1/7. legionellosis from legionella pneumophila serogroup 13.We describe 4 cases of legionella pneumophila serogroup 13-associated pneumonia. These cases originate from a broad geographic range that includes scotland, australia, and new zealand. L. pneumophila serogroup 13 pneumonia has a clinically diverse spectrum that ranges from relatively mild, community-acquired pneumonia to potentially fatal severe pneumonia with multisystem organ failure. All cases were confirmed by culture and direct fluorescent antibody staining or indirect immunofluorescent antibody tests. Proven or putative sources of L. pneumophila serogroup 13 infections in 2 patients included a contaminated whirlpool spa filter and river water. An environmental source was not found in the remaining 2 cases; environmental cultures yielded only other L. pneumophila serogroups or nonpneumophila Legionella species. We describe the clinical and laboratory features of L. pneumophila serogroup 13 infections. L. pneumophila serogroup 13 pneumonia is rarely reported, but it may be an underrecognized pathogenic serogroup of L. pneumophila.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
2/7. A legionellosis case due to contaminated spa water and confirmed by genomic identification in taiwan.Tracing the source of a legionellosis (LG) case revealed that the legionella pneumophila (LP) strain isolated from patient's sputum shared the same serogroup (SG) and PFGE-type with 4 LP strains obtained from a spa center. With a high LP-contamination rate (81.2%, 13/16) in all of its 16 basins, this spa center was also found to have a multi-genotypic distribution among its 13 LP isolates, which can be categorized into 5 PFGE-types. Despite such a serious contamination in the spa center, which usually had ca. 100 visitors per day, this male patient, bearing LG-risk factors of long-term heavy smoking and alcoholism, was the only case identifiable after an active investigation. To explore the possible reason for this sporadic infection, all 5 PFGE-types of LP isolated were assayed for their presence of two important virulent genes (lvh and rtx A) and were identified as either less-virulent (lvh ( ) , rtx A( )) or non-virulent (lvh (-), rtx A (-)) types. The strong virulent type (lvh ( ), rtx A ( )) usually seen in clinical strains elsewhere was not found here. Moreover, the LG-causative type in this infection was the only one to be classified as the less-virulent type, with the presence of lvh gene indicating its relatively more virulent potential than other 4 PFGE-types. Accordingly, mutual interaction between LP's virulent potential and patient's health-status was suggested to be the force directing the opportunistic infection of this sporadic case. This is the first spa-associated infection caused by SG 2 of LP.- - - - - - - - - - ranking = 4keywords = water (Clic here for more details about this article) |
3/7. Use of sequence-based typing for investigation of a case of nosocomial legionellosis.A fatal case of nosocomial legionellosis in a low prevalence region (Calgary, alberta, canada) prompted investigation into the source of infection. Hospital water systems contaminated with legionella pneumophila have been shown to pose a risk to compromised patients. Typing of an L. pneumophila serogroup 1 strain isolated from the patient using sequence-based typing (SBT) and amplified fragment length polymorphism (AFLP) analysis linked it to a persistent and widespread strain isolated from the hospital water system establishing a nosocomial mode of acquisition. Different SBT and AFLP patterns were determined for non-epidemiologically linked cases and isolates from different hospitals.- - - - - - - - - - ranking = 2keywords = water (Clic here for more details about this article) |
4/7. legionella pneumophila peritonitis in a kidney transplant patient.legionella pneumophila serotype 6 was isolated from the peritoneal fluid of a 59-year-old immunosuppressed patient who developed peritonitis shortly after kidney transplantation. Clinical and radiological examination did not show pulmonary abnormalities until shortly before his death when multiple organ failure developed with adult respiratory distress syndrome (ARDS). Post mortem examination showed L. pneumophila in the peritoneum and in a small pulmonary infiltrate, confirmed by positive cultures. A primary peritoneal inoculation via an indwelling Tenckoff catheter seems to have been the most likely route of infection. Positive L. pneumophila type 6 cultures were obtained from the shower and hot water tap in the room of the patient. L. pneumophila must be considered as a potential cause of peritonitis in which routine microbiological cultures remain negative.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
5/7. Pleural infection caused by Legionella anisa.The first case of infection caused by Legionella anisa with isolation of the organism is reported here. The presence of L. anisa in the water supply of the hospital and the isolation of this species in the pleural fluid of a patient suffering from nosocomial pleurisy confirm the potential pathogenicity of this Legionella species.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
6/7. Epidemiological typing of legionella pneumophila with ribotyping. Report of two clinical cases.The ribotyping method, adapted to the strains of legionella pneumophila in our possession, was tested in two separate cases of legionellosis and in the associated finding of legionella pneumophila in the water, from different sources, with which these patients had come into contact. Determination of the serogroup enabled us to carry out a preliminary analysis of the strains, which was then confirmed by application of the ribotyping procedure: the ribosomal profile of the strains found in the two patients correspond to that of the strains isolated from the water with which they had come into contact. These results provide important information concerning the probable sources of infection involved in these two cases of legionnaires' disease. We consider ribotyping to be a very useful tool, which is easy and simple to perform and is applicable to the Legionella genus as the method of choice for epidemiological studies.- - - - - - - - - - ranking = 2keywords = water (Clic here for more details about this article) |
7/7. Positive serology to legionella longbeachae in patients with adult respiratory distress syndrome.In an observational study we measured the legionella longbeachae antibody titre rise in patients mechanically ventilated for more than eight days during a two-month period. The patients were divided into two groups on the basis of the presence or absence of the adult respiratory distress syndrome (ARDS). In nine patients with ARDS all showed an antibody rise consistent with recent infection with legionella longbeachae with a rise in titre (six patients) or a high titre after eight to ten days of ventilation (three patients). Three patients without ARDS did not show a rise in titre. culture of the environment, ventilator circuits, humidifiers and humidification water did not reveal an environmental source of legionella longbeachae in the intensive care Unit. legionella longbeachae may be implicated as a pathogenic organism in ARDS, or as a secondary nosocomial infection. Alternatively the antibody titre rise may represent an epiphenomenon and may not be related to legionella longbeachae infection.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |