Review Global seroprevalence of legionellosis - a systematic review and meta-analysis

Abstract

Legionella is a ubiquitous pathogen yet the global occurrence of legionellosis is poorly understood. To address this deficit, this paper summarises the available evidence on the seroprevalence of Legionella antibodies and explores factors that may influence seroprevalence estimates. Through a systematic review, a total of 3979 studies were identified with seroprevalence results published after 1 January 1990. We tabulated findings by World Health Organization (WHO) region, location, study period and design, composition of study population(s) for all ages in terms of exposure, sex, detection methods, IFA titre, Legionella species measured, and present seroprevalence point estimates and 95% confidence intervals. Sampled populations were classified according to income, WHO region, gender, age, occupation and publication date. We conducted a meta-analysis on these subgroups using Comprehensive Meta-Analysis 3.0 software. Heterogeneity across studies was evaluated by the Q test in conjunction with I2 statistics. Publication bias was evaluated via funnel plot and Egger’s test. Fifty-seven studies met our inclusion criteria, giving an overall estimate of seroprevalence for Legionella of 13.7% (95% CI 11.3–16.5), but with substantial heterogeneity across studies.

Legionella and Biofilms—Integrated Surveillance to Bridge Science and Real-Field Demands

“…LD, besides being a significant societal problem, also represents a high economic cost to the health care system [10]. However, legionellosis incidence and its associated health risks are known to be increasing [11][12][13], due to global challenges such as urbanization, ageing populations, climatic changes, or circular economy approaches [12,13]. The number of people diagnosed with legionellosis will rise to around 2.5 billion by 2050 in urbanized centers [14,15], and the need for more climatization solutions will also grow [11].…”

“…However, legionellosis incidence and its associated health risks are known to be increasing [11][12][13], due to global challenges such as urbanization, ageing populations, climatic changes, or circular economy approaches [12,13]. The number of people diagnosed with legionellosis will rise to around 2.5 billion by 2050 in urbanized centers [14,15], and the need for more climatization solutions will also grow [11]. Circular economy and water reuse, while necessary, will likely increase the number of Microorganisms 2021, 9, 1212 2 of 23 water systems and their complexity and will change water consumption patterns [16].…”

Characterization of Legionella pneumophila Populations by Multilocus Variable Number of Tandem Repeats (MLVA) Genotyping from Drinking Water and Biofilm in Hospitals from Different Regions of the West Bank

“…The presence of Legionella in DWDS is a serious health risk to hospital staff and patients, but the magnitude of the problem is often unrecognized [8,14,15]. A high seroprevalence of L. pneumophila has been observed among health care workers [16]. The problem is compounded in the West Bank because awareness about the prevalence of L. pneumophila or LD is lacking, and few data are available for such arid regions.…”

Recent advances in structural studies of the Legionella pneumophila Dot/Icm type IV secretion system

“…1 Human-tohuman transmission of Legionella can occur, even though it is very rare, 5,6 and legionellosis morbidity is increasing annually worldwide. 7 Once L. pneumophila is internalized by macrophages, the bacterial phagosome is converted into an endoplasmic reticulum (ER)-like compartment called the Legionellacontaining vacuole (LCV), which serves as a replicative niche. For LCV biogenesis, L. pneumophila intercepts the early secretory pathway between the ER and the Golgi apparatus.…”