scholarly journals Contamination of Water Sources of Karaj Hospitals with Legionella pneumophila and Campylobacter jejuni

2020 ◽  
Vol 8 (4) ◽  
pp. 142-146
Author(s):  
Niloofar Ghomimaghsad ◽  
Somayeh Yaslianifard ◽  
Mohammad Mohammadzadeh ◽  
Masoud Dadashi ◽  
Mohammad Noorisepehr
Keyword(s):  
Campylobacter Jejuni ◽  
Legionella Pneumophila ◽  
Water Samples ◽  
High Efficiency ◽  
Cold Water ◽  
Bacterial Species ◽  
Water Sources ◽  
Hot Water ◽  
Water Supply Systems ◽  
Contaminated Water

Background: One of the most common routes of infection development in humans is contaminated water. Legionella pneumophila and Campylobacter jejuni are the important causes of community- and hospital-acquired pneumonia and gastroenteritis that are transmitted to humans via the inhalation of contaminated water droplets and consumption of contaminated water, respectively. Thus, continuous monitoring of the water supply systems for these pathogens has great importance in public health. Objective: This study aimed to evaluate the water contamination of Karaj hospitals with these two bacterial species. Materials and Methods: In this study, 62 water samples were obtained from different parts of the hospitals of Karaj from April to September 2019, including air conditioning systems, dialysis equipment, ventilation tanks, and different wards of a hospital such as infectious diseases, pediatrics, gastroenterology, dialysis, and intensive and neonatal intensive care units. The samples were collected in sterile containers and immediately transferred to the laboratory for further analysis. The culture on specific media, staining, and biochemical tests were performed to identify the L. pneumophila and C. jejuni. Results: Out of 62 water samples, 25.8% (16 samples) were positive for L. pneumophila; 68.75% were observed in hot water samples, and 31.25% were attributed to cold water samples. Among 62 samples, 4.84% (3 samples) were positive for C. jejuni, which were all detected in hot water samples. Conclusion: Considering that the methods of water refinery of municipal water have no high efficiency, the quality improvement of the water sources of hospitals seems to be necessary.

scholarly journals Legionella spp. Colonization in Water Systems of Hotels Linked with Travel-Associated Legionnaires’ Disease

2021 ◽  
Author(s):  
Antonios Papadakis ◽  
Maria Keramarou ◽  
Dimosthenis Chochlakis ◽  
Vassilios Sandalakis ◽  
Varvara Mouchtouri ◽  
...  
Keyword(s):  
Water Supply ◽  
Legionella Pneumophila ◽  
Cold Water ◽  
Water Systems ◽  
Hot Water ◽  
Water Supply Systems ◽  
Water Safety ◽  
Surveillance Network ◽  
Hot Water Supply ◽  
Supply Systems

Hotel water systems colonized with Legionella spp. have been the source of travel-associated Legionnaires’ disease and cases, clusters or outbreaks continue to be reported worldwide each year. A total of 132 hotels linked with travel-associated Legionnaires’ disease, as reported through the European Legionnaires’ Disease Surveillance Network, were inspected and tested for Legionella spp. during 2000–2019 by the public health authorities of the island of Crete (Greece). A total of 3,311 samples were collected: 1,885 (56.93%) from cold water supply systems, 1,387 (41.89%) from hot water supply systems, 37 (1.12%) were swab samples and two (0.06%) were soil. Of those, 685 (20.69%), were collected from 83 (62.89%) hotels, testing positive (≥ 50CFU/L) for Legionella pneumophila) serogroups 1-10, 12-14 and non-pneumophila species (L. anisa, L. erythra, L. tusconensis, L. taurinensis, L. birminghamensis, L. rubrilucens, L. londiniesis, L. oakridgensis, L. santicrusis, L. brunensis, L. maceacherii). The most frequently isolated L. pneumophila serogroups were 1 (27.92%) and 3 (17.08%). Significantly higher isolation rates were obtained from hot water supply systems (25.96%) versus cold water systems (16.98%) and swab samples (13.51%). A Relative Risk (R.R.) > 1 (p < 0.0001) was calculated for hot water temperature <55 °C (R.R.: 4.43), chlorine concentrations <0.2 mg/L (R.R.: 2.69), star rating <4 (R.R.: 1.73) and absence of Water Safety Plan implementation (R.R.: 1.57).

scholarly journals Co-Occurrence of Free-Living Amoeba and Legionella in Drinking Water Supply Systems

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 492 ◽  
Author(s):  
Valciņa ◽  
Pūle ◽  
Mališevs ◽  
Trofimova ◽  
Makarova ◽  
...  
Keyword(s):  
Drinking Water ◽  
Water Supply ◽  
Water Samples ◽  
Cold Water ◽  
Hot Water ◽  
Drinking Water Supply ◽  
Water Supply Systems ◽  
Free Living ◽  
Free Living Amoeba ◽  
Supply Systems

