires' disease (LD) is a serious problem, and hundreds of cases are reported every year among travelers who stayed at hotels, despite the... (Review)
Review
BACKGROUND
Travel-associated Legionnaires' disease (LD) is a serious problem, and hundreds of cases are reported every year among travelers who stayed at hotels, despite the efforts of international and governmental authorities and hotel operators to prevent additional cases.
METHODS
A systematic review of travel-associated LD events (cases, clusters, outbreaks) and of environmental studies of Legionella contamination in accommodation sites was conducted. Two databases were searched (PubMed and EMBASE). Data were extracted from 50 peer-reviewed articles that provided microbiological and epidemiological evidence for linking the accommodation sites with LD. The strength of evidence was classified as strong, possible, and probable.
RESULTS
Three of the 21 hotel-associated events identified and four of nine ship-associated events occurred repeatedly on the same site. Of 197 hotel-associated cases, 158 (80.2%) were linked to hotel cooling towers and/or potable water systems. Ship-associated cases were most commonly linked to hot tubs (59/83, 71.1%). Common contributing factors included inadequate disinfection, maintenance, and monitoring; water stagnation; poor temperature control; and poor ventilation. Across all 30 events, Legionella concentrations in suspected water sources were >10,000 cfu/L, <10,000 cfu/L, and unknown in 11, 3, and 13 events, respectively. In five events, Legionella was not detected only after repeated disinfections. In environmental studies, Legionella was detected in 81.1% of ferries (23/28) and 48.9% of hotels (587/1,200), while all 12 cruise ships examined were negative.
CONCLUSIONS
This review highlights the need for LD awareness strategies targeting operators of accommodation sites. Increased standardization of LD investigation and reporting, and more rigorous follow-up of LD events, would help generate stronger, more comparable evidence on LD sources, contributing factors, and control measure effectiveness.
Topics: Disease Outbreaks; Humans; Legionella pneumophila; Legionnaires' Disease; Risk Factors; Ships; Travel
PubMed: 26220258
DOI: 10.1111/jtm.12225 -
Clinical Microbiology Reviews Jan 1988In the summer of 1976, a mysterious epidemic of fatal respiratory disease in Philadelphia launched an intensive investigation that resulted in the definition of a new... (Review)
Review
In the summer of 1976, a mysterious epidemic of fatal respiratory disease in Philadelphia launched an intensive investigation that resulted in the definition of a new family of pathogenic bacteria, the Legionellaceae. In retrospect, members of the family had been isolated from clinical specimens as early as 1943. Unsolved epidemics of acute respiratory disease dating to the 1950s were subsequently attributed to the newly described pathogens. In the intervening years, the Legionellaceae have been firmly established as important causes of sporadic and epidemic respiratory disease. The sources of the infecting bacteria are environmental, and geographic variation in the frequency of infection has been documented. Airborne dissemination of bacteria from cooling towers and evaporative condensers has been responsible for some epidemics, but potable water systems are perhaps more important sources. The mode of transmission from drinking water is unclear. The Legionellaceae are gram-negative, facultative, intracellular pathogens. The resident alveolar macrophage, usually an effective antibacterial defense, is the primary site of growth. Cell-mediated immunity appears to be the most important immunological defense; the role of humoral immunity is less clear. Erythromycin remains the antibiotic of choice for therapy of infected patients, but identification and eradication of environmental sources are also essential for the control of infection.
Topics: Disease Outbreaks; History, 20th Century; Humans; Legionnaires' Disease; Philadelphia; United States
PubMed: 3060246
DOI: 10.1128/CMR.1.1.60 -
BMC Infectious Diseases Sep 2023Severe community-acquired pneumonia (SCAP) is commonly treated with an empiric combination therapy, including a macrolide, or a quinolone and a β-lactam. However, the...
BACKGROUND
Severe community-acquired pneumonia (SCAP) is commonly treated with an empiric combination therapy, including a macrolide, or a quinolone and a β-lactam. However, the risk of Legionella pneumonia may lead to a prolonged combination therapy even after negative urinary antigen tests (UAT).
METHODS
We conducted a retrospective cohort study in a French intensive care unit (ICU) over 6 years and included all the patients admitted with documented SCAP. All patients received an empirical combination therapy with a β-lactam plus a macrolide or quinolone, and a Legionella UAT was performed. Macrolide or quinolone were discontinued when the UAT was confirmed negative. We examined the clinical and epidemiological features of SCAP and analysed the independent factors associated with ICU mortality.
RESULTS
Among the 856 patients with documented SCAP, 26 patients had atypical pneumonia: 18 Legionella pneumophila (LP) serogroup 1, 3 Mycoplasma pneumonia (MP), and 5 Chlamydia psittaci (CP). UAT diagnosed 16 (89%) Legionella pneumonia and PCR confirmed the diagnosis for the other atypical pneumonia. No atypical pneumonia was found by culture only. Type of pathogen was not associated with a higher ICU mortality in the multivariate analysis.
