Implementación de técnica de cultivo para la investigación de Legionella pneumophila en depósitos domiciliarios de agua potable en Resistencia, Chaco / Implementation of cultivation technique for the investigation of Legionella pneumophila in household drinking water Resistencia, Chaco

Legionella pneumophila es una bacteria ambiental capaz de sobrevivir en un amplio intervalo de condiciones físico-químicas y de colonizar los sistemas de distribución y almacenamiento del agua potable. Es el principal patógeno trasmitido por el agua que produce el 90% de los casos de legionelosis. El objetivo del trabajo fue realizar la puesta a punto de la técnica por cultivo para la vigilancia de L. pneumophila en depósitos domiciliarios de agua potable acorde con la normativa internacional. En las muestras de agua analizadas no se obtuvo desarrollo de L. pneumophila; la cepa utilizada como control positivo, permitió constatar la aptitud de los medios utilizados para la detección de este patógeno en las muestras de agua. La vigilancia de este microorganismo en el agua de consumo humano representa el primer paso en pos de abordar el control de su diseminación hacia huéspedes susceptibles

Acciones de prevención y control de la legionelosis: un reto para la salud pública española / Actions for legionellosis prevention and control: a challenge for public health in Spain

La legionelosis es una enfermedad respiratoria con origen en sistemas que formen aerosol y que contenga el agente biológico Legionella sp. En las últimas décadas se ha desarrollado en España un marco normativo para su prevención y control. El presente artículo expone la epidemiología de la legionelosis y la importancia del control de la transmisión de la bacteria en la lucha contra la enfermedad. Para ello, se hace patente la revisión de las instalaciones críticas y la inclusión de otras nuevas en la legislación preventiva así como la estimación del riesgo, la mejora en los procesos de diagnóstico y el avance en nuevos protocolos de prevención.

Legionellosis is a respiratory disease originating in systems that produce aerosol and contain Legionella sp. In recent decades, Spain has developed a regulatory framework for prevention and control of legionellosis. This article describes the epidemiology of legionellosis and the importance of controlling the transmission of bacteria in the fight against the disease. In that regard, it becomes clear the role of reviewing critical facilities and the inclusion of new ones in the preventive legislation, the estimation of risk, and the improvement in the diagnostic processes and progress in new prevention protocols.

Legionella infection; an environmental and clinical study during hajj season

Respiratory system is most commonly affected during Hajj season. [1] to determine the prevalence of Legionella in drinking water, cooling sprinklers and other sources of water consumed in pilgrimage area of the holy city, Makkah; [2] to study the prevalence of pneumonia caused by Legionella species from clinically suspected cases; and [3] to determine whether there is any relationship disease incidence and water supply system. The clinical samples were received from in-patients of the following five Ministry of Health [MOH] Hospitals; Hera General Hospital, Al-Noor Specialist Hospital, King Faisal Hospital, King Abdul-Aziz Hospital, and Ajyad Hospital during Hajj 2003. The patients included in the study were those who fulfilled the following criteria; clinically diagnosed as pneumonia, negative on routine cultures and found negative for acid fast bacilli [AFB] from sputum/bronchial aspirate [BAL]. Serological tests was done by Enzyme linked Immunosorbent assay [ELISA] for Legionella antibodies total lgG and IgM. Out of total 133 patients suspected for Legionella, 83 [62.4%] were male and 50 [37.6%] female. The male versus female ratio was 1:0.6. The major age group affected was between 50-70 years [63.2%]. There were 4 [3.0%] cases of Legionella species isolated from microbiological cultures. The overall seropositive rate among clinically suspected cases was 4.51%. A total of 560 water samples were collected from Arafat, Muzdalifa, Mena, and areas around the Holy Mosque and found negative for Legionella species. Pneumonia was one of the most common illnesses among pilgrims. The water supplied to all areas of the pilgrimage was free from the Legionella and no link has been established among the patients with water supply systems. Both clinicians' awareness and availability of specialized laboratory tests for atypical pneumonia such as Legionella is necessary. Although, all water samples found negative for Legionella but it is recommended to screen all water reservoirs for Legionella annually before Hajj season

