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

Electrophoretic analysis of lipopolysaccharide (LPS) extracts from 430 previously serotyped Legionella isolates and 28 American Type Culture Collection (ATCC) non-Legionella pneumophila Legionella reference strains representing different Legionella species and serogroups has been performed. LPS was prepared from Legionella suspensions by sonication and proteinase K digestion. Following sodium dodecyl sulfate-polyacrylamide gel electrophoresis, LPS bands were either stained with silver nitrate or transferred onto a nitrocellulose membrane and detected with rabbit antibodies raised against L. pneumophila serogroup 5, which was known to cross-react with L. pneumophila serogroups 1 to 14. Silver staining revealed that each of the 28 ATCC non-L. pneumophila Legionella strains possessed an individual and characteristic LPS banding pattern. The LPS profile was defined by the molecular weight of the visualized bands and/or the individual ladder-like LPS pattern. It was demonstrated by immunoblotting that non-L. pneumophila Legionella strains did not react with the serogroup 5 antiserum, thus allowing for the differentiation between L. pneumophila and non-L. pneumophila species.
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PMID:Identification of Legionella species by lipopolysaccharide antigen pattern. 939 93

In vitro studies were performed to give information about the required metal concentrations in decontaminating Legionella-loaded warm water systems with the electrochemical generation of Ag+ and Cu2+ ions. The influence of Ag and Cu ions, as single compounds and in combination, on the survival of Legionella pneumophila (serogroup 6) was determined in tap water at 45 degrees C. Marked differences were detected in the action of these metals. Ag produced a much stronger inhibition than Cu. No additive effect was demonstrated when using Ag/Cu-combinations in the ratio of 1:10. In this case only the Ag-induced inhibition was detected. After 1 h of incubation at 45 degrees C a concentration of 80 + 800 micrograms/L Ag + Cu was needed to produce the maximal inhibitory effect (a 5 log decrease). An identical effect was seen after exposure to 20 + 200 micrograms/L Ag + Cu in the long-term action (24 h of incubation). The minimum inhibitory concentration after long-term incubation was 5 + 50 micrograms/L Ag + Cu. These metal concentrations produced a 1 log reduction. The in vitro results are discussed under consideration of earlier investigations after metering Ag and Cu into a Legionella-loaded water system and generated the following conclusions: In the beginning highly contaminated water systems at 45 degrees C need concentrations between 40 and 80 micrograms/L Ag + 400 to 800 micrograms/L Cu to kill Legionellas. After effective reduction of Legionella concentration of at least some logarithmic powers a slow constant maintenance concentration of 5 to 20 micrograms/L Ag + 50 to 200 micrograms/L Cu could be applied. At 22 degrees C the in vitro inactivation response is much lower. On the other hand in warm water systems with temperatures of 50 to 60 degrees C lower metal concentrations are sufficient.
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PMID:[Effect of silver and copper ions on survival of Legionella pneumophila in tap water]. 940 4

One copper-silver ionization system was sequentially installed onto the hot-water recirculation lines of two hospital buildings colonized with Legionella pneumophila, serogroup 1. A third building with the same water supply and also colonized with Legionella served as a control. Four weeks after activation of the system, distal site positivity for Legionella in the first test building dropped to zero. After operating for 16 weeks, the system was disconnected and installed onto the second test building. Twelve weeks of disinfection reduced the distal site positivity for Legionella in the second test building to zero. Legionella recolonization did not occur in the first test building for 6-12 weeks and in the second test building for 8-12 weeks after inactivation of the system. The control building remained Legionella-positive throughout the experimental period. A significantly higher copper concentration was found in the biofilm taken from a sampling device than in that from water. This is likely to be the reason that the copper-silver ionization system had the residual effect of preventing early recolonization. Our study raises the possibility that one copper-silver unit could be rotated among several buildings to maintain a Legionella-free environment. Such an approach may be cost-effective for buildings housing individuals at low risk for contracting legionnaires' disease.
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PMID:Intermittent use of copper-silver ionization for Legionella control in water distribution systems: a potential option in buildings housing individuals at low risk of infection. 945 22

Legionella have a predilection for infecting immunocompromised patients, and transplant recipients have the highest risk. Legionella spp have been the most common cause of nosocomial pneumonia among transplant recipients at selected medical centers. Diagnosis is dependent on the ability of the clinical microbiology laboratory to isolate the organism by culture; therefore, the disease is easily overlooked. The mode of transmission of Legionella pneumophila is likely aspiration in transplant recipients. Clinical manifestations are similar to that of other bacterial pneumonias, although diarrhea is often prominent. The quinolone antibiotics (especially ciprofloxacin) are the antibiotics of choice because, unlike the macrolides or rifampin, they do not interact with the immunosuppressive agents used to counter rejection. Prevention of nosocomial legionellosis involves disinfection of the hospital's potable water system. Effective disinfection methods include superheat and flush or copper-silver ionization; hyperchlorination is no longer recommended. Routine culture surveillance directed at the hospital water supply for Legionella is mandatory in hospitals caring for transplant patients.
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PMID:Legionella: a major opportunistic pathogen in transplant recipients. 964 91

