Legionella co-infection in HIV-associated pneumonia

Head, Breanne M.; Trajtman, Adriana; Bernard, Kathryn; Burdz, Tamara; Vélez, Lázaro A.; Herrera, Mariana; Rueda, Zulma Vanessa; Keynan, Yoav

doi:10.1016/j.diagmicrobio.2019.03.005

Cited by 14 publications

(16 citation statements)

References 21 publications

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“…Although several studies have reported the presence of different species of Legionella in the same samples during environmental surveillance, few have referred to the interaction between the most common, L. pneumophila, and less documented species, L. anisa and L. rubrilucens, in the environment, as well as in clinical samples [26-28, 37, 38]. As widely documented by epidemiological data, Lp1 is the major causative agent of legionellosis [3]; L. anisa is often linked to single cases or epidemic events [39,40]. The knowledge about etiology, as well as pathogenicity, of L. rubrilucens is less than that of Lp1 and L. anisa, with few clinical cases reported [38,41].…”

Section: Discussionmentioning

confidence: 99%

Dynamics of Legionella Community Interactions in Response to Temperature and Disinfection Treatment: 7 Years of Investigation

et al. 2021

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In man-made water distribution systems, Legionella community interactions remain unknown, due to their ability to change from sessile to planktonic states or live in viable but non-culturable forms, in response to anthropic and environmental stress. During 7 years of hospital Legionella surveillance, in 191 hot water positive samples, the interactions among the Legionella species, temperature, and disinfection treatment were evaluated. Legionella was isolated following ISO 11731:2017, and identification was performed by mip gene sequencing and sequence-based typing (SBT) for L. anisa or L. rubrilucens and L. pneumophila, respectively. The species with the higher frequency of isolation was L. pneumophila serogroup 1 (78.53%; 4865.36 ± 25,479.11 cfu/L), followed by L. anisa (54.45%; 558.79 ± 2637.41 cfu/L) and L. rubrilucens (21.99%; 307.73 ± 1574.95 cfu/L), which were sometimes present together. Spearman’s rho correlation test was conducted among the species with respect to temperature and disinfectant (H2O2/Ag+). The results showed a generally positive interaction among these species sharing the same environment, except for competition between L. anisa and L. rubrilucens. High temperature (48.83 ± 2.59 °C) and disinfection treatment (11.58 ± 4.99 mg/L) affected the presence of these species. An exception was observed with L. anisa, which showed disinfection treatment resistance. For the purposes of environmental surveillance, it is fundamental to better understand the interactions and dynamic of the Legionella community in man-made water systems in order to choose the proper physical or chemical treatments. The simultaneous presence of different Legionella species could result in an increased resistance to high temperature and disinfectant treatment, leading to changes in contamination level and species diversity.

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Section: Discussionmentioning

confidence: 99%

Dynamics of Legionella Community Interactions in Response to Temperature and Disinfection Treatment: 7 Years of Investigation

et al. 2021

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“…Among them, Legionella anisa (L. anisa) is frequently isolated together with L. pneumophila in the hospital plumbing systems and can be used as a probable indicator of epidemic risk, beyond being associated with some cases of human infections (Fallon and Stack, 1990;Fenstersheib et al, 1990;Van Der Mee-Marquet et al, 2006;Vaccaro et al, 2016). Moreover, cases of endocarditis due to L. anisa and co-infection in HIV-associated pneumonia have been reported (Compain et al, 2015;Head et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of MALDI–TOF Mass Spectrometry in Diagnostic and Environmental Surveillance of Legionella Species: A Comparison With Culture and Mip-Gene Sequencing Technique

