Clusters of Healthcare-Associated Legionnaires' Disease in Two Hospitals of Central Greece.

Healthcare-associated Legionnaires' disease often leads to fatal respiratory tract infection among hospitalized patients. In this report, three cases of Legionnaires' disease among patients in two different hospitals (Hospital A and Hospital B) were investigated. After conducting an epidemiologic and environmental investigation, the water distribution systems (WDSs) were identified as the possible source of infection, as Legionella pneumophila serogroup 1 (Lp1) was isolated from both clinical and environmental samples. Patients received aerosol therapy with nebulizers during their hospitalization. Based on the results of the investigation, the hospitals' infection control committees reviewed their policies for Legionnaires' disease prevention and implemented control measures focusing on using sterile fluids for aerosol treatments.

Analysis of seawater microbiological quality data in Greece from 1997 to 2006: association of risk factors with bacterial indicators.

This study deals with the examination of quality of seawater bathing areas in Greece over a 10-year period and identifies risk factors for high bacteria indicator organism concentrations. Qualitative descriptive analysis was applied and the microbiological test results of 231,205 water samples were associated with pollution markers and other parameters. Measurements of Escherichia coli (99.6%) and enterococci (100%) were found to be in accordance with the mandatory value guidelines set by the new European Directive. An increasing trend for the yearly mean value of faecal streptococci was noted. Using logistic regression analysis, phenolic smell (OR = 2.10, CI = 2.04-2.16), rainfall the day before sampling (OR = 1.67, CI = 1.64-1.74), high seas (OR = 1.42, CI = 1.39-1.46) and rainfall on the day of sampling (OR = 1.27, CI = 1.20-1.33) were positively independently associated with high levels of bacterial indicators (total coliforms, faecal coliforms, faecal streptococci and E. coli). The highest risk, absolute risk value 42.8% (RR = 3.17, CI = 2.97-3.38), was measured when previous day rainfall, phenolic smell and high seas were simultaneously recorded. Such parameters should be further investigated as predetermining factors for the assessment of beach bathing water quality, providing a timely indication of water risk assessment.