Abstract

Although the European reports highlight an increase in community-acquired Legionnaires’ disease cases, the risk of Legionella spp. in private houses is underestimated. In Pisa (Italy) we performed a three-year survey on Legionella presence in 121 buildings with an independent hot water production (IB); 64 buildings with a central hot water production (CB); and 35 buildings with a solar thermal system for hot water production (TB). From all the 220 buildings Legionella spp. was researched in two hot water samples collected either at the recirculation point or on the first floor and on the last floor, while the potable water quality was analysed in three cold water samples collected at the inlet from the aqueduct network, at the exit from the autoclave, and at the most remote tap. Legionella pneumophila sg1, Legionella pneumophila sg2–16, and non-pneumophila Legionella species were detected in 26% of the hot water networks, mostly in CB and TB. In these buildings we detected correlations between the presence of Legionella and the total chlorine concentration decrease and/or the increase of the temperature. Cold water resulted free from microbiological hazards, with the exception of Serratia liquefaciens and Enterobacter cloacae isolated at the exit from two different autoclaves. We observed an increase in total microbial counts at 22 °C and 37 °C between the samples collected at the most remote taps compared to the ones collected at the inlet from the aqueduct. The study highlights a condition of potential risk for susceptible categories of population and supports the need for measures of risk assessment and control.

Highlights

  • Legionella spp. is a Gram-negative aerobic bacterium, which is widely present in soil and freshwater but that can contaminate water systems; it replicates between 25 ◦ C and 42 ◦ C surviving at higher temperatures [1,2]

  • Following the previous published data, the aim of this study is the assessment of Legionella colonization in hot water networks in residential buildings in the Pisa district (Italy) in the period 2014–2017

  • Following the requests of some building administrators of controlling the drinking water quality, the survey was performed from April 2014 to April 2017 on 220 residential buildings located in Pisa (Italy)

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Summary

Introduction

Legionella spp. is a Gram-negative aerobic bacterium, which is widely present in soil and freshwater but that can contaminate water systems; it replicates between 25 ◦ C and 42 ◦ C surviving at higher temperatures [1,2]. Legionella infection may cause distinct clinical diseases as Legionnaires’. Infection is acquired by inhalation, aspiration, or micro-aspiration of Legionella-carrying aerosols. Droplets carrying the pathogen can originate by water spraying or by gurgling air through contaminated water. Immunocompromisation, chronic diseases, and old age are predisposing factors for the development of the disease [3]. Legionella pneumophila serogroup 1 is the species most commonly associated with the disease. It is the cause of 95% of Legionella infections in Europe and 85%

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