Antimicrobial Susceptibility Patterns of Legionella isolates in the Environment and in Patients / 대한진단검사의학회지

BACKGROUND: Antimicrobial susceptibility of Legionella spp. has rarely been studied in Korea. Therefore, we aimed to determine the susceptibility of Legionella spp. to various antibiotics. METHODS: We assessed the antimicrobial susceptibility of 66 environmental and clinical Legionella isolates collected between January 2001 and December 2008 from Korea and Japan. The minimum inhibitory concentrations (MICs) of 6 antibiotics, namely, azithromycin, ciprofloxacin, clarithromycin, clindamycin, gatifloxacin, and gemifloxacin were determined by the broth microdilution method using buffered starch yeast extract broth. RESULTS: The MIC ranges of the 6 antibiotics used against the Legionella isolates were as follows: 0.004-0.062 microgram/mL (azithromycin), 0.002-0.5 microgram/mL (ciprofloxacin), 0.004-0.5 microgram/mL (clarithromycin), 0.12-4 microgram/mL (clindamycin), 0.002-0.12 microgram/mL (gatifloxacin), and 0.008-1 microgram/mL (gemifloxacin). CONCLUSIONS: Legionella spp. isolates from Korea and Japan were most susceptible to gatifloxacin. Azithromycin, clarithromycin, ciprofloxacin, and gemifloxacin were also effective for treating legionellosis.

Legionella as a lower respiratory pathogen in north India.

One hundred patients of lower respiratory tract infection (LRTI) were prospectively studied over 2 years to find out if Legionella is a causative agent in these patients. In addition, 50 environmental samples and 50 age and sex matched controls were studied. Culture and direct fluorescent antibody testing (DFA) of respiratory tract secretions, and serodiagnosis by indirect immunofluorescence (IIF) and ELISA, were employed to detect Legionella. Respiratory tract secretions from all patients were negative for Legionella on culture and DFA. Low antibody titters to Legionella were observed in 21 patients and these could be attributed to cross reaction with other gram-negative bacteria. All environmental samples and controls tested negative for Legionella. Legionella does not seem to be an important lower respiratory tract pathogen in this part of the country and empirical addition of erythromycin to treatment regimens for pneumonia is not warranted in our setting.

Legionella pneumophila antibodies in dialysed uraemic patients

64 patients with chronic renal failure under treatment with maintenance hemodialysis were studied clinically for 3 months, with stress on manifestations suggestive of Legionellosis. Sera were monthly examined by ELISA and hemagglutination tests for detection of IgG and IgM antibodies, respectively. 37 patients [57.8%] showed IgG and/or IgM antibodies; 5 IgG, 28 IgM and 4 both IgG and IgM antibodies. The high prevalence could be attributed mainly to the decreased host defenses of these patients, and presence of water- storage tanks in hemodialysis units may be a contributing factor. No correlation was found between the clinical and the laboratory findings. This may be explained by the persistent elevation of IgG and IgM antibodies in sera for many years and by the presence of subclinical cases

Diagnóstico y tratamiento de las neumonias extrahospitalarias / Diagnosis and treatment of extrahospitalary pneumonias

Aún después de 50 años de iniciada la era antibiótica las neumopatías agudas siguen siendo uni de los principales grupos de enfermedades infecciosas y una de las principales causas de morbilidad respiratoria. El cuadro clínico y radiológico, así como las características del huésped son elementos de mucho valor en la orientación del diagnóstico etiológico. Sin embargo, su valor no es siempre categórico, lo que hace siempre necesario realizar esfuerzos tendientes a disponer de una información bacteriológica lo más precoz posible, lo que es imperativo en los casos graves. El tratamiento inicial es casi siempre empírico y basado en consideraciones clínicas y epidemiológicas. En las neumonías extrahospitalarias el Pneumococcus sigue desempeñando un rol preponderante y la penicilina sigue siendo el elemento terapéutico esencial