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Query: UMLS:C0023241 (Legionella)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Entry of Legionellae into domestic water systems by passing through the drinking water distribution network has been assumed. To prove this question, samples were collected within a two years period at warm and cold water taps of households, the pipeline network and three water works of the city of Mainz, and examined for the presence of Legionellae. To detect even very small numbers of Legionellae, improvement of the conventional isolation procedure was necessary. Additionally, large volumes of cold water samples (50-250 L) were processed by using a pressure filter. For identification of Legionellae, an immunological rapid test (colony-blot-assay, own development) and a commercial gene-probe test (EnvironAmp Legionella Kits, Applied Biosystems) were enclosed in the programme. With the refined techniques the detection limit was improved while expenses of time and labour were reduced. Finally, the advantages and disadvantages of the single methods are discussed. For routine detection of Legionellae in the microbiological laboratory, a combination of effective methods is proposed which are easy to perform.
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PMID:[Experiences with optimized methods for the detection of legionellae in drinking water]. 780 5

Of 21 cases of legionellosis, 14 were of nosocomial origin and 6 others had a possible nosocomial source. The hot and cold water systems, respiratory therapy equipment, puddles of rain water on flat roofs and in gutters, and demineralized water systems were all excluded as a source of nosocomial infection. By subtyping it was shown that Legionella pneumophila serogroup 1 isolates from 11 patients and from the cooling towers were indistinguishable. Because of this result the cooling towers were considered to be the infection source. After effective chlorination of the cooling towers, the frequency of legionellosis declined.
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PMID:Legionella monitoring: a continuing story of nosocomial infection prevention. 790 84

In this paper the prevalence of Legionella in water samples from cold and warm water supply systems made of copper, iron and polyethylene was determined. Water supplied by copper pipes revealed to be nearly free of Legionella (only 2% of probes positive), but water from iron (90%) or polyethylene pipes (65% probes positive) proved to be heavily contaminated. The 82 isolates were identified as Legionella pneumophila, one from serogroup 1, the others from serogroup 4.
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PMID:[The effect of the pipe material of the drinking water system on the frequency of Legionella in a hospital]. 791 76

In order to determine the value of regular surveillance for Legionella in the prevention of hospital-acquired (nosocomial) legionellosis, water samples were obtained over a three-year period from 17 hospitals located in England and Scotland. Prior to the study, all of the hospitals had in operation defined protocols and maintenance schedules which followed national guidelines for the prevention of legionellosis in health care premises. Six samples, from key locations in the water system of each hospital, were taken at six-monthly intervals. Total viable bacterial count (TVC), coliform count and legionella cultures were performed on all the samples. No coliforms were detected in any of the samples, whereas the TVC was variable. Legionella pneumophila was isolated from both the hot and cold water supplies of two hospitals. The TVC was not related to the isolation of Legionella. Confirmation of the presence of Legionella was subsequently attributed to defects in the equipment and water maintenance programmes. It was concluded that the microbiological examination of water is an effective approach to the audit of the maintenance of hospital water systems in order to prevent legionellosis.
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PMID:Monitoring of hospital water supplies for Legionella. 791 Jan 88

A 65-kDa protein (called S1) from Spirochaeta bajacaliforniensis was identified as 'tubulin-like' because it cross-reacted with at least four different antisera raised against tubulin and was isolated, with a co-polymerizing 45-kDa protein, by warm-cold cycling procedures used to purify tubulin from mammalian brain. Furthermore, at least three genera of non-cultivable symbiotic spirochetes (Pillotina, Diplocalyx, and Hollandina) that contain conspicuous 24-nm cytoplasmic tubules displayed a strong fluorescence in situ when treated with polyclonal antisera raised against tubulin. Here we summarize results that lead to the conclusion that this 65-kDa protein has no homology to tubulin. S1 is an hsp65 stress protein homologue. Hsp65 is a highly immunogenic family of hsp60 proteins which includes the 65-kDa antigens of Mycobacterium tuberculosis (an active component of Freund's complete adjuvant), Borrelia, Treponema, Chlamydia, Legionella, and Salmonella. The hsp60s, also known as chaperonins, include E. coli GroEL, mitochondrial and chloroplast chaperonins, the pea aphid 'symbionin' and many other proteins involved in protein folding and the stress response.
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PMID:The 'tubulin-like' S1 protein of Spirochaeta is a member of the hsp65 stress protein family. 815 49

Membrane expansion vessels (MEV) are installed between cold drinking water supply and hot water system to compensate pressure changes and water losses. An elastic membrane inside the MEV divides a gas pressurized compartment from a water filled compartment, which--in case of flow-through type of MEV--is directly coupled to the water current. While heating the system the expanding water enters the last mentioned compartment. When cooling down, the water is flowing out. Thus MEVs may prevent water losses. Bacteriological investigations of two DEVs of the flow-through type showed the following results: 1. While 5 samples taken from the cold water supply did not yield Legionella, all 7 samples from the outlets of both DEVs tested positive for Legionella (average 21 CFU/ml). 2. In each of 4 samples taken from the outlet of a DEV, total colony counts exceeded the guide value of 100 colonies/ml demanded in the German Drinking Water Act (average 724 colonies/ml at 20 degrees C, 921 colonies/ml at 36 degrees C). 3. Swab and contact culture from one of the membrane indicated excessive surface colonization with Legionella. The findings show the necessity to include MEVs in investigations of hot water systems for Legionella.
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PMID:[Legionella in membrane expansion vessels]. 831 37