et al. 2020

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Legionella spp. are widespread bacteria in aquatic environments with a growing impact on human health. Between the 61 species, Legionella pneumophila is the most prevalent in human diseases; on the contrary, Legionella non-pneumophila species are less detected in clinical diagnosis or during environmental surveillance due to their slow growth in culture and the absence of specific and rapid diagnostic/analytical tools. Reliable and rapid isolate identification is essential to estimate the source of infection, to undertake containment measures, and to determine clinical treatment. Matrix-assisted laser desorption ionization–time-of-flight mass spectrometry (MALDI–TOF MS), since its introduction into the routine diagnostics of laboratories, represents a widely accepted method for the identification of different bacteria species, described in a few studies on the Legionella clinical and environmental surveillance. The focus of this study was the improvement of MALDI–TOF MS on Legionella non-pneumophila species collected during Legionella nosocomial and community surveillance. Comparative analysis with cultural and mip-gene sequencing results was performed. Moreover, a phylogenetic analysis was carried out to estimate the correlations amongst isolates. MALDI–TOF MS achieved correct species-level identification for 45.0% of the isolates belonging to the Legionella anisa, Legionella rubrilucens, Legionella feeleii, and Legionella jordanis species, displaying a high concordance with the mip-gene sequencing results. In contrast, less reliable identification was found for the remaining 55.0% of the isolates, corresponding to the samples belonging to species not yet included in the database. The phylogenetic analysis showed relevant differences inside the species, regruped in three main clades; among the Legionella anisa clade, a subclade with a divergence of 3.3% from the main clade was observed. Moreover, one isolate, identified as Legionella quinlivanii, displayed a divergence of 3.8% from the corresponding reference strain. However, these findings require supplementary investigation. The results encourage the implementation of MALDI–TOF MS in routine diagnostics and environmental Legionella surveillance, as it displays a reliable and faster identification at the species level, as well as the potential to identify species that are not yet included in the database. Moreover, phylogenetic analysis is a relevant approach to correlate the isolates and to track their spread, especially in unconventional reservoirs, where Legionella prevention is still underestimated.

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“…En el caso de los pacientes VIH positivo con neumonía, el estudio realizado por Head y col. demostró la coinfección de Mycobacterium tuberculosis o Pneumocystis jirovecii con diferentes especies de Legionella, lográndose el diagnóstico a partir de técnicas moleculares. En los pacientes coinfectados por Legionella spp la presentación clínica fue más severa (36).…”

Section: Clínicaunclassified

“…La eritromicina fue el antibiótico de elección para el tratamiento de neumonía por Legionella desde 1976. por la especie no pneumophila no son diagnosticadas regularmente por las limitaciones de los actuales métodos diagnósticos. Las técnicas moleculares pueden mejorar el diagnóstico de la enfermedad del legionario, dado que detectan cualquier especie y serogrupo (34,36,(40)(41)(42).…”

Section: Clínicaunclassified

Legionella pneumophila: un patógeno emergente en Argentina

Medina

Lösch

Merino

2021

ASEI

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Legionella, siendo la especie pneumophila el principal agente etiológico de esta patología. Esta bacteria se describió por primera vez en 1977 como causa de un brote de neumonía grave registrado en 1976 en un centro de convenciones en los Estados Unidos de América. La enfermedad se presenta como una neumonía atípica, responsable del 1 al 15 % de los casos de neumonías adquiridas en la comunidad (NAC), del 5 al 10% de neumonías del adulto y del 1% en menores de 15 años. Los miembros de la familia Legionellaceae son bacilos aeróbicos gramnegativos que crecen lentamente y se encuentran ampliamente distribuidos en cuerpos de agua. La forma más común de transmisión de Legionella spp es la inhalación de aerosoles contaminados generados a partir de fuentes de agua artificiales. Se asocian con la aparición de brotes esporádicos y epidémicos en la comunidad y en infecciones nosocomiales. Las especies pertenecientes al género Legionella se consideran patógenos emergentes transmitidos por el agua. El objetivo de este trabajo es realizar una revisión sobre las manifestaciones y presentaciones clínicas de la infección causada por L. pneumophila, en virtud de que es considerado mundialmente un patógeno emergente y por existir evidencias de su presencia en sistemas de almacenamiento de agua tratada en la región Nordeste de la República Argentina, razón primordial para alertar y actualizar conocimientos al respecto.

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Legionella co-infection in HIV-associated pneumonia

Cited by 14 publications

References 21 publications

Dynamics of Legionella Community Interactions in Response to Temperature and Disinfection Treatment: 7 Years of Investigation

Dynamics of Legionella Community Interactions in Response to Temperature and Disinfection Treatment: 7 Years of Investigation

Evaluation of MALDI–TOF Mass Spectrometry in Diagnostic and Environmental Surveillance of Legionella Species: A Comparison With Culture and Mip-Gene Sequencing Technique

Legionella pneumophila: un patógeno emergente en Argentina

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