Hostname: page-component-77f85d65b8-zzw9c Total loading time: 0 Render date: 2026-04-17T19:16:19.346Z Has data issue: false hasContentIssue false
  • English
  • Français

Presence and Chromosomal Subtyping of Legionella Species in Potable Water Systems in 20 Hospitals of Catalonia, Spain

Published online by Cambridge University Press:  02 January 2015

Miquel Sabrià ,
Marian García-Núñez ,
Maria L. Pedro-Botet ,
Nieves Sopena ,
Josep M. Gimeno ,
Esteban Reynaga ,
Josep Morera  and
Celestino Rey-Joly
Miquel Sabrià*
Affiliation:
Section of Infectious Diseases, Sopena, Gimeno
Marian García-Núñez
Affiliation:
Section of Infectious Diseases, Sopena, Gimeno
Maria L. Pedro-Botet
Affiliation:
Section of Infectious Diseases, Sopena, Gimeno
Nieves Sopena
Affiliation:
Section of Infectious Diseases, Sopena, Gimeno
Josep M. Gimeno
Affiliation:
Section of Infectious Diseases, Sopena, Gimeno
Esteban Reynaga
Affiliation:
Section of Infectious Diseases, Sopena, Gimeno
Josep Morera
Affiliation:
Service of Pneumology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
Celestino Rey-Joly
Affiliation:
Service of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
*
Unitat de Malalties Infeccioses, Hospital Germans Trias i Pujol, Ctra de Canyet s/n. 08916 Badalona, Barcelona, Spain
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To investigate the presence and clonal distribution of Legionella species in the water supply of 20 hospitals in Catalonia, Spain.

Setting:

20 hospitals in Catalonia, an area of 32,000 km2, located in northeast Spain.

Methods:

Environmental cultures of 186 points of potable water supply and 10 cooling towers were performed for the presence of Legionella species. Following filtration and acid treatment, the samples were seeded in selective MWY (modified Wadowsky Yee)-buffered charcoal yeast extract-a agar. All isolates obtained were characterized microbiologically and genotyped by Sfil pulsed-field gel electrophoresis (PFGE).

Results:

73 of 196 water samples, representing 17 of the 20 hospitals included in the study, were positive for Legionella pneumophila (serogroups 1, 2-14, or both). The degree of contamination ranged from 200 to 74,250 colony-forming units/L. Twenty-five chromosomal DNA subtypes were detected by PFGE. A single DNA subtype was identified in 10 hospitals, 2 DNA subtypes were observed in 6 hospitals, and 1 hospital exhibited 3 different DNA subtypes. Each hospital had its own Legionella DNA subtype, which was not shared with any other hospitals.

Conclusions:

Legionella was present in the water of most of the hospitals studied; each such hospital had a unique, dominant chromosomal DNA subtype. The verification of several genomic DNA restriction profiles in such a small geographic area demonstrates the great genetic diversity of Legionella in the aquatic environment.

Information

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 11 , November 2001 , pp. 673 - 676
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

