Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023241 (Legionella)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Monochloramine disinfection of municipal water supplies is associated with decreased risk for Legionnaires' disease. We conducted a 2-year, prospective, environmental study to evaluate whether converting from chlorine to monochloramine for water disinfection would decrease Legionella colonization of hot water systems. Water and biofilm samples from 53 buildings were collected for Legionella culture during 6 intervals. Prevalence ratios (PRs) comparing Legionella colonization before and after monochloramine disinfection were adjusted for water system characteristics. Legionella colonized 60% of the hot water systems before monochloramine versus 4% after conversion (PR 0.07, 95% confidence interval 0.03-0.16). The median number of colonized sites per building decreased with monochloramine disinfection. Increased prevalence of Legionella colonization was associated with water heater temperatures <50 degrees C, buildings taller than 10 stories, and interruptions in water service. Increasing use of monochloramine in water supplies throughout the United States may reduce Legionella transmission and incidence of Legionnaires' disease.
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PMID:Reducing Legionella colonization in water systems with monochloramine. 1670 6

The reservoir for hospital-acquired Legionnaires' disease has been shown to be the potable water distribution system. The objectives of the present study were as follows: (1) to examine the possible relationship between physical-chemical characteristics of water such as temperature, pH, hardness, conductivity, and residual chlorine and the presence of amoebae as growth-promoting factors for Legionella species and (2) to determine eradication measures for water distribution systems to seek ways of reducing the risk of legionellosis. Ten hospitals in southwest France took part in this study. Water samples were collected from 106 hot water faucets, showers, hot water tanks, and cooling towers. Two analyses were performed to analyze the association between water characteristics and (1) the presence of Legionella species and (2) the proliferation of Legionella species. Of the 106 water samples examined, 67 (63.2%) were positive for Legionella species. Amoebae were detected in 73 of 106 (68.9%) samples and in 56 of 67 (86.6%) Legionella species-positive samples (P < 10(-6)). In these positive samples, conductivity was lower than 500 microOmega(-1).cm(-1) in 58.2% (P = .026), temperature was below 50 degrees C in 80.6% (P = .004), and hardness was significantly higher (P = 002) than in Legionella species-negative samples. Neither Legionella species nor amoebae were isolated from any sampling point in which the water temperature was above 58.8 degrees C. Multivariate analysis shows that high hardness and presence of amoebae were strongly correlated statistically with the presence of Legionella when showers, tanks, pH, and temperature promoted their proliferation. This study shows the importance of water quality evaluation in assessing environmental risk factors and in selecting the most appropriate prevention and control measures in hospital water systems.
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PMID:Influence of amoebae and physical and chemical characteristics of water on presence and proliferation of Legionella species in hospital water systems. 1701 58

The Legionella colonization frequency at 385 Greek hotel hot and cold water distribution systems was 20.8%. Legionella contamination was associated with the presence of an oil heater (odds ratio [OR]=2.04, 95% confidence interval [CI]=1.12 to 3.70), with the sample temperature (OR=0.26, 95% CI=0.1 to 0.5), with seasonal operation (OR=3.23, 95% CI=1.52 to 6.87), and with the presence of an independent disinfection system (OR=0.30, 95% CI=0.15 to 0.62). The same water temperatures, free-chlorine levels, and pHs differently affect the survival of various Legionella spp.
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PMID:Risk factors for contamination of hotel water distribution systems by Legionella species. 1726 27

