Skip to main content
NCBI home page
Epidemiology and Infection logoLink to Epidemiology and Infection
. 1992 Apr;108(2):261–270. doi: 10.1017/s0950268800049736

Each water outlet is a unique ecological niche for Legionella pneumophila.

T J Marrie 1, D Haldane 1, G Bezanson 1, R Peppard 1
PMCID: PMC2271983  PMID: 1582468

Abstract

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.

Full text

PDF
261

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Best M., Yu V. L., Stout J., Goetz A., Muder R. R., 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 Aug 6;2(8345):307–310. doi: 10.1016/s0140-6736(83)90290-8. [DOI] [PubMed] [Google Scholar]
  2. Bollin G. E., Plouffe J. F., Para M. F., Prior R. B. Difference in virulence of environmental isolates of Legionella pneumophila. J Clin Microbiol. 1985 May;21(5):674–677. doi: 10.1128/jcm.21.5.674-677.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. 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 Bakteriol Mikrobiol Hyg B. 1986 Dec;183(1):79–85. [PubMed] [Google Scholar]
  4. Edelstein P. H. Improved semiselective medium for isolation of Legionella pneumophila from contaminated clinical and environmental specimens. J Clin Microbiol. 1981 Sep;14(3):298–303. doi: 10.1128/jcm.14.3.298-303.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Edelstein P. H., Nakahama C., Tobin J. O., Calarco K., Beer K. B., Joly J. R., Selander R. K. 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 Jun;23(6):1121–1126. doi: 10.1128/jcm.23.6.1121-1126.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Farrell I. D., Barker J. E., Miles E. P., Hutchison J. G. A field study of the survival of Legionella pneumophila in a hospital hot-water system. Epidemiol Infect. 1990 Jun;104(3):381–387. doi: 10.1017/s0950268800047397. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Johnston J. M., Latham R. H., Meier F. A., Green J. A., Boshard R., Mooney B. R., Edelstein P. H. Nosocomial outbreak of Legionnaires' disease: molecular epidemiology and disease control measures. Infect Control. 1987 Feb;8(2):53–58. doi: 10.1017/s0195941700067072. [DOI] [PubMed] [Google Scholar]
  8. Marrie T. J., MacDonald S., Clarke K., Haldane D. Nosocomial legionnaires' disease: lessons from a four-year prospective study. Am J Infect Control. 1991 Apr;19(2):79–85. doi: 10.1016/0196-6553(91)90043-c. [DOI] [PubMed] [Google Scholar]
  9. Plouffe J. F., Para M. F., Maher W. E., Hackman B., Webster L. Subtypes of Legionella pneumophila serogroup 1 associated with different attack rates. Lancet. 1983 Sep 17;2(8351):649–650. doi: 10.1016/s0140-6736(83)92531-x. [DOI] [PubMed] [Google Scholar]
  10. Redd S. C., Cohen M. L. Legionella in water: what should be done? JAMA. 1987 Mar 6;257(9):1221–1222. [PubMed] [Google Scholar]
  11. Ribeiro C. D., Burge S. H., Palmer S. R., Tobin J. O., Watkins I. D. Legionella pneumophila in a hospital water system following a nosocomial outbreak: prevalence, monoclonal antibody subgrouping and effect of control measures. Epidemiol Infect. 1987 Jun;98(3):253–262. doi: 10.1017/s0950268800062002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Ruf B., Schürmann D., Horbach I., Seidel K., Pohle H. D. Nosocomial legionella pneumonia: demonstration of potable water as the source of infection. Epidemiol Infect. 1988 Dec;101(3):647–654. doi: 10.1017/s0950268800029526. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Schofield G. M., 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 Dec;59(6):519–527. doi: 10.1111/j.1365-2672.1985.tb03355.x. [DOI] [PubMed] [Google Scholar]
  14. Schulze-Röbbecke R., Jung K. D., Pullmann H., Hundgeburth J. Sanierung eines mit Legionella pneumophila kontaminierten Krankenhaus-Warmwassersystems. Zentralbl Hyg Umweltmed. 1990 May;190(1-2):84–100. [PubMed] [Google Scholar]
  15. States S. J., Conley L. F., Kuchta J. M., Oleck B. M., Lipovich M. J., Wolford R. S., Wadowsky R. M., McNamara A. M., Sykora J. L., Keleti G. Survival and multiplication of Legionella pneumophila in municipal drinking water systems. Appl Environ Microbiol. 1987 May;53(5):979–986. doi: 10.1128/aem.53.5.979-986.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Vickers R. M., Stout J. E., Yu V. L., Rihs J. D. Manual of culture methodology for Legionella. Semin Respir Infect. 1987 Dec;2(4):274–279. [PubMed] [Google Scholar]
  17. Vickers R. M., Yu V. L., Hanna S. S., Muraca P., Diven W., Carmen N., Taylor F. B. Determinants of Legionella pneumophila contamination of water distribution systems: 15-hospital prospective study. Infect Control. 1987 Sep;8(9):357–363. doi: 10.1017/s0195941700067412. [DOI] [PubMed] [Google Scholar]
  18. Wadowsky R. M., Butler L. J., Cook M. K., Verma S. M., Paul M. A., Fields B. S., Keleti G., Sykora J. L., Yee R. B. Growth-supporting activity for Legionella pneumophila in tap water cultures and implication of hartmannellid amoebae as growth factors. Appl Environ Microbiol. 1988 Nov;54(11):2677–2682. doi: 10.1128/aem.54.11.2677-2682.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Wright J. B., Ruseska I., Athar M. A., Corbett S., Costerton J. W. Legionella pneumophila grows adherent to surfaces in vitro and in situ. Infect Control Hosp Epidemiol. 1989 Sep;10(9):408–415. doi: 10.1086/646062. [DOI] [PubMed] [Google Scholar]

Articles from Epidemiology and Infection are provided here courtesy of Cambridge University Press

RESOURCES