1.McDade, JE, Shephard, CC, Fraser, DW, Tsai, TR, Resudus, MA, Dowdle, WR. Laboratory investigation team: legionnaires' disease. Isolation of a bacterium and demonstration of its role in other respiratory disease. N Engl J Med 1977;297:1197–1203.Google Scholar
2.Pedro-Botet, ML, Sabria-Leal, M, Haro, M, Rubio, C, Gimenez, G, Sopena, N, et al.Nosocomial and community-acquired Legionella pneumonia: clinical comparative analysis. Eur Respir J 1995;8:1929–1933.Google Scholar
3.Pedro-Botet, ML, Sabria, M, Sopena, N, Manterola, JM, Morera, J, Blavia, R, et al.Role of immunosuppression in the evolution of legionnaires' disease. Clin Infect Dis 1998;26:14–19.Google Scholar
4.Sopena, N, Sabria, M, Pedro-Botet, ML, Padilla, E, Dominguez, J, Morera, J, et al.Comparative study of the clinical presentation of Legionella pneumonia and other community-acquired pneumonias. Chest 1998;113:1195–1200.Google Scholar
5.Chang, FY, Jacobs, SL, Colodny, SM, Stout, JE, Yu, VL. Nosocomial legionnaires' disease caused by Legionella pneumophila serogroup 5: laboratory and epidemiologic implications. J Infect Dis 1996;174:1116–1119.Google Scholar
6.Lawrence, C, Reyrolle, M, Dubrou, S, Forey, F, Decludt, B, Goulvestre, C, et al.Single clonal origin of a high proportion of Legionella pneumophila serogroup 1 isolates from patients and the environment in the area of Paris, France, over a 10-year period. J Clin Microbiol 1999;37:2652–2655.Google Scholar
7.Luck, PC, Wenchel, H-M, Helbig, JH. Nosocomial pneumonia caused by three genetically different strains of Legionella pneumophila and detection of these strains in the hospital water supply. J Clin Microbiol 1998;36:1160–1163.Google Scholar
8.Visca, P, Goldoni, P, Luck, PH, Helbig, JH, Cattani, L, Giltri, G, et al.Multiple types of Legionella pneumophila serogroup 6 in a hospital heated system associated with sporadic infections. J Clin Microbiol 1999;37:2189–2196.CrossRefGoogle Scholar
9.Boulanger, CA, Edelstein, PH. Precision and accuracy of recovery of Legionella pneumophila from seeded tap water filtration and centrifugation. Appl Environ Microbiol 1995;61:1805–1809.Google Scholar
10.Reinthaler, FF, Sattler, J, Schaffler-Dulling, K, Weinmayr, B, Marth, E. Comparative study of procedures for isolation and cultivation of Legionella pneumophila from tap water in hospitals. J Clin Microbiol 1993;31:1213–1216.Google Scholar
11.Ta, AC, Stout, JE, Yu, VL, Wagener, MM. Comparison of culture methods for monitoring Legionella species in hospital water systems and recommendations for standardization of such methods. J Clin Microbiol 1995;33:2118–2123.Google Scholar
12.Fiore, AE, Nuorti, JP, Levine, OS, Marx, A, Weltman, AC, Yeager, S, et al.Epidemic legionnaires' disease two decades later: old sources, new diagnostic methods. Clin Infect Dis 1998;26:426–433.Google Scholar
13.Green, M, Wald, ER, Dashefskky, 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.CrossRefGoogle ScholarPubMed
14.Lawrence, C, Ronco, E, Dubrou, S, Leclercq, R, Nauciel, C, Matsiota-Bernard, P. Molecular typing of Legionella pneumophila serogroup 1 isolates from patients and the nosocomial environment by arbitrarily primed PCR and pulsed field gel electrophoresis. J Med Microbiol 1999;44:327–333.Google Scholar
15.Luck, PC, Kohler, J, Maiwald, M, Helbig, JH. DNA polymorphisms in strains of Legionella pneumophila serogroups 3 and 4 detected by macrorestriction analysis and their use for epidemiological investigation of nosocomial legionellosis. Appl Environ Microbiol 1995;61:2000–2003.CrossRefGoogle ScholarPubMed
16.Marrie, TJ, Yler, S, Bezanson, G, Dendy, C, Johnson, W. Analysis of Legionella pneumophila serogroup 1 isolates by pulsed-field gel electrophoresis. J Clin Microbiol 1999;37:251–254.CrossRefGoogle ScholarPubMed
