How Molecular Typing Can Support Environmental Surveillance in Hot Water Distribution Systems: A Hospital Experience

Overview

Journal Int J Environ Res Public Health

Publisher MDPI

Specialties Environmental Health
Public Health

Date 2020 Nov 25

PMID 33233464

Citations 4

Authors

Luna Girolamini

Silvano Salaris

Jessica Lizzadro

Marta Mazzotta

Maria Rosaria Pascale

Tiziana Pellati

Sandra Cristino

Affiliations

Soon will be listed here.

Abstract

In this study, we aimed to associate the molecular typing of isolates with a culture technique during routine hospital environmental surveillance in hot water distribution systems (HWDSs) to develop a risk map able to be used to prevent nosocomial infections and formulate appropriate preventive measures. Hot water samples were cultured according to ISO 11731:2017. The isolates were serotyped using an agglutination test and genotyped by sequence-based typing (SBT) for or macrophage infectivity potentiator () gene sequencing for non- species. The isolates' relationship was phylogenetically analyzed. The distribution and level of contamination were studied in relation to temperature and disinfectant residues. The culture technique detected 62.21% of positive samples, characterized by serogroup 1, non-, or both simultaneously. The SBT assigned two sequence types (STs): ST1, the most prevalent in Italy, and ST104, which had never been isolated before. The gene sequencing detected and . The phylogenetic analysis showed distinct clusters for each species. The distribution of isolates showed significant differences between buildings, with a negative correlation between the measured level of contamination, disinfectant, and temperature. The molecular approach introduced in HWDSs environmental surveillance permits (i) a risk map to be outlined that can help formulate appropriate disinfection strategies and (ii) rapid epidemiological investigations to quickly identify the source of infections.

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References

Girolamini L, Dormi A, Pellati T, Somaroli P, Montanari D, Costa A . Advances in Control by a New Formulation of Hydrogen Peroxide and Silver Salts in a Hospital Hot Water Network. Pathogens. 2019; 8(4). PMC: 6963979. DOI: 10.3390/pathogens8040209. View

Compain F, Bruneval P, Jarraud S, Perrot S, Aubert S, Napoly V . Chronic endocarditis due to Legionella anisa: a first case difficult to diagnose. New Microbes New Infect. 2015; 8:113-5. PMC: 4652024. DOI: 10.1016/j.nmni.2015.10.003. View

Perrin Y, Bouchon D, Hechard Y, Moulin L . Spatio-temporal survey of opportunistic premise plumbing pathogens in the Paris drinking water distribution system. Int J Hyg Environ Health. 2019; 222(4):687-694. DOI: 10.1016/j.ijheh.2019.04.010. View

Kearse M, Moir R, Wilson A, Stones-Havas S, Cheung M, Sturrock S . Geneious Basic: an integrated and extendable desktop software platform for the organization and analysis of sequence data. Bioinformatics. 2012; 28(12):1647-9. PMC: 3371832. DOI: 10.1093/bioinformatics/bts199. View

Gaia V, Fry N, Harrison T, Peduzzi R . Sequence-based typing of Legionella pneumophila serogroup 1 offers the potential for true portability in legionellosis outbreak investigation. J Clin Microbiol. 2003; 41(7):2932-9. PMC: 165343. DOI: 10.1128/JCM.41.7.2932-2939.2003. View

Vaccaro L, Izquierdo F, Magnet A, Hurtado C, Salinas M, Gomes T . First Case of Legionnaire's Disease Caused by Legionella anisa in Spain and the Limitations on the Diagnosis of Legionella non-pneumophila Infections. PLoS One. 2016; 11(7):e0159726. PMC: 4956277. DOI: 10.1371/journal.pone.0159726. View

Price M, Dehal P, Arkin A . FastTree 2--approximately maximum-likelihood trees for large alignments. PLoS One. 2010; 5(3):e9490. PMC: 2835736. DOI: 10.1371/journal.pone.0009490. View

Papadakis A, Chochlakis D, Sandalakis V, Keramarou M, Tselentis Y, Psaroulaki A . Legionella spp. Risk Assessment in Recreational and Garden Areas of Hotels. Int J Environ Res Public Health. 2018; 15(4). PMC: 5923640. DOI: 10.3390/ijerph15040598. View

Imlay J . The molecular mechanisms and physiological consequences of oxidative stress: lessons from a model bacterium. Nat Rev Microbiol. 2013; 11(7):443-54. PMC: 4018742. DOI: 10.1038/nrmicro3032. View

10.

Burillo A, Pedro-Botet M, Bouza E . Microbiology and Epidemiology of Legionnaire's Disease. Infect Dis Clin North Am. 2017; 31(1):7-27. DOI: 10.1016/j.idc.2016.10.002. View

11.

Ohno A, Kato N, Yamada K, Yamaguchi K . Factors influencing survival of Legionella pneumophila serotype 1 in hot spring water and tap water. Appl Environ Microbiol. 2003; 69(5):2540-7. PMC: 154533. DOI: 10.1128/AEM.69.5.2540-2547.2003. View

12.

Tesauro M, Bianchi A, Consonni M, Pregliasco F, Galli M . Environmental surveillance of Legionella pneumophila in two Italian hospitals. Ann Ist Super Sanita. 2010; 46(3):274-8. DOI: 10.4415/ANN_10_03_08. View

13.

Enright M, Spratt B . A multilocus sequence typing scheme for Streptococcus pneumoniae: identification of clones associated with serious invasive disease. Microbiology (Reading). 1998; 144 ( Pt 11):3049-3060. DOI: 10.1099/00221287-144-11-3049. View

14.

Shih H, Lin Y . Caution on interpretation of legionella results obtained using real-time PCR for environmental water samples. Appl Environ Microbiol. 2006; 72(10):6859. PMC: 1610306. DOI: 10.1128/AEM.00968-06. View

15.

Mentasti M, Fry N, Afshar B, Palepou-Foxley C, Naik F, Harrison T . Application of Legionella pneumophila-specific quantitative real-time PCR combined with direct amplification and sequence-based typing in the diagnosis and epidemiological investigation of Legionnaires' disease. Eur J Clin Microbiol Infect Dis. 2012; 31(8):2017-28. DOI: 10.1007/s10096-011-1535-0. View

16.

Gamage S, Ambrose M, Kralovic S, Roselle G . Water Safety and Legionella in Health Care: Priorities, Policy, and Practice. Infect Dis Clin North Am. 2016; 30(3):689-712. DOI: 10.1016/j.idc.2016.04.004. View

17.

van der Mee-Marquet N, Domelier A, Arnault L, Bloc D, Laudat P, Hartemann P . Legionella anisa, a possible indicator of water contamination by Legionella pneumophila. J Clin Microbiol. 2006; 44(1):56-9. PMC: 1351956. DOI: 10.1128/JCM.44.1.56-59.2006. View

18.

Gomez-Valero L, Rusniok C, Buchrieser C . Legionella pneumophila: population genetics, phylogeny and genomics. Infect Genet Evol. 2009; 9(5):727-39. DOI: 10.1016/j.meegid.2009.05.004. View

19.

Pancer K . Sequence-based typing of Legionella pneumophila strains isolated from hospital water distribution systems as a complementary element of risk assessment of legionellosis in Poland. Ann Agric Environ Med. 2013; 20(3):436-40. View

20.

Fontana S, Scaturro M, Rota M, Caporali M, Ricci M . Molecular typing of Legionella pneumophila serogroup 1 clinical strains isolated in Italy. Int J Med Microbiol. 2014; 304(5-6):597-602. DOI: 10.1016/j.ijmm.2014.04.004. View