The impact of legionellosis into fatal outcomes of pneumonia in Irkutsk

Aim. To study the diagnosis of legionellosis in patients who died because of pneumonia in Irkutsk (2016-2018).Materials and Methods. We performed 65 autopsies of patients who died from pneumonia in Irkutsk (2016-2018), studied their case histories, and interrogated 510 tap water samples for Legionella pneumophila by means of inoculation and polymerase chain reaction.Results. Among 65 fatal pneumonia outcomes registered in Irkutsk during 2016-2018, legionellosis has been confirmed in three cases (4.6%). Two of these patients were at the late stages of HIV infection while the third, 74-yearold, patient had multiple comorbid conditions. Nosocomial infection was suspected in one of these cases. None of these three patients left Irkutsk during the last month of their life. The assumed transmission factor was tap water, as Legionella pneumophila was found in tap water samples collected in 2013 and 2015.Conclusion. Patients with severe pneumonia need screening for legionellosis to perform the correct treatment, particularly during COVID-19 pandemic.

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Differences of Legionella Pneumophila Serogroups Distribution in Well Water, Tap Water, Ice Cubes, Hospital and Hotel Water in East Java

10.20944/preprints201809.0269.v1 ◽

2018 ◽

Author(s):

Eduardus Bimo Aksono ◽

Kadek Rachmawati ◽

Retno Bijanti

Keyword(s):

Polymerase Chain Reaction ◽

Phylogenetic Tree ◽

Legionella Pneumophila ◽

Water Samples ◽

Tap Water ◽

Natural Habitat ◽

Well Water ◽

Chain Reaction ◽

Water Ice ◽

Polymerase Chain

Background Legionella pneumophila is one of the causes of legionellosis. Water environments serve as the natural habitat and the main sources of Legionella pneumophila. Objectives The aims of this study was to understand the differences of Legionella pneumophila serogroups distribution in well water, tap water, ice cubes, hospital and hotel water in East Java-Indonesia. Methods a total of 60 water samples in east java-Indonesia; from well water (n=25), tap water (n=5), ice cubes (n=5), water from the hospital (n=16), and hotel water (n=9) were detected using polymerase chain reaction with mip gene spesific primers and then it was analyzed by phylogenetic tree. Results For the 60 water samples collected in East Java, 12% of the samples (7/60) were positively contaminated by L. pneumophila. In details, there was 8% of the well water samples (2/25), 2% of the tap water samples (1/5), 2% of the ice cubes samples (1/5), 0% of the hospital water samples (0/16) and 33.33% of the hotel water samples (3/9). The phylogenetic tree showed that Legionella pneumophila contaminating well water isolate 1 from Surabaya and tap water isolate from Sidoarjo was closer to L.pneumophila serogroup 2, 4, 6, 8, 10, 12, isolates from Brazil, China, Spain and Australia. L.pneumophila contaminating the ice cubes from Sidoarjo was closer to serogroup 1, 2, 4, 7, 8, 11, 13, 14, while the bacteria contaminating well water isolate 2 from Sidoarjo as well as water in hotel of Surabaya (hotel water isolate 1, 2 and 3) classified into their own group. Conclusion There is a difference in the distribution of L. pneumophila serogroups between well water, tap water, ice cubes, and hotels.

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Hydrocortisone vs Tocilizumab Effects on Cytokine Storm in Critically Ill Patients with COVID-19.

10.21203/rs.3.rs-43580/v1 ◽

2020 ◽

Author(s):

Maria Vargas ◽

Pasquale Buonanno ◽

Carmine Iacovazzo ◽

Gaetano Di Spigna ◽

Daniela Spalletti ◽

...