Background and Objectives: Legionella is one of the most important water-related pathogens. Inside the water supply systems and the biofilms, Legionella interact with other bacteria and free-living amoeba (FLA). Several amoebas may serve as hosts for bacteria in aquatic systems. This study aimed to investigate the co-occurrence of Legionella spp. and FLA in drinking water supply systems. Materials and Methods: A total of 268 water samples were collected from apartment buildings, hotels, and public buildings. Detection of Legionella spp. was performed in accordance with ISO 11731:2017 standard. Three different polymerase chain reaction (PCR) protocols were used to identify FLA. Results: Occurrence of Legionella varied from an average of 12.5% in cold water samples with the most frequent occurrence observed in hot water, in areas receiving untreated groundwater, where 54.0% of the samples were Legionella positive. The occurrence of FLA was significantly higher. On average, 77.2% of samples contained at least one genus of FLA and, depending on the type of sample, the occurrence of FLA could reach 95%. In the samples collected during the study, Legionella was always isolated along with FLA, no samples containing Legionella in the absence of FLA were observed. Conclusions: The data obtained in our study can help to focus on the extensive distribution, close interaction, and long-term persistence of Legionella and FLA. Lack of Legionella risk management plans and control procedures may promote further spread of Legionella in water supply systems. In addition, the high incidence of Legionella-related FLA suggests that traditional monitoring methods may not be sufficient for Legionella control.

scholarly journals Presence of Legionella spp. in Hot Water Networks of Different Italian Residential Buildings: A Three-Year Survey

2017 ◽  
Author(s):  
Michele Totaro ◽  
Paola Valentini ◽  
Anna Laura Costa ◽  
Lorenzo Frendo ◽  
Alessia Cappello ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Water Samples ◽  
Cold Water ◽  
Residential Buildings ◽  
Hot Water ◽  
Water Production ◽  
Water Networks ◽  
Legionella Species ◽  
Solar Thermal System ◽  
And Control

Although the European reports highlight an increase in community-acquired Legionnaires’ disease cases, the risk of Legionella spp. in private houses is underestimated. In Pisa (Italy) we performed a three-year survey on Legionella presence in 121 buildings with an independent hot water production (IB); 64 buildings with a central hot water production (CB); and 35 buildings with a solar thermal system for hot water production (TB). From all the 220 buildings Legionella spp. was researched in two hot water samples collected either at the recirculation point or at on the first floor and on the last floor, while the potable water quality was analyzed in three cold water samples collected at the inlet from the aqueduct network, at the exit from the autoclave, and at the most remove remote? tap. Legionella pneumophila sg1, Legionella pneumophila sg2-16 and not-pneumophila Legionella species were detected in 26% of the hot water networks, mostly in CB and TB. In these buildings we detected correlations between the presence of Legionella and the total chlorine concentration decrease or/and the increase of the temperature. Cold water resulted free from microbiological hazards, with the exception of Serratia liquefaciens and Enterobacter cloacae isolated at the exit from two different autoclaves. We observed an increase in total microbial counts at 22 and 37°C between the samples collected at the most remote taps compared to the ones collected at the inlet from the aqueduct. The study highlights a condition of potential risk for susceptible categories of population and supports the need for measures of risk assessment and control.

scholarly journals Legionella spp. Colonization in Water Systems of Hotels Linked with Travel-Associated Legionnaires’ Disease

Water ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 2243
Author(s):  
Antonios Papadakis ◽  
Maria Keramarou ◽  
Dimosthenis Chochlakis ◽  
Vassilios Sandalakis ◽  
Varvara A. Mouchtouri ◽  
...  
Keyword(s):  
Water Supply ◽  
Legionella Pneumophila ◽  
Cold Water ◽  
Water Systems ◽  
Hot Water ◽  
Water Supply Systems ◽  
Surveillance Network ◽  
Legionnaires Disease ◽  
Hot Water Supply ◽  
Supply Systems

Hotel water systems colonized with Legionella spp. have been the source of travel-associated Legionnaires’ disease, and cases, clusters and outbreaks continue to be reported worldwide each year. A total of 132 hotels linked with travel-associated Legionnaires’ disease, as reported through the European Legionnaires’ Disease Surveillance Network, were inspected and tested for Legionella spp. during 2000–2019 by the public health authorities of the island of Crete (Greece). A total of 3311 samples were collected: 1885 (56.93%) from cold water supply systems, 1387 (41.89%) from hot water supply systems, 37 (1.12%) were swab samples and two (0.06%) were soil. Of those, 685 (20.69%), were collected from 83 (62.89%) hotels, testing positive (≥50 CFU/L) for Legionella pneumophila) serogroups 1–10, 12–14 and non-pneumophila species (L. anisa, L. erythra, L. tusconensis, L. taurinensis, L. birminghamensis, L. rubrilucens, L. londiniesis, L. oakridgensis, L. santicrusis, L. brunensis, L. maceacherii). The most frequently isolated L. pneumophila serogroups were 1 (27.92%) and 3 (17.08%). Significantly higher isolation rates were obtained from hot water supply systems (25.96%) versus cold water systems (16.98%) and swab samples (13.51%). A Relative Risk (R.R.) > 1 (p < 0.0001) was calculated for hot water temperature <55 °C (R.R.: 4.43), chlorine concentrations <0.2 mg/L (R.R.: 2.69), star ratings <4 (R.R.: 1.73) and absence of Water Safety Plan implementation (R.R.: 1.57).

