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Persistence of Legionella Pneumophila in a Hospital's Water System: A 13-Year Survey

Published online by Cambridge University Press:  02 January 2015

M. Sigfrido Rangel-Frausto ,
Paul Rhomberg ,
Richard J. Hollis ,
Michael A. Pfaller ,
Richard P. Wenzel ,
Charles M. Helms  and
Loreen A. Herwaldt
M. Sigfrido Rangel-Frausto
Affiliation:
Division of General Internal Medicine, the Department of Internal Medicine, Iowa City, Iowa
Paul Rhomberg
Affiliation:
Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa
Richard J. Hollis
Affiliation:
Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa
Michael A. Pfaller
Affiliation:
Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa
Richard P. Wenzel
Affiliation:
Division of General Internal Medicine, the Department of Internal Medicine, Iowa City, Iowa
Charles M. Helms
Affiliation:
Division of General Internal Medicine, the Department of Internal Medicine, Iowa City, Iowa
Loreen A. Herwaldt*
Affiliation:
Division of General Internal Medicine, the Department of Internal Medicine, Iowa City, Iowa Iowa City Veterans' Administration Medical Center, Iowa City, Iowa University of Iowa Hospitals and Clinics, Iowa City, Iowa
*
Department of Internal Medicine, University of Iowa College of Medicine, C-41 GH, 200 Hawkins Dr. Iowa City. IA 52242-1081
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Abstract

Objective:

To describe the molecular epidemiology of Legionella pneumophila infections in the University of Iowa Hospitals and Clinics (UIHC).

Design:

Molecular epidemiological study using pulsed-field gel electrophoresis (PFGE).

Setting:

A large university teaching hospital.

Isolates:

All surviving isolates obtained from culture-proven nosocomial L pneumophila infections and all surviving isolates obtained from the University of Iowa Hospital and Clinics' water supply between 1981 and 1993.

Results:

Thirty-three isolates from culture-proven nosocomial cases of L pneumophila pneumonia were available for typing. PFGE of genomic DNA from the clinical isolates identified six different strains. However, only strain C (16 cases) and strain D (13 cases) caused more than 1 case. Strain C caused clusters of nosocomial infection in 1981, 1986, and 1993 and also caused 4 sporadic cases. Strain D caused a cluster in 1987 and 1988 plus 4 sporadic cases. Of the six strains causing clinical infections, only strains C and D were identified in water samples. PFGE identified three strains in the water supply, of which strains C and D caused clinical disease and also persisted in the water supply during most of the study period.

Conclusion:

Specific strains of L pneumophila can colonize hospital water supplies and cause nosocomial infections over long periods of time.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 12 , December 1999 , pp. 793 - 797
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

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