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Sequence-based typing of Legionella pneumophila strains isolated from hospital water distribution systems as a complementary element of risk assessment of legionellosis in Poland.
[legionellosis]
Many
factors
affect
the
risk
of
Legionella
infection
,
such
as
the
design
,
construction
and
maintenance
of
water
distribution
systems
,
the
presence
of
individuals
who
may
be
exposed
and
their
vulnerability
to
infection
,
and
the
degree
of
water
system
colonization
and
properties
of
Legionella
strains
.
For
epidemiological
investigations
,
two
properties
of
the
Legionella
strains
are
usually
determined
:
serotyping
and
genotyping
(
sequence-based
typing
,
SBT
)
.
In
Poland
,
data
regarding
legionellosis
are
fragmentary
,
despite
the
fact
that
this
has
been
a
notifiable
disease
since
2002
.
The
number
of
reported
cases
is
very
low
;
moreover
,
the
main
method
of
diagnosis
is
serological
examination
(
delayed
diagnosis
and
cheaper
methods
)
,
and
only
single
cases
of
LD
were
confirmed
by
culture
of
bacteria
.
Therefore
,
after
10
years
of
mandatory
reporting
of
the
Legionella
spp
.
infection
in
Poland
,
the
real
epidemiological
situation
is
still
unknown
;
however
,
risk
assessment
should
be
carried
out
,
especially
in
hospitals
.
In
the
presented
study
,
comparison
of
the
sequence
types
of
111
isolated
L
.
pneumophila
strains
(
from
hospital
water
systems
)
with
those
present
in
the
EWGLI
SBT
data
was
undertaken
for
complex
risk
analysis
as
a
complementary
element
.
In
total
,
strains
of
L
.
pneumophila
belonging
to
12
out
of
19
STs
determined
in
the
presented
study
were
previously
reported
to
the
EWGLI
SBT
database
(
ST
1
,
ST
42
,
ST
5
9
,
ST
81
,
ST
87
,
ST
114
,
ST
152
,
ST
191
,
ST
371
,
ST
421
,
ST
461
,
ST
5
20
)
.
Among
these
strains
,
only
7
STs
were
previously
reported
in
the
amount
of
≥
10
(
mainly
ST
1
,
ST
42
,
ST
81
)
.
Analysis
of
EWGLI
data
were
carried
out
and
,
proportionally
,
the
highest
percentage
of
hospital-acquired
strains
(
clinical
and
environmental
)
was
found
for
ST
81
,
ST
421
and
ST
152
,
but
the
largest
number
was
for
ST
1
.
Based
on
the
EWGLI
data
and
the
presented
results
,
it
was
found
that
persistent
colonization
of
HWS
of
3
hospitals
by
strains
belonging
to
ST
42
,
ST
1
,
ST
87
indicated
an
increased
risk
of
legionellosis
,
especially
ST
42
.
Diseases
Validation
Diseases presenting
"only single cases"
symptom
legionellosis
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