Association of Legionnaires' Disease with Construction: Contamination of Potable Water?

Mermel, Leonard A.; Josephson, Stephen L.; Giorgio, Christina; Dempsey, Jane; Parenteau, Stephen

doi:10.2307/30140946

Cited by 60 publications

(17 citation statements)

References 28 publications

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“…Inhalation of aerosols or microaspiration of contaminated water has been recognized as a source of legionellosis (227). After the initial description of an outbreak of severe respiratory disease occurring in Pennsylvania, which showed that person-to-person transmission was unlikely (77), subsequent reports of Legionella infections were repeatedly associated with contaminated water in both communityacquired (165,229) and nosocomial (30,90,140,142,176) settings. The ecology of L. pneumophila was extensively studied and confirmed empirical observations of its predilection for growth in hot water tanks and its localization in sediment (228).…”

Section: Legionellaceaementioning

confidence: 99%

Microorganisms Resistant to Free-Living Amoebae

2004

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Free-living amoebae feed on bacteria, fungi, and algae. However, some microorganisms have evolved to become resistant to these protists. These amoeba-resistant microorganisms include established pathogens, such as Cryptococcus neoformans, Legionella spp., Chlamydophila pneumoniae, Mycobacterium avium, Listeria monocytogenes, Pseudomonas aeruginosa, and Francisella tularensis, and emerging pathogens, such as Bosea spp., Simkania negevensis, Parachlamydia acanthamoebae, and Legionella-like amoebal pathogens. Some of these amoeba-resistant bacteria (ARB) are lytic for their amoebal host, while others are considered endosymbionts, since a stable host-parasite ratio is maintained. Free-living amoebae represent an important reservoir of ARB and may, while encysted, protect the internalized bacteria from chlorine and other biocides. Free-living amoebae may act as a Trojan horse, bringing hidden ARB within the human “Troy,” and may produce vesicles filled with ARB, increasing their transmission potential. Free-living amoebae may also play a role in the selection of virulence traits and in adaptation to survival in macrophages. Thus, intra-amoebal growth was found to enhance virulence, and similar mechanisms seem to be implicated in the survival of ARB in response to both amoebae and macrophages. Moreover, free-living amoebae represent a useful tool for the culture of some intracellular bacteria and new bacterial species that might be potential emerging pathogens

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Section: Legionellaceaementioning

confidence: 99%

Microorganisms Resistant to Free-Living Amoebae

2004

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“…Some outbreaks of legionellosis have been associated with construction, and it was originally believed that the bacteria could survive and be transmitted to humans via soil. However, L. pneumophila does not survive in dry environments, and these outbreaks are more likely the result of massive descalement of plumbing systems due to changes in water pressure during construction (159,205).…”

Section: Microbial Ecologymentioning

confidence: 99%

Legionella and Legionnaires' Disease: 25 Years of Investigation

2002

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There is still a low level of clinical awareness regarding Legionnaires' disease 25 years after it was first detected. The causative agents, legionellae, are freshwater bacteria with a fascinating ecology. These bacteria are intracellular pathogens of freshwater protozoa and utilize a similar mechanism to infect human phagocytic cells. There have been major advances in delineating the pathogenesis of legionellae through the identification of genes which allow the organism to bypass the endocytic pathways of both protozoan and human cells. Other bacteria that may share this novel infectious process are Coxiella burnetti and Brucella spp. More than 40 species and numerous serogroups of legionellae have been identified. Most diagnostic tests are directed at the species that causes most of the reported human cases of legionellosis, L. pneumophila serogroup 1. For this reason, information on the incidence of human respiratory disease attributable to other species and serogroups of legionellae is lacking. Improvements in diagnostic tests such as the urine antigen assay have inadvertently caused a decrease in the use of culture to detect infection, resulting in incomplete surveillance for legionellosis. Large, focal outbreaks of Legionnaires' disease continue to occur worldwide, and there is a critical need for surveillance for travel-related legionellosis in the United States. There is optimism that newly developed guidelines and water treatment practices can greatly reduce the incidence of this preventable illness

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“…Aspergillus and Legionella species are the leading causes of construction-related HAIs (213,240,281). Legionella species are ubiquitous aquatic organisms commonly isolated from water (281).…”

Section: Facility Construction and Renovationmentioning

confidence: 99%

Hospital Epidemiology and Infection Control in Acute-Care Settings

2011

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SUMMARY Health care-associated infections (HAIs) have become more common as medical care has grown more complex and patients have become more complicated. HAIs are associated with significant morbidity, mortality, and cost. Growing rates of HAIs alongside evidence suggesting that active surveillance and infection control practices can prevent HAIs led to the development of hospital epidemiology and infection control programs. The role for infection control programs has grown and continues to grow as rates of antimicrobial resistance rise and HAIs lead to increasing risks to patients and expanding health care costs. In this review, we summarize the history of the development of hospital epidemiology and infection control, common HAIs and the pathogens causing them, and the structure and role of a hospital epidemiology and infection control program.

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Association of Legionnaires' Disease with Construction: Contamination of Potable Water?

Cited by 60 publications

References 28 publications

Microorganisms Resistant to Free-Living Amoebae

Microorganisms Resistant to Free-Living Amoebae

Legionella and Legionnaires' Disease: 25 Years of Investigation

Hospital Epidemiology and Infection Control in Acute-Care Settings

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