17.Pruckler, JM, Mermel, LA, Benson, RF, Giorgio, C, Cassiday, PK, Breiman, RF, et al.Comparison of Legionella pneumophila isolates by arbitrarily primed PCR and pulsed-field gel electrophoresis: analysis from seven epidemic investigations. J Clin Microbiol 1995;33:2872–2875.Google Scholar
18.Riffard, S, Lo Presti, F, Vandenesch, F, Forey, F, Reyrolle, M, Eitenne, J. Comparative analysis of infrequent-restriction-site PCR and pulsed-field gel electrophoresis for epidemiological typing of Legionella pneumophila serogroup 1 strains. J Clin Microbiol 1998;36:161–167.Google Scholar
19.Schoonmaker, D, Heimberger, T, Birkhead, G. Comparison of ribotyping and restriction enzyme analysis using pulsed-field gel electrophoresis for distinguishing Legionella pneumophila isolates obtained during a nosocomial outbreak. J Clin Microbiol 1992;30:1491–1498.Google Scholar
20.Luck, PC, Helbig, JH, Hagedorn, H, Ehret, W. DNA fingerprinting by pulsed-field gel electrophoresis to investigate a nosocomial pneumonia caused by Legionella bozemanii serogroup 1. Appl Environ Microbiol 1995;61:2759–2761.CrossRefGoogle ScholarPubMed
21.Montanaro-Punzengruber, JC, Hicks, L, Meyer, W, Gilbert, GL. Australian isolates of Legionella longbeache are not a clonal population. J Clin Microbiol 1999;37:3249–3254.Google Scholar
22.Smith, CL, Cantor, CR. Purification, specific fragmentation, and separation of large DNA molecules. Methods Enzymol 1987;155:449–467.Google Scholar
23.Bollin, GE, Plouffe, JF, Para, MF, Hackman, B. Aerosols containing Legionella pneumophila generated by shower heads and hot-water. Appl Environ Microbiol 1985;50:1128–1131.Google Scholar
24.Castellani Pastoris, M, Ciceroni, L, Lo Monaco, R, Goldoni, P, Mentore, B, Fiego, G, et al.Molecular epidemiology of an outbreak of legionnaires' disease associated with a cooling tower in Genova-Sestri Ponente, Italy. Eur J Clin Microbiol Infect Dis 1997;16:883–892.Google Scholar
25.Marrie, TJ, Haldane, D, Bezanson, G, Peppard, R. Each water outlet is a unique ecological niche for Legionella pneumophila. Epidemiol Infect 1992;108:261–270.CrossRefGoogle ScholarPubMed
26.Ruf, B, Schurmann, D, Horbach, Y, Seidel, K, Pohle, HD. Nosocomial Legionella pneumonia: demonstration of potable water as the source of infection. Epidemiol Infect 1998;103:647–654.Google Scholar
27.Yu, VL. Resolving the controversy on environmental cultures for Legionella: a modest proposal. Infect Control Hosp Epidemiol 1998;19:893–897.Google Scholar
28.Liu, WK, Healing, DE, Yeomans, JT, Elliot, TS. Monitoring of hospital water supplies for Legionella pneumophila. J Hosp Infect 1993;24:1–9.Google Scholar
29.Alary, M, Joly, JR. Factors contributing to the contamination of hospital water distribution systems. J Infect Dis 1992;165:565–569.Google Scholar
30.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
31.Second Report of the Committee of Inquiry Into the Outbreak of Legionnaire's Disease in Stafford in April 1985. London, England: Her Majesty's Stationery Office (HMSO); 1987.Google Scholar
32.Marrie, TJ, Johnson, W, Tyler, S, Bezanson, G, Haldane, D, Burbridge, S, et al.Potable water and nosocomial legionnaires' disease: check water from all rooms in which patient has stayed. Epidemiol Infect 1995;114:267–276.Google Scholar
33.Bezanson, G, Burbridge, S, Haldane, D, Yoell, C, Marrie, T. Diverse populations of Legionella pneumophila present in the water of geographically clustered institutions served by the same water reservoir. J Clin Microbiol 1992;30:570–576.Google Scholar
34.Dominguez, JA, Matas, L, Manterola, JM, Blavia, R, Sopena, N, Belda, FJ, et al.Comparison of radioimmunoassay and enzyme immunoassay kits for detection of Legionella pneumophila serogroup 1 antigen in both concentrated and nonconcentrated urine samples. J Clin Microbiol 1997;35:1627–1629.Google Scholar