Amoebae are the natural hosts for Legionella pneumophila and play essential roles in bacterial ecology and infectivity to humans. When L. pneumophila colonizes an aquatic installation, it can persist for years despite repeated treatments with disinfectants. We hypothesized that freshwater amoebae play an important role in bacterial resistance to disinfectants, and in subsequent resuscitation of viable non-culturable (VNC) L. pneumophila that results in re-emergence of the disease-causing strain in the disinfected water source. Our work showed that in the absence of Acanthamoeba polyphaga, seven L. pneumophila strains became non-culturable after treatment by 256 p.p.m. of sodium hypochlorite (NaOCl). In contrast, intracellular L. pneumophila within A. polyphaga was resistant to 1024 p.p.m. of NaOCl. In addition, L. pneumophila-infected A. polyphaga exhibited increased resistance to NaOCl. When chlorine-sterilized water samples were co-cultured with A. polyphaga, the non-culturable L. pneumophila were resuscitated and proliferated robustly within A. polyphaga. Upon treatment by NaOCl, uninfected amoebae differentiated into cysts within 48 h. In contrast, L. pneumophila-infected A. polyphaga failed to differentiate into cysts, and L. pneumophila was never detected in cysts of A. polyphaga. We conclude that amoebic trophozoites protect intracellular L. pneumophila from eradication by NaOCl, and play an essential role in resuscitation of VNC L. pneumophila in NaOCl-disinfected water sources. Intracellular L. pneumophila within trophozoites of A. polyphaga block encystation of the amoebae, and the resistance of both organisms to NaOCl is enhanced. To ensure long-term eradication and complete loss of the VNC state of L. pneumophila, we recommend that Legionella-protozoa co-culture should be an important tool to ensure complete loss of the VNC state of L. pneumophila.
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PMID:Acanthamoeba polyphaga resuscitates viable non-culturable Legionella pneumophila after disinfection. 1747 39

In a 30-month prospective study, we evaluated the efficacy of chlorine dioxide to control Legionella organisms in a water distribution system of a hospital with 364 patient beds and 74 skilled nursing beds. The number of hot water specimens positive for Legionella organisms decreased from 12 (60%) of 20 to 2 (10%) of 20. An extended time (18 months) was needed to achieve a significant reduction in the rate of Legionella positivity among hot water specimens. At the time of writing, no cases of hospital-acquired Legionnaires disease have been detected at the hospital since the chlorine dioxide system was installed in January 2003. Use of chlorine dioxide was safe, based on Environmental Protection Agency limits regarding maximum concentrations of chlorine dioxide and chlorite.
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PMID:Safety and efficacy of chlorine dioxide for Legionella control in a hospital water system. 1762 Feb 53

Previous studies showed that temperature and total organic carbon in drinking water would cause chlorine dioxide (ClO(2)) loss in a water distribution system and affect the efficiency of ClO(2) for Legionella control. However, among the various causes of ClO(2) loss in a drinking water distribution system, the loss of disinfectant due to the reaction with corrosion scales has not been studied in detail. In this study, the corrosion scales from a galvanized iron pipe and a copper pipe that have been in service for more than 10 years were characterized by energy dispersive spectroscopy (EDS) and X-ray diffraction (XRD). The impact of these corrosion scale materials on ClO(2) decay was investigated in de-ionized water at 25 and 45 degrees C in a batch reactor with floating glass cover. ClO(2) decay was also investigated in a specially designed reactor made from the iron and copper pipes to obtain more realistic reaction rate data. Goethite (alpha-FeOOH) and magnetite (Fe(3)O(4)) were identified as the main components of iron corrosion scale. Cuprite (Cu(2)O) was identified as the major component of copper corrosion scale. The reaction rate of ClO(2) with both iron and copper oxides followed a first-order kinetics. First-order decay rate constants for ClO(2) reactions with iron corrosion scales obtained from the used service pipe and in the iron pipe reactor itself ranged from 0.025 to 0.083 min(-1). The decay rate constant for ClO(2) with Cu(2)O powder and in the copper pipe reactor was much smaller and it ranged from 0.0052 to 0.0062 min(-1). Based on these results, it can be concluded that the corrosion scale will cause much more significant ClO(2) loss in corroded iron pipes of the distribution system than the total organic carbon that may be present in finished water.
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PMID:Effect of pipe corrosion scales on chlorine dioxide consumption in drinking water distribution systems. 1788 30

