1.Kool, JL, Fiore, AE, Kioski, CM, Brown, EW, Benson, RF, Pruckler, JM, et al.More than 10 years of unrecognized nosocomial transmission of legionnaires' disease among transplant patients. Infect Control Hosp Epidemiol 1998;19:898–904.Google Scholar

2.Lepine, L, Jernigan, DB, Butler, JC, Pruckler, JM, Benson, RF, Kim, F, et al.A recurrent outbreak of nosocomial legionnaire's disease detected by urinary antigen testing: evidence for long-term colonization of a hospital plumbing system. Infect Control Hosp Epidemiol 1998;19:905–910.Google Scholar

3.Evans, AS. Causation and disease: the Henle-Koch postulates revisited. Yale J Biol Med 1998;49:175–195.Google Scholar

4.Best, M, Yu, VL, Stout, J, Goetz, A, Muder, RR, Taylor, F. Legionellaceae in the hospital water supply—epidemiological link with disease and evaluation of a method of control of nosocomial legionnaires' disease and Pittsburgh pneumonia. Lancet 1983;2:307–310.Google Scholar

5.Johnson, JT, Yu, VL, Best, M, Vickers, RM, Goetz, A, Wagner, R, et al.Nosocomial legionellosis uncovered in surgical patients with head and neck cancer: implications for epidemiologic reservoir and mode of transmission. Lancet 1985;2:298–300.Google Scholar

6.Yu, VL. Nosocomial legionellosis: current epidemiological issues. In: Schwartz, M, Remington, J, eds. Current Clinical Topics in Infectious Disease. New York, NY: McGraw-Hill; 1986.Google Scholar

7.Chow, J, Yu, VL. Legionella: a major opportunistic pathogen in transplant recipients. Semin Respir Infect 1998;13:132–139.Google Scholar

8.Patterson, WJ, Hay, J, Seal, DV, McLuckie, JC. Colonization of transplant unit water supplies with Legionella and protozoa: precautions required to reduce the risk of legionellosis. J Hosp Infect 1997;37:7–17.Google Scholar

9.Allegheny County Health Department. Approaches to Prevention and Control of Legionella Infection in Allegheny County Health Care Facilities. 2nd ed. Pittsburgh, PA: Allegheny County Health Department; 1997: 1–15.Google Scholar

10.Yu, VL, Beam, TR, Lumish, RM, Vickers, RM, Fleming, J, McDermott, C, et al.Routine culturing for Legionella in the hospital environment may be a good idea: a three-hospital prospective study. Am J Med Sci 1987;294: 97–99.Google Scholar

11.Joly, J, Alary, M. Occurrence of nosocomial legionnaires' disease in hospitals with contaminated potable water supply. In: Barbaree, JD, Breiman, RF, Dufour, AP, eds. Current Status and Emerging Perspectives. Washington, DC: American Society of Microbiology 1994;39.Google Scholar

12.Modol, JM, Pedro-Botet, ML, Sabria, M, Gimeno, JM, Prats, R, Nieto, J, et al.Environmental and clinical legionellosis in hospitals in Catalonia, Spain. Presented at the 38th Interscience Conference on Antimicrobial Agents Chemotherapy; 09 1998; San Diego, CA. Abstract #K-490A.Google Scholar

13. Second Report of the Committee of Inquiry Into the Outbreak of Legionnaires' Disease in Stafford in April 1985, London, England. Her Majesty's Stationery Office (HMSO); 1987.Google Scholar

14.Alary, M, Joly, JR. Factors contributing to the contamination of hospital water distribution systems. J Infect Dis 1992;165:565–569.Google Scholar

15.Vickers, RM, Yu, VL, Hanna, SS, Muraca, P, Diven, W, Carmen, N, et al.Determinants of Legionella pneumophila contamination of water distribution systems: 15-hospital prospective study. Infect Control 1987;8:357–363.Google Scholar

