Environmental surveillance of Legionella pneumophila in distal water supplies of a hospital for early identification & prevention of hospital-acquired legionellosis

Abstract

Background & objectives:Legionella pneumophila, a ubiquitous aquatic organism is found to be associated with the development of the community as well as hospital-acquired pneumonia. Diagnosing Legionella infection is difficult unless supplemented with, diagnostic laboratory testing and established evidence for its presence in the hospital environment. Hence, the present study was undertaken to screen the hospital water supplies for the presence of L. pneumophila to show its presence in the hospital environment further facilitating early diagnosis and prevention of hospital-acquired legionellosis.Methods:Water samples and swabs from the inner side of the same water taps were collected from 30 distal water outlets present in patient care areas of a tertiary care hospital. The filtrate obtained from water samples as well as swabs were inoculated directly and after acid buffer treatment on plain and selective (with polymyxin B, cycloheximide and vancomycin) buffered charcoal yeast extract medium. The colonies grown were identified using standard methods and confirmed for L. pneumophila by latex agglutination test.Results:About 6.66 per cent (2/30) distal water outlets sampled were found to be contaminated with L. pneumophila serotype 2-15. Isolation was better with swabs compared to water samples.Interpretation & conclusions:The study showed the presence of L. pneumophila colonization of hospital water outlets at low levels. Periodic water sampling and active clinical surveillance in positive areas may be done to substantiate the evidence, to confirm or reject its role as a potential nosocomial pathogen in hospital environment.

Genetic Diversity of the Legionella pneumophila dotA Gene Detected on Surfaces of Respiratory Therapy Equipment

“…Legionella has emerged as major pathogen and may consequence to death. Knowledge of its affliction in India is limited to a few clinical studies [14][15][16][17] and fewer environmental studies 15,18 . There is a need to prioritize studies on this unexplored pathogen as the rates of ventilator associated pneumonia is fairly larger in India 19,20 .…”

Overview of the Clinical and Molecular Features of Legionella Pneumophila: Focus on Novel Surveillance and Diagnostic Strategies

“…Of note, the main reservoirs for Legionella spp. are represented by water distribution systems, especially in large public buildings, households and industrial facilities [85]. However, the most dangerous type of colonization occurs in water distribution systems, cooling towers and hydric pipeline of hospitals, because in these environments LP can multiply causing severe infection in immunosuppressed hospitalized patients.…”

Legioneliozė: Etiologija, Diagnostika, Gydymas, Profilaktika

“…Pagrindinės profilaktikos priemonės skirtos sukėlėjo šaltinio paieškai ir jo sunaikinimui terminiais ar cheminiais būdais [19]. Tai apima vandens dezinfekciją chloro preparatais, tinkamą oro kondicionavimo, aušinimo sistemų, indaplovių eksploataciją, tinkamos vandens temperatūros palaikymą (bakterijos nesidaugina mažesnėje nei 20 0 C ir didesnėje nei 60 0 C temperatūroje) [20]. Išvados 1.…”