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Virulence of Legionella pneumophila strains isolated from hospital water system and healthcare-associated Legionnaires' disease in Northern Italy between 2004 and 2009.
[legionellosis]
Worldwide
,
L
.
pneumophila
sg
1
is
the
most
common
agent
of
Legionnaires
'
disease
(
80
to
90
%
of
the
reported
cases
)
.
In
contrast
,
L
.
pneumophila
sg
2
-
14
account
for
only
15
to
20
%
of
community-acquired
cases
,
although
they
account
for
over
50
%
of
the
environmental
isolates
.
The
discrepancy
between
environmental
isolates
and
clinical
cases
of
disease
suggested
that
there
are
differences
in
virulence
.
We
decided
to
subtype
the
environmental
Legionella
strains
isolated
from
health
care
facilities
(
HCFs
)
and
to
compare
the
distribution
of
strains
with
the
occurrence
of
hospital-acquired
legionellosis
.
Observational
ecological
study
based
on
the
data
provided
by
the
regional
surveillance
of
legionellosis
and
on
data
obtained
from
hospitals
environmental
monitoring
.
Using
the
monoclonal
antibody
MAb
3
/
1
of
the
Dresden
Panel
we
collected
and
typed
environmental
strains
of
L
.
pneumophila
sg
1
obtained
during
routine
testing
in
56
health
care
facilities
from
2004
to
2009
.
The
results
of
the
laboratory
analyses
of
the
environmental
samples
were
compared
with
the
number
of
cases
that
each
health
care
facility
reported
during
the
study
period
.
The
association
between
the
type
of
colonisation
(
L
.
pneumophila
sg
1
vs
others
serogroups
)
and
the
incidence
of
reported
cases
was
statistically
significant
(
p
 
=
 
0
.
03
according
to
the
χ
2
test
)
.
Legionella
strains
with
the
virulence-associated
epitope
recognised
by
MAb
3
/
1
were
isolated
in
8
of
the
26
HCFs
colonised
by
L
.
pneumophila
sg
1
;
7
of
the
HCFs
colonised
by
MAb
3
/
1
-
positive
strains
accounted
for
85
%
of
the
cases
of
hospital-acquired
legionellosis
reported
during
the
6
-
year
study
period
.
There
was
a
statistically
significant
association
(
p
 
=
 
0
.
003
)
between
the
presence
of
cases
and
colonisation
by
MAb
3
/
1
-
positive
Legionella
strains
.
This
study
suggests
that
hospitals
colonised
by
more
virulent
strains
should
be
aware
of
the
increased
risk
and
consider
the
opportunities
of
increase
their
monitoring
efforts
and
implement
more
effective
contamination
control
strategies
.
Diseases
Validation
Diseases presenting
"typed environmental strains of l. pneumophila sg"
symptom
legionellosis
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