16.Marrie, TJ, Green, T, Burbridge, S. Legionellaceae in the potable water of Nova Scotia hospital and Halifax residences. Epidemiol Infect 1994;112:143–150.Google Scholar

17.Arnow, PM, Weil, D, Para, MF. Prevalence and significance of Legionella pneumophila contamination of residential hot-tap water systems. J Infect Dis 1985;152:145–151.Google Scholar

18.Butler, JC, Fields, BS, Breiman, RF. Prevention and control of legionellosis. Infect Dis Clin Pract 1997;6:458–464.Google Scholar

19.Centers for Disease Control and Prevention. Guidelines for prevention of nosocomial pneumonia. MMWR 1997;46:31–34.Google Scholar

20.Tobin, JO, Swann, RA, Bartlett, CLR. Isolation of L pneumophila from water systems: methods and preliminary results. BMJ 1981;282:515–517.Google Scholar

21.Dennis, PJ, Taylor, JA, Fitzgeorge, RB, Bartlett, CLR, Barrow, GI. Legionella pneumophila in water plumbing systems. Lancet 1982;2:949–951.Google Scholar

22.Marrie, TJ, Macdonald, S, Clarke, K, Haldane, D. Nosocomial legionnaires' disease: lessons from a four-year prospective study. Am J Infect Control 1991;19:79–85.Google Scholar

23.Wadowsky, RM, Yee, RB, Mezmar, L, Wing, EJ, Dowling, J. Hot water systems as sources of Legionella pneumophila in hospital and nonhospital plumbing fixtures. Appl Environ Microbiol 1982;43:1104–1110.Google Scholar

24.Rudin, J, Wing, E. Prospective study of pneumonia: unexpected incidence of legionellosis. South Med J 1986;79:417–419.Google Scholar

25.Green, M, Wald, ER, Dashefsky, B, Barbadora, K, Wadowsky, RM. Field inversion gel electrophoretic analysis of Legionella pneumophila strains associated with nosocomial legionellosis in children. J Clin Microbiol 1996;34:175–176.Google Scholar

26.Tkatch, LS, Kusne, S, Irish, WD, Kristofiak, S, Wing, E. Factors affecting mortality for Legionella pneumonia at a university hospital. Presented at the 35th ICAAC annual meeting; 09 1995; San Francisco, CA. Abstract 279.Google Scholar

27.Yu, VL, Breiman, RF. Point-counterpoint: surveillance cultures for Legionella. Presented at the 6th annual meeting of the Society for Healthcare Epidemiology of America; 04 1996; Washington, DC. LaCrescenta, CA: Audio Archives; #I60421-090, Symposium IV Compromised Hosts (audiotape).Google Scholar

28.Goetz, AM, Stout, JE, Jacobs, SL, Fisher, MA, Ponzer, RE, Drenning, S, et al.Nosocomial legionnaires' disease discovered in community hospitals following cultures of the water system: seek and ye shall find. Am J Infect Control 1998;26:6–11.Google Scholar

29.Stout, JE, Lin, Y-SE, Goetz, AM, Muder, RR. Controlling Legionella in hospital water systems: experience with the superheat-and-flush method and copper-silver ionization. Infect Control Hosp Epidemiol 1998;19: 911–914.Google Scholar

30.Lin, YE, Vidic, RD, Stout, JE, Yu, VL. Legionella in water distribution systems. Journal of the American Water Works Association 1998;90:112–121.Google Scholar

31.Liu, WK, Healing, DE, Yeomans, JT, Ellioit, TSJ. Monitoring of hospital water supplies for Legionella. J Hosp Infect 1993;24:1–9.Google Scholar

32.Muder, RR, Yu, VL, McClure, J, Kominos, S. Nosocomial legionnaires' disease uncovered in a prospective pneumonia study: implications for underdiagnosis. JAMA 1983;249:3184–3188.Google Scholar