Surveillance of Legionella spp. in hospital water systems was performed in forty-four inpatient healthcare facilities in Spain during 2005-2006. A total of 2,341 samples were collected: 470 from cooling systems (cooling towers) and 1,871 from potable water systems. The latter included 211 from cold-water tanks and 260 from hot-water tanks, totalling 471 from central water reservoirs 136 from showers, 1,172 from unfiltered taps and 92 from filtered taps, totalling 1,400 from peripheral points. Temperature, chlorine levels and the presence of Legionella spp. were determined. In all, 373 (15.9%) samples yielded Legionella spp. Significantly higher isolation rates were obtained from cooling towers (23.8%) versus cold- and hot-water tanks (approximately 4.7%), due to the significantly higher number of samples positive for serogroup 1 (19.4 vs 0.9-3.5%). In potable water systems, no differences were found between central water tanks and showers, but significant differences in isolation rates between central water tanks and unfiltered taps were observed (4.7 vs 19.6%) due to differences in non-serogroup 1 L. pneumophila. Filters significantly decreased isolation rates of these serotypes (11 vs 0%). Some seasonal differences were noted, with higher isolation rates in summer for legionella serogroup 1 in cooling systems and for L. pneumophila serogroups 2-14 in potable water systems. In regression models, higher temperatures were associated with colonisation in cooling systems, while lower chlorine levels were associated with colonisation in potable water systems.
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PMID:Isolation of Legionella species/serogroups from water cooling systems compared with potable water systems in Spanish healthcare facilities. 1793 46

Legionella spp. (> or = 500 cfu liter(-1)) were detected in 92 of 497 water distribution systems (WDS) examined. Thermal disinfection was applied at 33 WDS. After the first and second application of the disinfection procedure, 15 (45.4%) and 3 (9%) positive for remedial actions WDS were found, respectively. Legionella pneumophila was more resistant to thermal disinfection than Legionella non-pneumophila spp. (relative risk [RR]=5.4, 95% confidence intervals [CI]=1-35). WDS of hotels with oil heater were more easily disinfected than those with electrical or solar heater (RR=0.4 95% CI=0.2-0.8). Thermal disinfection seems not to be efficient enough to eliminate legionellae, unless repeatedly applied and in combination with extended heat flushing, and faucets chlorine disinfection.
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PMID:Thermal disinfection of hotels, hospitals, and athletic venues hot water distribution systems contaminated by Legionella species. 1798 Feb 43

We performed an environmental monitoring in an hospital to estimate the level of contamination from Legionella spp., in connection with several treatments of reclamation. In period 2002-2006 we executed 238 samplings in 21 units hospitals (from hot water, biofilm, filter of the conditioning system, instrument for the assisted respiration) for the detection of Legionella spp. The contaminated points have been subordinates to reclamation (hyperchlorination, maintenance of boilers/tanks, taps' and showers' substitution, increased temperature, elimination of dead points of the system and chlorine dioxide) and subsequently we sampled to verify the efficiency of the disinfection. Environmental investigation found 58% of the cases positive for Legionella spp. (139/238), with maximum count in order of the 10(4) UFC/L, demonstrating colonization of Legionella pneumophila (132/139, 70% Serogroup 2-14, 19% Serogroup 1, 11% both). The used treatments were effective, in different ways, in the short period, but not in the medium-term, because progressive recolonization happened approximately after a month; only the use of chlorine dioxide brought to counts less than 100 UFC/L until now. Chlorine dioxide seems to maintain a mainly protecting effect, however this effectiveness will have to be demonstrated also for longer periods.
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PMID:[5-year surveillance for Legionella pneumophila and comparison of disinfection methods in two hospitals of Milan]. 1837 74

This study was conducted in our 650 bed general hospital, which is situated on the southern outskirts of Milan (Italy). After a first nosocomial case of pneumonia (caused by Legionella pneumophila serogroup 1), we first used a conventional method (heat shock) without success. To solve the problem we then tried a copper-silver ionization system combined with a chlorine dioxide device. During the four years after the installation of these two systems we recorded a significant (p < or = 0.05) reduction in Legionella colonization, and no new cases of Legionnaires' disease were observed. Our results suggest that the Cu-Ag ionization system, combined with a chlorine dioxide device, is a highly promising method for the control of Legionella pneumophila in a hospital water distribution system.
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PMID:Prolonged effect of two combined methods for Legionella disinfection in a hospital water system. 1837 73


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