scholarly journals A field study of the survival ofLegionella pneumophilain a hospital hot–water system

1990 ◽  
Vol 104 (3) ◽  
pp. 381-387 ◽  
Author(s):  
I. D. Farrell ◽  
J. E. Barker ◽  
E. P. Miles ◽  
J. G. P. Hutchison
Keyword(s):  
Water Supply ◽  
Legionella Pneumophila ◽  
Water Samples ◽  
Cold Water ◽  
Water System ◽  
Hot Water ◽  
Undetectable Level ◽  
Drain Water ◽  
Water Feed ◽  
And Control

SUMMARYThe colonization, survival and control ofLegionella pneumophilain a hospital hot–water system was examined. The organism was consistently isolated from calorifier drain–water samples at temperatures of 50°C or below, despite previous chlorination of the system. When the temperature of one of two linked calorifiers was raised to 60°C, by closing off the cold–water feed, the legionella count decreased from c. 104c.f.u./l to an undetectable level. However, 10 min after turning on the cold–water feed which produced a fall in calorifier temperature, the count in the calorifier drain water returned to its original level. Investigations revealed that the cold–water supply was continually feeding the calorifiers withL. pneumophila. Simple modifications in the design of the system were made so that the cold–water feed no longer exceeds 20°C; these measures have considerably reduced the number ofL. pneumophilareaching the calorifiers.

Determinants of Legionella pneumophila Contamination of Water Distribution Systems: 15-Hospital Prospective Study

1987 ◽  
Vol 8 (9) ◽  
pp. 357-363 ◽  
Author(s):  
Richard M. Vickers ◽  
Victor L. Yu ◽  
S. Sue Hanna ◽  
Paul Muraca ◽  
Warren Diven ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Distribution System ◽  
Distribution Systems ◽  
Water Distribution ◽  
Cold Water ◽  
Physicochemical Characteristics ◽  
Hot Water ◽  
Environmental Study ◽  
Water Tank ◽  
One Year

AbstractWe conducted a prospective environmental study for Legionella pneumophila in 15 hospitals in Pennsylvania. Hot water tanks, cold water sites, faucets, and show-erheads were surveyed four times over a one-year period. Sixty percent (9/15) of hospitals surveyed were contaminated with L pneumophila. Although contamination could not be linked to a specific municipal water supplier, most of the contaminated supplies came from rivers. Parameters found to be significantly associated with contamination included elevated hot water temperature, vertical configuration of the hot water tank, older tanks, and elevated calcium and magnesium concentrations of the water (P < 0.05). This study suggests that L pneumophila contamination could be predicted based on design of the distribution system, as well as physicochemical characteristics of the water.

Occurrence of heterotrophic bacteria and fungi in cold and hot water distribution systems using water of different quality

1995 ◽  
Vol 41 (12) ◽  
pp. 1088-1094 ◽  
Author(s):  
Outi M. Zacheus ◽  
Pertti J. Martikainen
Keyword(s):  
Surface Water ◽  
Water Samples ◽  
Distribution Systems ◽  
Heterotrophic Bacteria ◽  
Cold Water ◽  
Hot Water ◽  
Thermophilic Fungi ◽  
Cell Counts ◽  
Bacteria And Fungi ◽  
Water Plants

The microbiological quality of cold and hot water samples of 67 Finnish buildings was studied. Most of the buildings were apartment buildings receiving their cold water from municipal groundwater or surface water plants. Disinfection with chlorine was applied in all the surface water plants and 33% of the groundwater plants. Water samples in buildings were taken from incoming cold water, from the hot water main just before and after the heat exchanger, and from a tap or shower in an apartment. The viable counts of mesophilic bacteria and fungi and total cell counts were higher in cold than in hot water samples. In hot water, the microbial counts were higher in samples from taps and showers than from the mains. In taps and showers, the decrease in hot water temperature probably increased the microbial numbers. Thermophilic bacteria appeared with high numbers in all the hot water samples, but thermophilic fungi were found in only one sample. Bacterial biomass and mean cell volume were greater in processed surface water than in processed groundwater samples. Disinfection with chlorine reduced the viable plate counts, although the chlorine concentration was extremely low in the water samples studied.Key words: heterotrophic bacteria, fungi, distribution system, groundwater, surface water.

scholarly journals Is a Proactive Approach to Controlling Legionella in the Environment Justified?

