Relationship between<i>Legionella</i>spp. and antibody titres at a therapeutic thermal spa in Portugal

Rocha, G.; Veríssimo, António; Bowker, Richard G.; Bornstein, N.; Costa, Milton S. da

doi:10.1017/s0950268800058143

Cited by 21 publications

(15 citation statements)

References 27 publications

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“…Furthermore, groundwater has been used, mainly in Europe, without being disinfected to supply therapeutic spas or bottled mineral water. Some cases of disease associated with exposure to contaminated water in spas have already been reported (8,38).…”

Section: Discussionmentioning

confidence: 99%

Presence and Persistence of Legionella spp. in Groundwater

Costa¹,

Tiago²,

Costa

et al. 2005

Appl Environ Microbiol

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Groundwater samples (111) from six different boreholes located in two geographical areas were examined for the presence of legionellae over a 7-year period. The number of Legionella isolates detected was generally low. The colonization of the aquifers was not uniform, and the persistence of Legionella was independent of the hydraulic pumps and the plumbing system present in the borehole. A total of 374 isolates identified by fatty acid methyl ester analysis belonged to Legionella pneumophila, L. oakridgensis, L. sainthelensi, and L. londiniensis. In area 1, L. oakridgensis constituted the major population detected, exhibiting only one random amplified polymorphic DNA (RAPD)-PCR profile. L. sainthelensi strains were less frequently isolated and also displayed a single RAPD profile, while L. pneumophila was only sporadically detected. In contrast, L. pneumophila comprised the vast majority of the isolates in area 2 and exhibited six distinct RAPD patterns, indicating the presence of different genetic groups; three L. londiniensis RAPD types were also detected. Two of the L. pneumophila and one of the L. londiniensis RAPD types were persistent in this environment for at least 12 years. The genetic structure of L. pneumophila groundwater populations, inferred from rpoB and dotA gene sequences, was peculiar, since the majority of the isolates were allied in a discrete group different from the lineages containing most of the type and reference strains of the three subspecies of L. pneumophila. Furthermore, gene exchange events related to the dotA allele could be envisioned.

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Section: Discussionmentioning

confidence: 99%

Presence and Persistence of Legionella spp. in Groundwater

Costa¹,

Tiago²,

Costa

et al. 2005

Appl Environ Microbiol

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“…However, strains of Legionella pneumophila other than serogroup-1 have also been reported to be the causative agents of Legionella pneumonia, the sources of infection with which seem to be the waters of hot spring spas (6,15). The reason for this difference in causative agents is considered to be differences in bacterial distribution in the environment (3,15,16).…”

Section: Discussionmentioning

confidence: 99%

Legionella Pneumonia due to Exposure to 24-hour Bath Water Contaminated by Legionella pneumophila Serogroup-5

Mineshita¹,

Nakamori²,

Seida³

et al. 2005

Intern. Med.

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A 79-year-old man was admitted to hospital from his nursing home for treatment of pneumonia, but died 7 days after admission. Legionella pneumonia was diagnosed after isolation of Legionella pneumophila serogroup-5 from sputum culture. The environment of the nursing home was investigated; only water specimens from the 24-hour bath were positive by culture for Legionella pneumophila serogroup-5. Subsequent analysis by pulsed-field gel electrophoresis revealed an identical pattern in isolates from both sputum culture and 24 hour bath water culture. Among 123 inpatients and staff of the nursing home, 17 were found to be seropositive for Legionella pneumophila serogroup-5.

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“…However, this study revealed directly that hot spring spa water is the source of Legionella infection. Considered together with the serological studies of hot spring spas performed by Rocha et al (10) and Bornstein et al (2), monitoring hot spring spa water for legionellae and disinfection of the water to minimize the viable number of organisms are necessary for the prevention of legionellosis associated with hot spring spas. …”

Section: Discussionmentioning

confidence: 99%

“…Yabuuchi et al (16) reported that legionellae inhabited the bath water of 84 (62.2%) of the 135 Japanese hot springs investigated. At a therapeutic thermal spa in Portugal, Rocha et al (10) showed an association between exposure to hot spring water and an increase in antibody titers against the majority of species Recently, we isolated L. pneumophila serogroup (SG) 3 from a patient who developed pneumonia after nearly drowning in a hot spring spa bath (12), but the infection source remained to be determined because the viable number of legionellae (3 CFU/100 ml) in the probable source of the infection were of low risk for causing legionellosis. We describe the molecular determination of the infection source of this sporadic Legionella pneumonia case associated with the hot spring bath, and also discuss the usefulness of PCR fingerprinting in epidemiological investigations.…”

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confidence: 99%

Molecular Determination of Infection Source of a Sporadic Legionella Pneumonia Case Associated with a Hot Spring Bath

Miyamoto

Jitsurong

Shiota

et al. 1997

Microbiology and Immunology

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To determine the infection source of a sporadic Legionella pneumonia case associated with a hot spring bath, we used five molecular methods, including repetitive element polymerase chain reaction (rep-PCR), arbitrarily primed PCR (AP-PCR), ribotyping, restriction endonuclease analysis (REA), and macrorestriction endonuclease analysis (MREA) by pulsed-field gel electrophoresis. L. pneumophila serogroup (SG) 3 strain EY 3702, isolated from an intratracheal specimen of a 71-year-old Japanese female who developed pneumonia after nearly drowning in a hot spring spa bath, produced rep-PCR and AP-PCR fingerprints identical to those of L. pneumophila SG 3 strains EY 3768 and EY 3769 isolated from the bath water. Four epidemiologically unrelated L. pneumophila SG 3 strains showed different rep-PCR or AP-PCR fingerprints from those of the three EY strains (EY 3702, 3768, and 3769). The three EY strains were also genotypically indistinguishable by ribotyping with EcoRI and PstI, by REA with EcoRI or Hindill, and by MREA with Nod. Based on these results, we identified the bath water of the hot spring spa as the source of infection of this patient, even though the viable number of the organisms in the bath water was low (3 CFU/100 ml) when determined 27 days after her nearly drowning.

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Relationship betweenLegionellaspp. and antibody titres at a therapeutic thermal spa in Portugal

Cited by 21 publications

References 27 publications

Presence and Persistence of Legionella spp. in Groundwater

Presence and Persistence of Legionella spp. in Groundwater

Legionella Pneumonia due to Exposure to 24-hour Bath Water Contaminated by Legionella pneumophila Serogroup-5

Molecular Determination of Infection Source of a Sporadic Legionella Pneumonia Case Associated with a Hot Spring Bath

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