Typing of Legionella strains isolated from environmental samples in Crete, Greece, during the period 2004–2011

Chochlakis, Dimosthenis; Sandalakis, Vassilios; Panoulis, C.; Goniotakis, Ioannis; Makridaki, E.; Tselentis, Yannis; Psaroulaki, Anna

doi:10.2166/wh.2013.015

Cited by 10 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In Italy, the Lp sg1 distribution rates in the hotel setting differed greatly between two studies, at 27.7% and 55%, including mixed cultures [15,34]. On the other hand, findings from Italy [19], Greece [23], and Turkey [21] have shown that the most frequent colonizers of the hotel water systems in these studies were Lp sg2-14.…”

Section: Discussionmentioning

confidence: 67%

“…[30]. In another study from Crete, Greece [23], carried out from 2004 to 2011, about 50 non-Lp Legionella spp. were identified in the water systems of the hotel setting.…”

Section: Discussionmentioning

confidence: 99%

“…These studies revealed variable rates of contamination and species diversity [18][19][20][21], but limited data is published on the molecular diversity of Legionella spp. in hotel settings [22][23][24].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Snapshot of the Prevalence and Molecular Diversity of Legionella pneumophila in the Water Systems of Israeli Hotels

Yakunin

Kostyál²,

Agmon

et al. 2020

Pathogens

View full text Add to dashboard Cite

Exposure to Legionella spp. contaminated aerosols in hotel settings confers risk for travel-associated Legionnaire’s disease (TALD). In this study, we investigated the prevalence of Legionella contamination and its molecular diversity in hotels and resorts across Israel. The study was comprised of a convenience sample of water systems from 168 hotels and resorts countrywide, routinely inspected between March 2015 and February 2017. Isolation and quantitation of Legionella were performed in a water laboratory using the ISO 11731 method. The distribution of Legionella isolates was analyzed according to geography and source. The genetic diversity of a subset of isolates was analyzed by sequence-based typing (SBT) at the National Reference Laboratory for Legionella and compared to the national database. Out of 2830 samples tested, 470 (17%) obtained from 102 different premises (60% of hotels) were positive for Legionella spp. In 230 samples (49% of all positive, 8% of total samples), accounting for 37% of hotels, Legionella spp. counts exceeded the regulatory threshold of 1000 CFU/L. The most frequently contaminated water sources were cooling towers (38%), followed by faucets, hot tubs, water lines, and storage tanks (14–17% each). Furthermore, 32% and 17% of samples obtained from cooling towers and hot tubs, respectively, exceeded the regulatory thresholds. SBT was performed on 78 strains and revealed 27 different sequence types (STs), including two novel STs. The most prevalent STs found were ST1 (26%), ST87 (10%), ST93 (6%), and ST461 and ST1516 (5% each). Several L. pneumophila STs were found to be limited to certain geographical regions. This is the first study to investigate the prevalence and diversity of Legionella in hotels and resorts in Israel during non-outbreak environmental inspections. These findings will inform risk assessment, surveillance, and control measures of TALD.

show abstract

Section: Discussionmentioning

confidence: 67%

“…[30]. In another study from Crete, Greece [23], carried out from 2004 to 2011, about 50 non-Lp Legionella spp. were identified in the water systems of the hotel setting.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Snapshot of the Prevalence and Molecular Diversity of Legionella pneumophila in the Water Systems of Israeli Hotels

Yakunin

Kostyál²,

Agmon

et al. 2020

Pathogens

View full text Add to dashboard Cite

show abstract

“…The presence of 1559 hotels and accommodation units in Crete with 85,407 rooms and 161,578 beds (data drawn from the Hellenic National Service of Tourism for 2015), could not exclude the island from the presence of TALDs [ 29 ]. The current research was focused mostly on the significance of sampling from recreation areas and spas and in particular from pools, spas, jacuzzis, showers next to swimming pools, shower heads and spa showers.…”

Section: Discussionmentioning

confidence: 99%

Legionella spp. Risk Assessment in Recreational and Garden Areas of Hotels

Papadakis

Chochlakis

Sandalakis

et al. 2018

IJERPH

Self Cite

View full text Add to dashboard Cite

Several Travel-associated Legionnaires’ disease (TALD) cases occur annually in Europe. Except from the most obvious sites (cooling towers and hot water systems), infections can also be associated with recreational, water feature, and garden areas of hotels. This argument is of great interest to better comprehend the colonization and to calculate the risk to human health of these sites. From July 2000–November 2017, the public health authorities of the Island of Crete (Greece) inspected 119 hotels associated with TALD, as reported through the European Legionnaires’ Disease Surveillance Network. Five hundred and eighteen samples were collected from decorative fountain ponds, showers near pools and spas, swimming pools, spa pools, garden sprinklers, drip irrigation systems (reclaimed water) and soil. Of those, 67 (12.93%), originating from 43 (35.83%) hotels, tested positive for Legionella (Legionella pneumophila serogroups 1, 2, 3, 6, 7, 8, 13, 14, 15 and non-pneumophila species (L. anisa, L. erythra, L. taurinensis, L. birminghamensis, L. rubrilucens). A Relative Risk (R.R.) > 1 (p < 0.0001) was calculated for chlorine concentrations of less than 0.2 mg/L (R.R.: 54.78), star classification (<4) (R.R.: 4.75) and absence of Water Safety Plan implementation (R.R.: 3.96). High risk (≥104 CFU/L) was estimated for pool showers (16.42%), garden sprinklers (7.46%) and pool water (5.97%).