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Statistical Significance ◽

Plasma Concentrations ◽

Severe Pneumonia ◽

Cytokine Storm ◽

Tnf Α ◽

Speed Up ◽

The Impact ◽

Late Stages

Abstract Introduction: Patients with severe pneumonia due COVID-19 are reported to have substantially lower lymphocyte counts and higher plasma concentrations of a number of inflammatory cytokines. In the late stages of COVID-19, cytokine storms are the mainly cause of disease progression and death. We performed a prospective observational study to evaluate the impact of tocilizumab and hydrocortisone on cytokine storm in critically ill patients with COVID-19.Methods: We included all adult patients with laboratory-confirmed COVID-19 infection and severe respiratory failure admitted to our ICU from March 10 to April 30. As therapeutic options, patients received tocilizumab od hydrocortisone. The primary end point was the evaluation of cytokine storm in terms of variation of the IL-6 and IL-6R, sgp130 and TNF-α concentrations during time to different treatment.Results: Eight patients received tocilizumab while 15 patients received hydrocortisone. IL-6 levels were lower in the hydrocortisone group with statistical significance was found at the days 2, 3, 8 and 9. The levels of IL-6R were lower during the days in the hydrocortisone group with statistical significance at days 1, 2, 3, 4, 5, 6, 8 and 10. Hydrocortisone group had higher levels of TNF-α at days 2, 3 and 4. The levels of sgo130 between tocilizumab and hydrocortisone groups were not statistically different during the days.Conclusions: In critically ill patients with severe COVID-19, the use of hydrocortisone allowed a better control of the cytokine storms, was further associated to less days of curarization, pronation and length of stay in ICU, and speed up the time to get negative RT-PCR swab.

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Rapid, specific and quantitative polymerase chain reaction (PCR) detection of pathogenic protozoa Entamoeba histolytica for drinking water supply

Water Science & Technology Water Supply ◽

10.2166/ws.2011.057 ◽

2011 ◽

Vol 11 (4) ◽

pp. 418-425 ◽

Cited By ~ 1

Author(s):

S. W. Lam ◽

H. B. Zhang ◽

L. Yu ◽

C. H. Woo ◽

K. N. Tiew ◽

...

Keyword(s):

Real Time ◽

Water Samples ◽

Real Time Pcr ◽

Genomic Dna ◽

Tap Water ◽

Pcr Detection ◽

Raw Water ◽

Conventional Pcr ◽

Polymerase Chain ◽

Species Specific

In this study, a quantitative species-specific polymerase chain reaction (PCR) method to rapidly detect E. histolytica in water is developed. First, the specificity of E. histolytica PCR detection was verified by using species-specific primers of 16S-like rRNA genes to clearly differentiate it from the closely related amoebae species E. dispar and E. moshkovskii. The sensitivity of this method was subsequently determined using purified E. histolytica genomic DNA and culture cells as PCR reaction templates. Results indicated that conventional PCR visualized on 1% agarose gel was able to detect as low as 0.02 pg genomic DNA and 5 cells, while real-time PCR could detect 0.01 pg genomic DNA and 2 cells of E. histolytica. The protocols for E. histolytica PCR detection in real water samples were then optimized by spiking E. histolytica cells into tap water and reservoir raw water samples. A two-round centrifugation treatment to concentrate amoeba cells directly as a PCR template was the most effective way to detect E. histolytica in spiked tap water samples, while DNA extraction after concentrating amoeba cells was required for spiked reservoir raw water samples. The detection limit of 50 E. histolytica cells in 100 ml tap water was achieved in 2 h from sample collection to real-time PCR data readout. With these established protocols, 78 tap water samples, 11 reservoir raw water samples and 4 feed water samples from Singapore water supply systems were analyzed by both conventional PCR and real-time PCR methods. No E. histolytica cell was detected in tested samples.

