Abstract
Legionnaires’ disease (LD) is a severe pneumonia caused by bacteria belonging to the genus Legionella. This is a major public health concern and infections are steadily increasing worldwide. Several sources of infection have been identified, but they have not always been linked to human isolates by molecular match. The well-known Legionella contamination of private homes has rarely been associated with the acquisition of the disease, although some patients never left their homes during the incubation period. This study demonstrated by genomic matching between clinical and environmental Legionella isolates that the source of an LD cluster was a private building. Monoclonal antibodies and sequence-based typing were used to type the isolates, and the results clearly demonstrated the molecular relationship between the strains highlighting the risk of contracting LD at home. To contain this risk, the new European directive on the quality of water intended for human consumption has introduced for the first time Legionella as a microbiological parameter to be investigated in domestic water systems. This should lead to a greater attention to prevention and control measures for domestic Legionella contamination and, consequently, to a possible reduction in community acquired LD cases.
Highlights
Several sources of infection have been identified, but they have not always been linked to human isolates by molecular match
Urinary antigen test was positive in both patients and cultural isolation of Legionella pneumophila serogroup 1 was obtained by lung tissue fragments of the patient who died
Six water samples collected in the patients’ apartments and from the boiler and recirculation hot water were positive for Legionella pneumophila serogroup 1 with a contamination ranging from 1 × to 1.4 ×
Summary
Several sources of infection have been identified, but they have not always been linked to human isolates by molecular match. This study demonstrated by genomic matching between clinical and environmental Legionella isolates that the source of an LD cluster was a private building. To contain this risk, the new European directive on the quality of water intended for human consumption has introduced for the first time Legionella as a microbiological parameter to be investigated in domestic water systems. The new European directive on the quality of water intended for human consumption has introduced for the first time Legionella as a microbiological parameter to be investigated in domestic water systems This should lead to a greater attention to prevention and control measures for domestic Legionella contamination and, to a possible reduction in community acquired LD cases. As largely documented and reported by LD surveillance schemes in place in many countries around the world, most reported LD cases are often part of epidemic clusters and are more often due to the contamination of the water systems of hospitals or hotels [1]
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