Hot Spring Bath and Legionella Pneumonia: An Association Confirmed by Genomic Identification.

Ito, Isao; Naito, Junko; Kadowaki, Seizo; Mishima, Michiaki; Ishida, Tadashi; Hongo, Toshiharu; Ma, Liang; Ishii, Yoshikazu; Matsumoto, Tetsuya; Yamaguchi, Keizo

doi:10.2169/internalmedicine.41.859

Cited by 30 publications

(13 citation statements)

References 22 publications

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“…1). Legionellae are frequently isolated from natural waters, but these sources are typically not implicated in direct transmission, with one possible exception being natural hot springs adapted for human bathing, such as public baths, which are popular in Japan and Taiwan, among other locations (86,(95)(96)(97)(98)(99)(100)(101). Aspiration of water containing Legionella has also been suggested to be a common transmission route (102), although the frequency with which this occurs is unclear.…”

Section: Epidemiology and Diseasementioning

confidence: 99%

Current and Emerging Legionella Diagnostics for Laboratory and Outbreak Investigations

2015

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SUMMARY Legionnaires' disease (LD) is an often severe and potentially fatal form of bacterial pneumonia caused by an extensive list of Legionella species. These ubiquitous freshwater and soil inhabitants cause human respiratory disease when amplified in man-made water or cooling systems and their aerosols expose a susceptible population. Treatment of sporadic cases and rapid control of LD outbreaks benefit from swift diagnosis in concert with discriminatory bacterial typing for immediate epidemiological responses. Traditional culture and serology were instrumental in describing disease incidence early in its history; currently, diagnosis of LD relies almost solely on the urinary antigen test, which captures only the dominant species and serogroup, Legionella pneumophila serogroup 1 (Lp1). This has created a diagnostic “blind spot” for LD caused by non-Lp1 strains. This review focuses on historic, current, and emerging technologies that hold promise for increasing LD diagnostic efficiency and detection rates as part of a coherent testing regimen. The importance of cooperation between epidemiologists and laboratorians for a rapid outbreak response is also illustrated in field investigations conducted by the CDC with state and local authorities. Finally, challenges facing health care professionals, building managers, and the public health community in combating LD are highlighted, and potential solutions are discussed.

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Section: Epidemiology and Diseasementioning

confidence: 99%

Current and Emerging Legionella Diagnostics for Laboratory and Outbreak Investigations

2015

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“…Radiation-primed organising pneumonia is thus quite similar to COP. Interestingly, this peculiar iatrogenic organising pneumonia provides some insight into the pathogenesis of Chlamydia pneumoniae [184,185] Coxiella burnetii [186,187] Legionella pneumophila [95,[188][189][190][191][192][193][194] Mycoplasma pneumoniae [95,189,[195][196][197] Nocardia asteroides [198,199] Pseudomonas aeruginosa [200] Serratia marcescens [201]; in lung transplant recipient [200] Staphylococcus aureus In lung transplant recipient [200] Streptococcus pneumoniae [5,6,202] Viruses Adenovirus [203] Cytomegalovirus [203,204] Herpes virus In lung transplant recipient [200] HIV [205][206][207][208][209][210]; in a pregnant patient using cocaine [205]; following highly active antiretroviral therapy introduction [211] Influenza virus [189,[212][213][214] Parainfluenza virus [215] Human herpes virus-7 …”

Section: Determined Causes Of Organising Pneumoniamentioning

confidence: 99%

Cryptogenic organising pneumonia

Jf¹

2006

Eur Respir J

484

466

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Organising pneumonia is defined histopathologically by intra-alveolar buds of granulation tissue, consisting of intermixed myofibroblasts and connective tissue. Although nonspecific, this histopathological pattern, together with characteristic clinical and imaging features, defines cryptogenic organising pneumonia when no cause or peculiar underlying context is found. Rapid clinical and imaging improvement is obtained with corticosteroid treatment, but relapses are common after stopping treatment.

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“…Millions of people in Taiwan enjoy bathing in hot spring tubs. A particular risk factor of Legionella has been identified in the hot spring areas (Hsu et al 2006;Ito et al 2002;Katsunori et al 2004). The capacity to rapidly detect Legionella in hot spring recreation areas of Taiwan is imperative to avoid exposing people to Legionella.…”

Section: Introductionmentioning

confidence: 99%

Isolation and identification of Legionella and their host amoebae from weak alkaline carbonate spring water using a culture method combined with PCR

et al. 2011

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Legionella were detected with the direct DNA extraction method, Legionella culture method, and free-living amoebae (FLA) culture method from weak alkaline carbonate spring water in Taiwan. Moreover, we also investigated the existence of Acanthamoeba, Hartmannella, and Naegleria, ubiquitous FLA in aquatic environments, to identify the correlations between existing Legionella. This study reports detecting Legionella in 15 of the 51 weak alkaline carbonate spring water samples (29.4%). This work also found five of the 51 samples (9.8%) analyzed by the direct DNA extraction method, three of the 51 (5.9%) samples analyzed by the Legionella culture method, and 11 of the 51 samples (21.6%) evaluated using the FLA culture method to be positive for Legionella. The most frequently identified Legionella species was the Legionella-like amoebal pathogen (n=5), followed by unidentified Legionella spp. (n=4), and Legionella pneumophila (n=4), Legionella fairfieldensis (n=3), and then Legionella rubrilucens (n=2). Legionella waltersii was detected once. The occurrence of Acanthamoeba, Hartmannella, and Naegleria were 5.9% (3/51), 52.9% (27/51), and 5.9% (3/51), respectively. All Hartmannella isolates were identified as Hartmannella vermiformis, and Naegleria isolates were all identified as Naegleria australiensis. The three Acanthamoeba isolates were identified as one Acanthamoeba polyphaga and two Acanthamoeba jacobsi. H. vermiformis (40.7%) were Legionella hosts, including all of the amoebae-resistant Legionella detected in the present study. Therefore, the important correlations between Legionella and H. vermiformis require further clarification. The combined results of this survey confirm that Legionella and FLA are ubiquitous in weak alkaline carbonate spring water in Taiwan.

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Hot Spring Bath and Legionella Pneumonia: An Association Confirmed by Genomic Identification.

Cited by 30 publications

References 22 publications

Current and Emerging Legionella Diagnostics for Laboratory and Outbreak Investigations

Current and Emerging Legionella Diagnostics for Laboratory and Outbreak Investigations

Cryptogenic organising pneumonia

Isolation and identification of Legionella and their host amoebae from weak alkaline carbonate spring water using a culture method combined with PCR

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