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Legionella pneumophila infection and antibiotic treatment engenders a highly disturbed pulmonary microbiome with decreased microbial diversity

10.1101/808238 ◽

2019 ◽

Author(s):

Ana Elena Pérez-Cobas ◽

Christophe Ginevra ◽

Christophe Rusniok ◽

Sophie Jarraud ◽

Carmen Buchrieser

Keyword(s):

Antibiotic Treatment ◽

Legionella Pneumophila ◽

Severe Pneumonia ◽

Resistant Bacteria ◽

Rrna Gene ◽

Microbial Composition ◽

Bacterial Composition ◽

Lung Microbiome ◽

The Impact ◽

Healthy Lung

ABSTRACTBackgroundLung microbiome analyses have shown that the healthy lung is not sterile but it is colonized like other body sites by bacteria, fungi and viruses. However, little is known about the microbial composition of the lung microbiome during infectious diseases such as pneumonia and how it evolves during antibiotic therapy. To better understand the impact of the composition of the pulmonary microbiome on severity and outcome of pneumonia we analysed the composition and evolution of the human lung microbiome during pneumonia caused by the bacterium Legionella pneumophila.ResultsWe collected 10 bronchoalveolar lavage (BAL) samples from three patients during long-term hospitalisation due to severe pneumonia and performed a longitudinal in-depth study of the composition of their lung microbiome by high-throughput Illumina sequencing of the 16S rRNA gene (bacteria and archaea), ITS region (fungi) and 18S rRNA gene (eukaryotes). We found that the composition of the bacterial lung microbiome during pneumonia is hugely disturbed containing a very high percentage of the pathogen, a very low bacterial diversity, and an increased presence of opportunistic microorganisms such as species belonging to Staphylococcaceae and Streptococcaceae. The microbiome of antibiotic treated patients cured from pneumonia represented a different perturbation state with a higher abundance of resistant bacteria (mainly Firmicutes) and a significantly different bacterial composition as that found in healthy individuals. In contrast, the mycobiome remains more stable during pneumonia and antimicrobial therapy. Interestingly we identified possible cooperation within and between both communities. Furthermore, archaea (Methanobrevibacter) and protozoa (Acanthamoeba and Trichomonas) were detected.ConclusionsBacterial pneumonia leads to a collapse of the healthy microbiome and a strongly disturbed bacterial composition of the pulmonary microbiome that is dominated by the pathogen. Antibiotic treatment allows some bacteria to regrow or recolonize the lungs but the restoration of a healthy lung microbiome composition is only regained a certain time after the antibiotic treatment. Archaea and protozoa should also be considered, as they might be important but yet overseen members of the lung microbiome. Interactions between the micro- and the mycobiome might play a role in the restoration of the microbiome and the clinical evolution of the disease.

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Sewage Disposal and Viral Pollution of the Ottawa River

Water Quality Research Journal ◽

10.2166/wqrj.1979.005 ◽

1979 ◽

Vol 14 (1) ◽

pp. 45-62

Author(s):

S.A. Sattar ◽

V.S. Springthorpe ◽

S. Ramia

Keyword(s):

Water Samples ◽

Tap Water ◽

Point Sources ◽

Virus Concentration ◽

Viral Agent ◽

Sewage Disposal ◽

Ottawa River ◽

The Impact ◽

Virus Isolates

Abstract The quality of water in the Ottawa River is being affected by the disposal of increased volumes of sewage into it. Some of the sewage disposal points are situated upstream of beaches and intake points for water purification plants. The aim of this study was to assess the impact of such waste disposal on the virological quality of recreational and drinking waters for the Ottawa area. A total of 132 weekly samples of raw sewage, chlorinated secondary effluents, raw and finished surface waters were examined for viruses from June to December 1977. In addition to these, ten samples of tap water, collected during the first two weeks of April 1978, were also included in this study. Virus concentration from these samples was carried out using the talc-Celite technique developed in the laboratory. Primary human embryonic kidney (HEK) cells and BS-C-1 cells were used for the detection and quantitation of viruses present in the sample concentrates. Virus isolates were identified by their cytopathology, examination under the electron microscope and serology. When 6 1. volumes were processed, nearly all the samples of raw sewage and 54% chlorinated effluent samples were found to be positive for virus. Approximately 50% of the surface water samples were also shown to contain virus using 40 1. sample volumes. Concentrates of some of the potable water samples showed virus-like degeneration in cell cultures. Although this degeneration was found to be transmissible, at this stage it is not possible to say if this effect was in fact due to a viral agent. The following major conclusions were drawn from this study: (a) All three major enteric virus groups were represented in the virus isolates. However, inherent limitations of sample concentration and virus isolation techniques may have resulted in the detection of only a small fraction of the viruses present in the samples. (b) There was no apparent correspondence between the numbers of indicator bacteria and the presence or absence of detectable virus in the samples. (c) Viruses detected in the recreational and raw water samples may be due to the presence of point sources of raw sewage discharge upstream. This could result in the dissemination of human pathogenic viruses through recreational and potable waters.