Hospital-acquired legionnaires' disease arises from the presence of Legionella in hospital water systems. Legionella not only persists in hot water tanks but is also found in the biofilm throughout the entire water distribution system. Conditions within water systems that promote Legionella colonization include water temperature, configuration and age of the hot water tank, physicochemical constituents of the water, plumbing materials, and commensal microflora. Hospital-acquired legionnaires' disease has been prevented by instituting control measures directed at the water distribution system. These include superheat-and-flush, copper/silver ionization, ultraviolet light, instantaneous heating systems, and hyperchlorination. Each of the above disinfection methods has been proven to be effective in the short-term, but long-term efficacy has been difficult due to limitations associated with each method. The complexities of Legionella disinfection, including advantages and disadvantages of each method, are reviewed. A successful Legionella prevention program requires cooperation and communication among hospital administrative personnel, engineers, and infection control staff. Routine environmental surveillance cultures for Legionella are the critical component for successful long-term disinfection. Culture results document the efficacy of the disinfection method and alert the hospital staff to consider Legionella in hospitalized patients with pneumonia.
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PMID:Disinfection of water distribution systems for Legionella. 964 93

The detection in April 1997 of a case of nosocomial legionellosis in our hospital led to the discovery that both our hot- and cold-water circuits were heavily colonized with Legionella pneumophila. Conventional methods for eradication of the organisms were unsuccessful, so a copper-silver (Cu-Ag) ionization system and a continuous chlorination system were installed. Five months later, the number of colonized sites decreased from an initial 58.3% to 16.7%.
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PMID:Treatment of a Legionella pneumophila-colonized water distribution system using copper-silver ionization and continuous chlorination. 1039 46

Silver-copper ionization was used for controlling Legionella distribution in a German university hospital hot water plumbing system for 4 years. In the beginning, silver concentrations were not allowed to exceed 10 microg/L because of drinking water regulation limits in Germany. Water samples were monitored for Legionella counts, temperature, and silver and copper concentrations. A significant (P<.001) 3.8-log reduction of Legionella counts, from 40, 000 cfu/L to 7 cfu/L, was found during the first year with silver-copper ionization. Nevertheless, the long-term efficacy of silver concentrations <10 ,++microg/L was not sufficient. Legionella counts increased to 10,000 cfu/L during the third year. During the fourth year, we studied the influence of higher silver concentrations on Legionella distribution. With an average silver level of 30 microg/L, only a 1.3-log reduction in Legionella, to 500 cfu/L, was achieved. The effect was not significant (P=.071); therefore, it must be considered that Legionella developed a tolerance to silver ions.
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PMID:Four years of experience with silver-copper ionization for control of legionella in a german university hospital hot water plumbing system. 1118 27

The disinfectant effects on Legionella and nontuberculous mycobacteria of hot water, ultraviolet light, silver ions and chlorine, were evaluated. The bacterial strains Legionella pneumophila ATCC33152 and Mycobacterium avium ATCC25291 and strains of L. pneumophila and M. avium which had been isolated from a 24 h bath, were examined for their resistance to treatments. All strains were killed within 3 min on exposure to hot water at 70 degrees C and exposure to ultraviolet light at 90 mW.s/cm2. The strains of L. pneumophila tested were killed within 6 h on exposure to a solution of silver ions at 50 micrograms/l. The number of viable cells of strains of M. avium fell from 10(5) CFU/ml to 10(3) CFU/ml after exposure to an aqueous solution of silver ions at 100 micrograms/l for 24 h. Chlorine effectively killed strains of Legionella which were exposed to an aqueous solution of chlorine at 2 mg/l within 3 min, but strains of Mycobacterium survived exposure to chlorine at 4 mg/l for more than 60 min.
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PMID:Disinfectant effects of hot water, ultraviolet light, silver ions and chlorine on strains of Legionella and nontuberculous mycobacteria. 1067 39