To prevent fatal outbreaks of Legionnaires' disease, particularly in hospitals and other health-care premises, building services engineers are recommended to store and operate hot water systems at a temperature of 60 degrees C. However, water at this temperature can cause serious scalding. It is therefore advised that mixing valves be installed in the hot water supply pipework to provide hot water at safe temperatures for washing and bathing. Electricity Association Technology Ltd (EATL) investigated the performance of three makes of automatic mixing valve. Tests showed that with constant supply conditions there was little difference in performance between the three valves when blending hot and cold water. However, the ability of the valves to respond to the loss of the cold water supply was quite valve was able, consistently, to shut the hot water off in the event of cold water failure. These results suggest that where it is necessary to safeguard people or patients against any risk of scalding, e.g. young children and handicapped patients, a quality thermostatic valve should be installed rather than a cheaper tempering valve.
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PMID:Prevention of hot tap water burns--a comparative study of three types of automatic mixing valve. 843 18

Pneumonias caused by atypical organisms usually have extra-pulmonary features. Chlamydial pneumonia often starts with hoarseness and fever, and respiratory tract symptoms may not appear for days. Mycoplasmal pneumonia may manifest with ear pain and a nonproductive cough. Legionnaires' disease presents with high fevers and central nervous system and gastrointestinal abnormalities. Diagnosis of chlamydial infection is accomplished with serologic testing. Patients are unresponsive to erythromycin treatment and should be started on empirical doxycycline (Doryx, Vibramycin) therapy. The presence of cold agglutinins in the appropriate clinical setting permits a presumptive diagnosis of mycoplasmal infection. Clinical diagnosis of Legionella pneumonia may be made in patients with pneumonia who also have relative bradycardia with elevated serum transaminases or hypophosphatemia with gastrointestinal or central nervous system symptoms. Erythromycin is the mainstay of treatment of legionnaires' disease, but treatment failures have been reported. Doxycycline is less expensive, has a better safety profile, and is better tolerated than erythromycin.
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PMID:Atypical pneumonias. Clinical and extrapulmonary features of Chlamydia, Mycoplasma, and Legionella infections. 849 98

For the isolation and cultivation of Legionella pneumophila from tap water in hospitals, we compared different media and selection techniques. A second part of the study compared the L. pneumophila yields from different water samples at identical sites. A total of 210 water samples (500 ml each) were collected from two selected sites in each of 21 hospitals. Warm water samples were collected after flow times of 0, 5, 10, and 15 min; in addition, one cold water sample was collected. Filtration was used to concentrate all samples. Following filtration, 0.1 and 1 ml each of untreated samples, heat-treated samples (3 min, 59 degrees C), and acid-treated samples (pH 2.2, 15 min) were spread onto the selective media MWY (SR 118; Oxoid) and BMPA alpha (SR 111; Oxoid), and samples from 12 hospitals were also spread onto GVPC medium (SR 152; Oxoid). A total of 72 (34%) of the 210 samples from 12 hospitals were positive. With respect to the positive Legionella cultures, there was no significant difference between the selective media MWY, BMPA alpha, and GVPC. With the BMPA alpha supplement, more samples were positive following heat treatment (P < 0.05) or acid treatment (P < 0.05) than without any further treatment. For the maximum yield of Legionella colonies with minimum additional microbial flora, acid treatment was the most effective, and by all methods, the GVPC supplement was the most selective. For routine water tests in hospitals for differentiating between systemic and local contamination, acid treatment of the concentrated samples, the use of different selective media, and the correct selection of sampling sites are recommended.
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PMID:Comparative study of procedures for isolation and cultivation of Legionella pneumophila from tap water in hospitals. 850 Dec 21

Organ transplant recipients and other immunosuppressed patients are known to be at increased risk of nosocomial Legionnaires' disease. Although the ecology of Legionella in hospital water storage and distribution systems (including a protozoonotic relationship with free-living protozoa) has been well documented, little is known regarding the quality of water supplied to high-risk units. Hot- and cold-water samples (two first draw and one run to waste for 5 min) were taken from 69 (85%) of the 81 United Kingdom organ transplant units (31 renal, 24 bone marrow, nine cardiopulmonary and five liver transplant units) and cultured for Legionella and protozoa. Legionella spp. were isolated from the water supplies of 38 (55%) units and Legionella pneumophila from 31 (45%). The blue-white fluorescent group of Legionella (Legionella gormanii, Legionella bozemanii and others) was isolated from 18 (26%) units. Free-living protozoa were isolated from 47 units (68%) and genera of the protozoa known to permit the intracellular growth of Legionella (PGIGL), from 40 units (58%). Possible associations between Legionella and the variables Protozoa; PGIGL; water pH; and circulating water temperature (recorded after running to waste for 5 min) were examined by logistic regression analysis. In cold-water supplies, a significant association was found between the isolation of Legionella and PGIGL (P = 0.032; OR = 1.81; 95% CI 1.1-3.1). In hot-water supplies, an inverse association was found between the isolation of Legionella and circulating water temperature (P = 0.034; OR = 1.0719 per degree C; 95% CI 1.0052-1.1432). (We failed to isolate Legionella when the circulating hot water was > 58 degrees C. No other associations were significant. We recommend the active surveillance of water quality in high-risk patient areas, and that transplant units, either with a history of nosocomial Legionnaires' disease, or where active surveillance indicates a persistently high Legionella colony count, take remedial action. The quality of cold water may be improved by provision of a dedicated supply taken directly from the incoming mains; and of hot water by the use of a dedicated calorifier, able to maintain a minimum circulating hot water return temperature of 60 degrees C.
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PMID:Colonization of transplant unit water supplies with Legionella and protozoa: precautions required to reduce the risk of legionellosis. 932 24


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