2021 ◽  
Vol 59 (3) ◽  
Author(s):  
Daniela Glažar Ivče ◽  
Dobrica Rončević ◽  
Marina Šantić ◽  
Arijana Cenov ◽  
Dijana Tomić Linšak ◽  
...  
Keyword(s):  
Drinking Water ◽  
Legionella Pneumophila ◽  
Cold Water ◽  
Aged Care ◽  
Water Systems ◽  
Hot Water ◽  
Plate Count ◽  
Surveillance Program ◽  
Adequate Treatment ◽  
Proactive Approach

Research background. Legionella are Gram-negative bacteria that are ubiquitous in the natural environment. Contaminated water in manmade water systems is a potential source of transmission of Legionnaires’ disease (LD). The aim of this study was to explore the prevalence of Legionella pneumophila (L. pneumophila) in the drinking water distribution system (DWDS) of Primorje-Gorski Kotar County (PGK County), Croatia, for the period 2013-2019, coupled with the incidence of LD. A number of L. pneumophila-positive samples (>100 CFU/L), serogroup distribution, and the degree of contamination of specific facilities (health & aged care, tourism, sports) were assessed. Based on the results obtained, the reasoning for the implementation of a mandatory Legionella environmental surveillance program was assessed. Experimental approach. Sample testing for Legionella was carried out according to ISO 1173. A Heterotrophic Plate Count (HPC) and P. aeruginosa were analysed along with the basic physico-chemical indicators of drinking water quality. The research period was divided into two parts, namely, the 2013-2018 period (before implementation of the prevention program, after the outbreak of LD), and year 2019 (proactive approach, no LD cases recorded). Results and conclusion. During the 7-year observation period in PGK County, an increase in the number of samples tested for Legionella was found. An increase in Legionella-positive samples (particularly pronounced during the warmer part of the year) was recorded, along with a growing trend in the number of reported LD cases. In addition to hot water systems, the risk of Legionella colonization also applies to cold water systems. Health & aged care facilities appear to be at highest risk. In addition to the higher proportion of positive samples and a higher degree of microbiological load at these facilities, the highest proportion of L. pneumophila SGs 2-14 was identified. Due to the diagnostic limitations of the applied tests, the number of LD cases is underdiagnosed. Novelty and scientific contribution. The introduction of a mandatory preventive approach to monitoring Legionella in DWDS water samples, along with the definition of national criteria for the interpretation of results, will create the preconditions for diagnosis and adequate treatment of larger numbers of LD cases.

scholarly journals Multiple Types of Legionella pneumophilaSerogroup 6 in a Hospital Heated-Water System Associated with Sporadic Infections

1999 ◽  
Vol 37 (7) ◽  
pp. 2189-2196 ◽  
Author(s):  
Paolo Visca ◽  
Paola Goldoni ◽  
P. Christian Lück ◽  
Jürgen H. Helbig ◽  
Lorena Cattani ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Water Samples ◽  
Water System ◽  
Hot Water ◽  
Control Measures ◽  
Hospital Environment ◽  
Modes Of Transmission ◽  
Sequence Of Events ◽  
Single Clone ◽  
Arbitrarily Primed Pcr

Five sporadic cases of nosocomial Legionnaires’ disease were documented from 1989 to 1997 in a hospital in northern Italy. Two of them, which occurred in a 75-year-old man suffering from ischemic cardiopathy and in an 8-year-old girl suffering from acute leukemia, had fatal outcomes. Legionella pneumophila serogroup 6 was isolated from both patients and from hot-water samples taken at different sites in the hospital. These facts led us to consider the possibility that a single clone of L. pneumophila serogroup 6 had persisted in the hospital environment for 8 years and had caused sporadic infections. Comparison of clinical and environmental strains by monoclonal subtyping, macrorestriction analysis (MRA), and arbitrarily primed PCR (AP-PCR) showed that the strains were clustered into three different epidemiological types, of which only two types caused infection. An excellent correspondence between the MRA and AP-PCR results was observed, with both techniques having high discriminatory powers. However, it was not possible to differentiate the isolates by means of ribotyping and analysis of rrnoperon polymorphism. Environmental strains that antigenically and chromosomally matched the infecting organism were present at the time of infection in hot-water samples taken from the ward where the patients had stayed. Interpretation of the temporal sequence of events on the basis of the typing results for clinical and environmental isolates enabled the identification of the ward where the patients became infected and the modes of transmission of Legionellainfection. The long-term persistence in the hot-water system of different clones of L. pneumophila serogroup 6 indicates that repeated heat-based control measures were ineffective in eradicating the organism.

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