Abstract
Legionella species distribution in the Emilia-Romagna region, involving hospital (H) and community (C) environments, was conducted. Legionella culture, agglutination test, and mip-gene sequencing were applied on 240 isolates. The analysis showed a higher prevalence of non-Legionella pneumophila (n-Lp) species (84.1%) compared with L. pneumophila (Lp) (15.9%), with a higher frequency of n-Lp with respect to Lp species in both environments (77.6% and 96.4%, in H and C, respectively). The Shannon index showed a significant difference in Legionella distribution (p = 0.00017), with a significant abundance of Lp in the H compared with C environment (p = 0.00028). The continuous disinfection treatment in H could contribute to adaptive survival of the Lp species. Phylogenetic analysis revealed a conservative clade distribution between H and C: L. feeleii clade with three subclades in C and the Lp clade with five subclades in H and two in C, respectively. Our findings suggest the importance of Legionella surveillance both in H and C, with a focus on n-Lp species less connected to human disease. The Legionella prevalence and diversity found here indicate that geographical and temporal isolate evolution should be considered during surveillance, particularly in the light of global warming and changes in population risk factors.
Highlights
A low a lowoflevel of environmental contamination not guarantee theofabsence of clinical level environmental contamination does notdoes guarantee the absence clinical cases. This the is because the risk of contracting a result of the environThis because risk of contracting legionellosislegionellosis is as a resultisofasthe environmental level mental level of host colonization, host receptivity, pathogen factors
Considering that the domestic water distribution system in facilities such as spas, hotels, bathhouses, and gyms, involved in this study do not carry out systematic Legionella surveillance, this study demonstrates how the risk of exposure to Legionella is underestimated, especially in communities where people stay for a longer time for work or recreation activities
This study has demonstrated that both hospital and community environments are widely colonized by Legionella species, including the species most frequently to clinical cases and unknown relevant species
Summary
Legionella is a Gram-negative bacterium belonging to the Legionellaceae family associated with respiratory pathologies [1]. Legionella is widespread in natural aqueous environments and in man-made water systems such as potable water systems, cooling towers, air-conditioning units, and various water plumbing fixtures [3,4,5]. From these different sources, Legionella can be transmitted to humans through the inhalation of contaminated water aerosols. The risk of legionellosis is related to various factors, such as smoking, old age, and underlying diseases [8]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call