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Investigation of Virulence Genes and Biofilm Formation Among Legionella Pneumophila Isolated from Hospital Water Sources

10.21203/rs.3.rs-34398/v1 ◽

2020 ◽

Author(s):

shiva mirkalantari ◽

Sara Hayatimehr ◽

Noor Amirmozafari ◽

Faramarz Masjedian

Keyword(s):

Legionella Pneumophila ◽

Biofilm Formation ◽

Virulence Genes ◽

Tap Water ◽

Severe Pneumonia ◽

Water Sources ◽

Hospital Environment ◽

Contamination Rate ◽

Elevated Concentration ◽

Contributing Factors

Abstract Background: Legionella pneumophila as a ubiquitous bacterium is inherently resistant to chlorine in tap water. It can easily enter water piping systems and get transmitted to immunocompromised populations and cause severe pneumonia. Owing to the fact that its presence in water sources doesn’t necessarily lead to onset of disease; therefore, several factors such as inhaled bacteria dose, virulence factors and diversity of serogroups can be considered as contributing factors. The main aim of current project was to investigate the contamination rate of hospital water systems with Legionella by culture and evaluate presence of major virulence factor genes as well as the ability to form biofilms among the Legionella isolates. Results: Twelve (12%) of the 100 water samples produced positive results in culture method. Additional confirmation was performed by PCR method with specific primers for Legionella genus (16SrRNA) and pneumophila species (mip). Fifty (5%) samples of 12 with positive culture have a colony forming unit higher than 1000cfu/100 ml. Legionella were isolated with a rate of 8%, 3% and 1% from shower heads, oxygen humidifier bottle and water bath, respectively. PCR assay for the virulence genes showed that all 12 (100%) isolates were positive for mip genes, 9 (75%) were positive for dot gene, 8 (66.66%) were positive for hsp, 6(50%) were positive for lvh and 4(33.33%) for rtx. Two of the isolates displayed higher ability to form biofilm in reference to the standard strain.Conclusion: Although the presence of Legionella pneumophila in hospital environment does not necessarily confer a threat to public health; continuous monitoring of water sources should be conducted in order to avoid elevated concentration of this bacterium and visible biofilm formation.

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Prevalence of Legionella spp. and Escherichia coli in the drinking water distribution system of Wrocław (Poland)

Water Science & Technology Water Supply ◽

10.2166/ws.2020.034 ◽

2020 ◽

Vol 20 (3) ◽

pp. 1083-1090

Author(s):

M. Wolf-Baca ◽

A. Siedlecka

Keyword(s):

Escherichia Coli ◽

Drinking Water ◽

Legionella Pneumophila ◽

Water Samples ◽

Distribution System ◽

Water Distribution ◽

Tap Water ◽

Potential Threat ◽

E Coli ◽

Drinking Water Distribution

Abstract Drinking water should be free from bacterial pathogens that threaten human health. The most recognised waterborne opportunistic pathogens, dwelling in tap water, are Legionella pneumophila and Escherichia coli. Drinking water samples were tested for the presence of Legionella spp., L. pneumophila, and E. coli in overall sample microbiomes using a quantitative real-time polymerase chain reaction (qPCR) approach. The results indicate a rather low contribution of Legionella spp. in total bacteria in the tested samples, but L. pneumophila was not detected in any sample. E. coli was detected in only one sample, but at a very low level. The qacEΔ1 gene, conferring resistance to quaternary ammonium compounds, was also not detected in any sample. The results point to generally sufficient quality of drinking water, although the presence of Legionella spp. in tap water samples suggests proliferation of these bacteria in heating units, causing a potential threat to consumer health.