show abstract

“…Epidemiological data for Greece and Europe since 2011 show that the majority of cases were diagnosed with the urine antigen test at a percentage ranging from 82 to 96% and 77 to 82%, respectively (6,(19)(20)(21). Two recent studies in Greece performed environmental detection of Legionella in water distribution systems and molecular typing, but until now no other study in Greece had detected virulence genes (22,23). The objective of this study was to investigate the genetic diversity of L. pneumophila sg2 to sg14 (Lp2-14) in the Greek environment and the existence of virulence genes among them.…”

mentioning

confidence: 99%

Epidemiological Investigation of Legionella pneumophila Serogroup 2 to 14 Isolates from Water Samples by Amplified Fragment Length Polymorphism and Sequence-Based Typing and Detection of Virulence Traits

Katsiaflaka

Pournaras

Kristo

et al. 2016

Appl Environ Microbiol

View full text Add to dashboard Cite

The aim of this study is to explore the dispersion, clonality, and virulence of Legionella pneumophila serogroups 2 to 14 in the Greek environment. Eighty L. pneumophila serogroup 2 to 14 strains isolated from water distribution systems of hotels, hospitals, athletic venues, and ferries in Greece were tested by monoclonal antibodies (MAbs) for serogroup discrimination and molecularly by amplified fragment length polymorphism (AFLP) for genetic diversity. Fifty-six of 80 strains were also typed by the sequence-based typing (SBT) method. 〈ll strains were further analyzed for detection of two pathogenicity loci: Legionella vir homologue (lvh) and repeats in structural toxin (rtxA). Thirty-seven strains (46.2%) belonged to serogroup 6, 26 strains (32.5%) to serogroup 3, and 7 (8.8%) to other serogroups (4, 5, 8, and 10). Ten strains (12.5%) were nontypeable (NT) into the known serogroups. Thirty-nine different AFLP types were found among the 80 L. pneumophila serogroup 2 to 14 strains, and 24 different SBT types were found among the 56 strains tested. Among the 80 strains, the lvh locus was present in 75 (93.8%), the rtxA locus was found in 76 (95%), and both loci were found in 73 (91.3%) strains. This study showed that there is genetic variability of L. pneumophila serogroups 2 to 14 in the Greek environment as well as a high percentage of the pathogenicity loci. ⌱ntroducing an effective diagnostic test for L. pneumophila serogroups 2 to 14 in urine and promoting the examination of respiratory specimens from patients hospitalized for pneumonia in Greek hospitals are essential. IMPORTANCEIn this study, the dispersion, clonality, and virulence of environmental isolates of Legionella pneumophila serogroups 2 to 14 (Lp2-14) in Greece were investigated. Genetic variability of Lp2-14 in the Greek environment was identified together with the presence of the pathogenicity loci in a high percentage of the isolates. Despite the high prevalence of Lp2-14 in the Greek environment, no clinical cases were reported, which may be due to underdiagnosis of the disease. Almost all the legionellosis cases are diagnosed in Greece by using the urine antigen test, which is specific for Lp1. There is an urgent need to improve the clinical diagnosis of legionellosis by introducing an effective diagnostic test for Lp2-14 in urine and by promoting the PCR examination of respiratory specimens from patients with compatible clinical symptoms. L egionella species are inhabitants of water and biofilms in both natural and industrial aquatic environments (1). Legionella spp. can cause Legionnaires' disease and the flu-like Pontiac fever in humans, through inhalation of Legionella-contaminated water aerosols (2, 3). In Europe, according to the World Health Organization (WHO), the incidence rate was 10 to 15 cases per million population, and the total case-fatality rate (CFR) was about 12% (4, 5). In the last surveillance report from the European Centre for Disease Prevention and Control (ECDC), for the year 2014, the notification rate of Leg...

show abstract

Typing of Legionella strains isolated from environmental samples in Crete, Greece, during the period 2004–2011

Cited by 10 publications

References 0 publications

A Snapshot of the Prevalence and Molecular Diversity of Legionella pneumophila in the Water Systems of Israeli Hotels

A Snapshot of the Prevalence and Molecular Diversity of Legionella pneumophila in the Water Systems of Israeli Hotels

Legionella spp. Risk Assessment in Recreational and Garden Areas of Hotels

Epidemiological Investigation of Legionella pneumophila Serogroup 2 to 14 Isolates from Water Samples by Amplified Fragment Length Polymorphism and Sequence-Based Typing and Detection of Virulence Traits

Contact Info

Product

Resources

About