CONCLUSION
Legionella pneumophila UAT proved to be highly effective in detecting the majority of cases, with only a negligible percentage of patients being missed, but is not sufficient to diagnose atypical pneumonia, and culture did not provide any supplementary information. These results suggest that the discontinuation of macrolides or quinolones may be a safe option when Legionella UAT is negative in countries with a low incidence of Legionella pneumonia.
Topics: Humans; Anti-Bacterial Agents; Retrospective Studies; Pneumonia, Mycoplasma; Legionnaires' Disease; Lactams; Quinolones; Antigens, Bacterial; Community-Acquired Infections; Influenza, Human; beta-Lactams
PubMed: 37723456
DOI: 10.1186/s12879-023-08493-5 -
Journal of Clinical Pathology Nov 1979
Topics: Aged; Antibodies, Bacterial; Humans; Immunoglobulin M; Legionnaires' Disease; Male; Middle Aged; Retrospective Studies
PubMed: 512034
DOI: 10.1136/jcp.32.11.1191 -
Canadian Medical Association Journal May 1979
Topics: Diagnosis, Differential; Humans; Legionnaires' Disease; Male; Middle Aged
PubMed: 445298
DOI: No ID Found -
Revista Chilena de Infectologia :... Jun 2008
Topics: Humans; Legionella pneumophila; Legionnaires' Disease
PubMed: 18581001
DOI: No ID Found -
Frontiers in Cellular and Infection... 2018is a gram-negative bacterium that inhabits freshwater ecosystems, where it is present in biofilm or as planktonic form. is mainly found associated with protozoa, which... (Review)
Review
is a gram-negative bacterium that inhabits freshwater ecosystems, where it is present in biofilm or as planktonic form. is mainly found associated with protozoa, which serve as protection from hostile environments and as replication niche. If inhaled within aerosols, is also able to infect and replicate in human alveolar macrophages, eventually causing the Legionnaires' disease. The transition between intracellular and extracellular environments triggers a differentiation program in which metabolic as well as morphogenetic changes occur. We here describe the current knowledge on how the different developmental states of this bacterium are regulated, with a particular emphasis on the stringent response activated during the transition from the replicative phase to the infectious phase and the metabolic features going in hand. We propose that the cellular differentiation of this intracellular pathogen is closely associated to key metabolic changes in the bacterium and the host cell, which together have a crucial role in the regulation of virulence.
Topics: Animals; Energy Metabolism; Environment; Host-Pathogen Interactions; Humans; Legionella pneumophila; Legionnaires' Disease; Life Cycle Stages; Metabolic Networks and Pathways; Virulence
PubMed: 29404281
DOI: 10.3389/fcimb.2018.00003 -
BMC Pulmonary Medicine May 2022Acute fibrinous and organizing pneumonia (AFOP) is a rare clinicopathological condition. Studies in the literature have reported that AFOP may be associated with... (Review)
Review
BACKGROUND
Acute fibrinous and organizing pneumonia (AFOP) is a rare clinicopathological condition. Studies in the literature have reported that AFOP may be associated with respiratory infections, such as respiratory syncytial virus, influenza virus, Pneumocystis jirovecii, Penicillium citrinum, and Chlamydia infections. However, AFOP associated with Legionella infection has not been reported previously. Here, we report a case of a patient with AFOP secondary to Sjögren's syndrome and Legionella infection.
CASE PRESENTATION
A 47-year-old man was admitted to the hospital because of fever, expectoration, and shortness of breath. Lung imaging showed irregular patchy consolidation. A diagnosis of Legionella pneumonia was initially considered on the basis of the patient's history of exposure to soil before disease onset, signs of extrapulmonary involvement, and a positive Legionella urine antigen test result. However, the patient's symptoms and lung imaging did not improve after treatment with levofloxacin, moxifloxacin, and tigecycline for Legionella infection. In addition, Sjögren's syndrome was diagnosed on the basis of clinical manifestations and immunological indicators. Pathological changes associated with AFOP were confirmed from the results of ultrasound-guided percutaneous lung biopsy. The patient's clinical symptoms improved rapidly after a short course of low-dose corticosteroid therapy, and lung imaging showed significant improvement.
CONCLUSIONS
The possibility of secondary AFOP should be considered when Legionella pneumonia does not improve after standard antibiotic therapy. Lung biopsy and histopathological examination are important for the adjustment of treatment strategy. Our case also highlights the importance of screening for autoimmune diseases in patients with AFOP.
Topics: Humans; Image-Guided Biopsy; Legionella; Legionnaires' Disease; Lung; Male; Middle Aged; Pneumonia; Sjogren's Syndrome
PubMed: 35610634
DOI: 10.1186/s12890-022-01997-x -
Tidsskrift For Den Norske Laegeforening... Sep 2005
Topics: Communicable Disease Control; Disease Outbreaks; Humans; Legionella pneumophila; Legionnaires' Disease; Norway; Polymerase Chain Reaction; Water Microbiology; Water Supply
PubMed: 16186884
DOI: No ID Found