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The impact of electrochemical disinfection on Escherichia coli and Legionella pneumophila in tap water

Microbiological Research ◽

10.1016/j.micres.2006.05.002 ◽

2008 ◽

Vol 163 (2) ◽

pp. 192-199 ◽

Cited By ~ 24

Author(s):

Yasmine Delaedt ◽

Arne Daneels ◽

Priscilla Declerck ◽

Jonas Behets ◽

Jaak Ryckeboer ◽

...

Keyword(s):

Escherichia Coli ◽

Legionella Pneumophila ◽

Tap Water ◽

Electrochemical Disinfection ◽

The Impact

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Detection of Pseudomonas aeruginosa by PCR in tap-water and bottled mineral water in the Isfahan province of Iran

Water Science & Technology Water Supply ◽

10.2166/ws.2011.108 ◽

2011 ◽

Vol 11 (5) ◽

pp. 642-646 ◽

Cited By ~ 1

Author(s):

Hassan Momtaz ◽

Ebrahim Rahimi ◽

Saadat Moshkelani

Keyword(s):

Pseudomonas Aeruginosa ◽

Water Samples ◽

Mineral Water ◽

Tap Water ◽

Molecular Method ◽

Pcr Assay ◽

Isfahan Province ◽

Operon Gene ◽

Polymerase Chain ◽

Bottled Mineral Water

The purpose of this study was to consider the use of a simple polymerase chain reaction (PCR) as an accurate, safe and rapid method to detect Pseudomonas aeruginosa in tap-water and bottled mineral water from Isfahan province, Iran. A total of 224 tap-water and bottled mineral water samples were taken over six months, from July to December 2010. DNA (deoxyribonucleic acid) was extracted from water samples after filtration and culture and PCR was performed by primers derived from the ETA (Exotoxin A) operon gene sequence of the P. aeruginosa. Out of all the samples, 13.8% and 1.97% were positive by this molecular method for tap-water and bottled mineral water, respectively. The results show that PCR assay could become a valuable diagnostic or screening test for water quality.

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THE IMPACT OF DRINKING WATER OF VARIOUS QUALITY ON INTACT AND IRRADIATED MICE

Hygiene and Sanitation ◽

10.18821/0016-9900-2017-96-9-854-860 ◽

2019 ◽

Vol 96 (9) ◽

pp. 854-860

Author(s):

Aleksandr A. Ivanov ◽

I. E. Andrianova ◽

V. N. Mal'tsev ◽

G. A. Shalnova ◽

N. M. Stavrakova ◽

...

Keyword(s):

Drinking Water ◽

Water Samples ◽

Body Weight Gain ◽

Tap Water ◽

Lethal Dose ◽

Electrochemical Treatment ◽

Behavioral Activity ◽

Hematological Indices ◽

Oxidation Reduction ◽

The Impact

In experiments on intact mice provided by continuous access to drinking water with reduced oxidation-reduction potential (ORP) only for 30-49 days there are revealed following signs of a modification of the vital status: a slowdown in body weight gain, a decrease in behavioral activity, a decrease in the thymus and spleen mass, signs of a change in intestinal microflora composition, in comparison with the original tap water and distilled water. Reduction of ORP was achieved by distillation of water, and also by electrochemical treatment at the "Ideal" plant. In addition, water samples were used in the experiment with the addition of antioxidants: ascorbic acid and melanin, which also reduced the ORP. At X-ray irradiation in a non-lethal dose of 1.5 Gy, 24 hours after exposure to radiation, there were no statistically significant differences in the damaging effect of radiation in animals that drank water of different quality. At the same time, with an irradiation dose of 5 Gy, an acceleration in the recovery of hematological indices and behavioral activity in the use of water with reduced ORP was noted. The intake of these water samples after irradiation contributed to a statistically significant increase in the number of endogenous hematopoiesis colonies in the spleen as compared to the use of tap water.

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