This section is designed to provide a brief summary of some of the findings. A good deal of work has been conducted by Mr N. L. Pavey and the team at BSRIA, Bracknell. The BSRIA publications are an excellent source of further information. Ultraviolet radiation: UV radiation of wavelength 254 nm destroys bacteria by a mechanism of damaging nucleic acids by producing thymine dimers which disrupt DNA replication [Gavdy and Gavdy, 1980]. L. pneumophila has been reported as sensitive to UV dosages of 2,500-7,000 uW.s/cm2 [Antopol & Ellner, 1979; Knudson, 1985]. Antopol and Ellner [1979] examined the susceptibility of L. pneumophila to UV dosage. Their results indicated that 50% of the organisms were killed by 380 uWs/cm2 and 90% were killed by 920 uWs/cm2. Kills of 99 and 99.9% were obtained using 1,840 and 2,760 uWs/cm2 respectively. Muraca et al [1987] showed that continuous UV irradiation resulted in a 5 logarithm decrease in waterborne L. pneumophila in a circulating system. Gilpin [1984] reported that in laboratory buffer solutions, exposure to 1 uW of UV radiation per cm2 achieved a 50% kill of L longbeachae in 5 minutes, L. gormanii in 2-30 minutes and L pneumophila in 17 minutes. Exposure times for 99% kills for L. longbeachae, L pneumophila and L. Gormanii were 33, 48 and 63 minutes respectively. The same research worker conducted experiments using a 3 litre circulating water system, connected to a stainless steel housing containing a UV source. The UV lamp output was 7 ergs/mm2 per second per 100 cm at 254 nm. L. pneumophila was killed within 15 seconds, that is within their first pass through the system. Continuous disinfection with UV has the advantages of imparting no taste, odour or harmful chemical by-products and requires minimal operation and maintenance [Muraca et al 1988]. Keevil et al [1989] state that UV irradiation fails to clear systems of biofilm because of poor penetration into microflocs of the micro-organisms. Copper/silver ionisation: A recent study of full scale hot water test rigs incorporating copper-silver ionisation systems has been reported by Pavey, 1996. Copper and silver ions were introduced into the water by electrolysis. One of the principal mechanisms of biocidal action of these ions is thought to be cell penetration. The positively charged copper ions form electrostatic bonds with negatively charged sites on the cell wall. The cell membrane is thus distorted, allowing ingress of silver ions which attack the cell by binding at specific sites to DNA, RNA, respiratory enzymes and cellular protein, causing catastrophic failure of the life support systems of the cell. Silver and copper ion concentrations of 40 and 400 ug/L respectively were effective against planktonic Legionellae in cold water systems and hot water systems containing soft water. In hard water, the ionisation was ineffective due to the inability to control silver ion concentrations. This was caused by scaling of the electrodes and silver ion complexation by the high concentration of dissolved solids. Bosch et al [1993] had earlier extended the application of copper-silver disinfection to human enteric viruses in water, such as adenovirus, rotavirus, hepatitis A virus, and poliovirus. Their work showed that copper and silver ions in the presence of reduced levels of free chlorine did not ensure the total elimination of viral pathogens from water. In the case of an amoeba, Naegleria fowleria [responsible for primary amoebic meningoencephalitis], Cassells et al [1995] have demonstrated that a combination of silver and copper ions were ineffective at inactivating the amoebae at 80 and 800 ug/L respectively. However addition of 1.0 mg/L free chlorine produced a synergistic effect, with superior inactivation relative to either chlorine or silver-copper in isolation. A similar synergy was reported by Yahya et al [1989] in their study of Staphylococcus sp. and Pseudomonas aeruginosa. Yahya et al [1992] also suggested an additive or synergistic effect in the inactivation of coliphage MS-2 and poliovirus. Other techniques: There are a number of other techniques. We have conducted trials of most of these in the control of Legionella sp., but these fall out of the scope of this article, and as such less emphasis has been placed on them here. Ozonation: Ozone [O3] is an oxidising gas, generated electrically from oxygen [O2]. L. pneumophila can be killed at < 1 mg/L of ozone [Edelstien et al 1982]. Muraca et al [1987] found that 1-2 mg/L of continuous ozone over a six hour contact time, produced a 5 logarithm decrease of L. pneumophila. The effectiveness of ozone treatment against a range of bacteria and coliphages has been studied Botzenhart et al [1993]. E. coli was least resistant to ozone, followed by MS 2-coliphage and PhiX 174-coliphage, with L. pneumophila and Bacillus subtilis spores being the most resistant. (ABSTRACT TRUNCATED)
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PMID:Reviewing efficacy of alternative water treatment techniques. 1144 90

Copper-silver (Cu-Ag) ionization has effectively controlled Legionella spp. in the hot water systems of numerous hospitals. However, it was ineffective at controlling Legionella in one Ohio hospital despite the confirmation of adequate total concentrations of copper and silver ions. The pH of the water at this hospital was found to be 8.5 to 9.0. The purpose of this study was to investigate the impact of pH and other water quality parameters, including alkalinity (HCO3-), hardness (Ca2+ and Mg2+), and amount of dissolved organic carbon (DOC), on the control of Legionella by Cu-Ag ionization. Initial concentrations of Legionella and copper and silver ions used in batch experiments were 3 x 10(6) CFU/ml and 0.4 and 0.08 mg/liter, respectively. Changes in bicarbonate ion concentration (50, 100, and 150 mg/liter), water hardness (Ca2+ at 50 and 100 mg/liter; Mg2+ at 40 and 80 mg/liter), and level of DOC (0.5 and 2 mg/liter) had no significant impact on the efficacy of copper and silver ions in killing Legionella at a neutral pH. When the pH was elevated to 9 in these experiments, copper ions achieved only a 10-fold reduction in the number of Legionella organisms in 24 h, compared to a millionfold decrease at pH 7.0. Silver ions were able to achieve a millionfold reduction in 24 h at all ranges of water quality parameters tested. Precipitation of insoluble copper complexes was observed at a pH above 6.0. These results suggest that pH may be an important factor in the efficacy of copper-silver ionization in controlling Legionella in water systems.
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PMID:Negative effect of high pH on biocidal efficacy of copper and silver ions in controlling Legionella pneumophila. 1203 24


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