Hostname: page-component-76fb5796d-9pm4c Total loading time: 0 Render date: 2024-04-26T15:01:05.380Z Has data issue: false hasContentIssue false

Each water outlet is a unique ecological niche for Legionella pneumophila

Published online by Cambridge University Press:  15 May 2009

T. J. Marrie
Affiliation:
Departments of Medicine, Dalhousie University and the Victoria General Hospital, Halifax, N.S., Canada Departments of Microbiology, Dalhousie University and the Victoria General Hospital, Halifax, N.S., Canada
D. Haldane
Affiliation:
Departments of Medicine, Dalhousie University and the Victoria General Hospital, Halifax, N.S., Canada Departments of Microbiology, Dalhousie University and the Victoria General Hospital, Halifax, N.S., Canada
G. Bezanson
Affiliation:
Departments of Microbiology, Dalhousie University and the Victoria General Hospital, Halifax, N.S., Canada
R. Peppard
Affiliation:
Departments of Microbiology, Dalhousie University and the Victoria General Hospital, Halifax, N.S., Canada
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

We determined the natural history of the colonization of our hospital's potable water by culturing water approximately biweekly from 20 sites throughout the hospital for 4 years. Overall, 545 (24.7%) of the 2200 samples grew Legionella pneumophila. During hyperchlorination, 11·7% of the samples were positive while 41·6% were positive in the absence of chlorination. There was no seasonal trend towards positivity, but there was marked inter-site variation in the semi-quantitative culture results. However, a single strain of legionella (as defined by plasmid profiling) tended to persist at a site. Such a site was a unique ecological niche in that different sites in the same wing were populated by distinct strains.

The two wings of our hospital had a significantly different distribution of strains of legionella – plasmid profile type III predominated in the Victoria Wing while types II and VI predominated in Centennial Wing. Twenty-four of our 28 cases of nosocomial Legionnaires' disease occurred in the Centennial Wing. Three of the four cases in the Victoria Wing were caused by plasmid profile type III while 18 of the 24 isolates from patients who acquired their infection in the Centennial Wing were type II. We conclude that each water outlet serves as its own ecological niche of L. pneumophila.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1992

References

REFERENCES

1.Ruf, B.Schurmann, D.Horbach, I.Seidel, K.Pohle, HD. Nosocomial Legionella pneumonia: demonstration of potable water as a source of infection. Epidemiol Infect 1987; 101: 647–54.CrossRefGoogle Scholar
2.Best, M.Yu, VLStout, J.Goetz, A.Muder, RR.Taylor, F.Legionellaceae in the hospital water supply. Epidemiological link with disease and evaluation of a method for control of nosocomial Legionnaires' disease and Pittsburgh Pneumonia. Lancet 1983; ii: 307–10.CrossRefGoogle Scholar
3.Redd, SC, Cohen, ML. Legionella in water: What should be done? JAMA 1987; 257: 1221–2.CrossRefGoogle Scholar
4.Botzenhart, K, Heizmann, W, Sedaghat, S, Heeg, P, Hahn, T. Bacterial colonization and occurrence of Legionella pneumophila in warm and cold water, in faucet aerators, and in drains of hospitals. Zentralbl Backteriol. Microbiol Hyg 1986; B183: 7985.Google Scholar
5.Ribeiro, CD, Burge, SH, Palmer, SR, Tobin, JOH, Watkins, ID. Legionella pneumophila in a hospital water system following a nosocomial outbreak: prevalence, monoclonal antibody subgrouping and effect of control measures. Epidemiol Infect 1987; 98: 253–62.CrossRefGoogle Scholar
6.Farrell, ID, Barker, JE, Miles, EP, Hutchison, JGP. A field study of survival of Legionella pneumophila in a hospital hot water system. Epidemiol Infect 1990; 104: 381–7.CrossRefGoogle Scholar
7.Marrie, TJ, MacDonald, S, Clarke, K, Haldane, D. Nosocomial Legionnaires' disease: Lessons from a four year prospective study. Am J Infect Control 1991; 19: 7985.CrossRefGoogle ScholarPubMed
8.Vickers, RM, Stout, JE, Yu, VLRihs, JD. Manual of culture methodology for Legionella. Semin Respir Infect 1987; 2: 274–9.Google ScholarPubMed
9.Cherry, WB, Pittman, B, Harris, PP, Hebert, GA, Thomason, BM, Weaver, RE. Detection of Legionnaires' disease bacteria by direct immunofluorescent staining. J Clin Microbiol 1981; 14: 298303.Google Scholar
10.Dillon, JR, Bezanson, GS, Yeung, K-H. Basic techniques. In: Dillon, JR, Nasim, A, Nestman, E, editors. Recombinant DNA methodology. Toronto: J Wiley and Sons Inc, 1985: 1126.Google Scholar
11.Vickers, RM, Yu, VL, Hanna, SS et al. , Determinants of Legionella pneumophila contamination of water distribution systems: 15-hospital prospective study. Infect Control 1987; 8: 357–63.CrossRefGoogle ScholarPubMed
12.Wadowsky, RM, Butler, LJ, Cook, MK et al. , Growth-supporting activity for Legionella pneumophila in tap water cultures and implication of Hartmannellid amoebae as growth factors. Appl Environ Microbiol 1988; 54: 2677–82.CrossRefGoogle ScholarPubMed
13.States, SJ, Conley, LF, Kuchta, JM et al. , Survival and multiplication of Legionella pneumophila in municipal drinking water systems. Appl Environ Microbiol 1987; 53: 979–86.CrossRefGoogle ScholarPubMed
14.Wright, JB, Ruseska, I, Arthur, MA, Corbett, S, Costeston, JW.Legionella pneumophila grows adherent to surfaces in vitro and in situ. Infect Control Hosp Epidemiol 1989; 10: 408–15.CrossRefGoogle ScholarPubMed
15.Schofield, GM, Locci, R. The persistence of Legionella pneumophila in non-sterile, sterile, and artificial hard waters and their growth pattern on tap washer fittings. J Appl Bacteriol 1985; 59: 519–27.CrossRefGoogle ScholarPubMed
16.Schulze-Robbecke, R, Jung, KD, Pullmann, H, Hundgeburth, J. Control of Legionella pneumophila in a hospital hot water system. Internat J Hyg Environ Med 1990; 190: 84100.Google Scholar
17.Plouffe, JF, Para, MF, Maher, WE, Hackman, B, Webster, L. Subtypes of Legionella pneumophila serogroup 1 associated with different attack rates. Lancet 1983; ii: 649–50.CrossRefGoogle Scholar
18.Bollin, GE, Plouffe, JF, Para, MF, Prior, RB. Difference in virulence of environmental isolates of Legionella pneumophila. J Clin Microbiol 1985; 21: 674–7.CrossRefGoogle ScholarPubMed
19.Johnston, JM, Latham, RH, Meier, FA et al. , Nosocomial outbreak of Legionnaires' disease: Molecular epidemiology and disease control measures. Infect Control 1987; 8: 53–8.CrossRefGoogle ScholarPubMed
20.Edelstein, PH, Nakahama, C, Tobin, JO et al. , Paleoepidemiologic investigation of Legionnaires' disease at Wadsworth Veterans Administration Hospital by using three typing methods for comparison of Legionellae from clinical and environmental sources. J Clin Microbiol 1986; 23: 1121–6.CrossRefGoogle ScholarPubMed