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Nosocomial legionella pneumonia: demonstration of potable water as the source of infection

Published online by Cambridge University Press:  15 May 2009

B. Ruf ,
D. Schürmann ,
I. Horbrach ,
K. Seodel  and
H. D. Pohle
B. Ruf
Affiliation:
II. Department of Internal Medicine, Rudolf Virchow University Hospital (Wedding), Freie Universität, Berlin, Federal Republic of Germany (FRG)
D. Schürmann
Affiliation:
II. Department of Internal Medicine, Rudolf Virchow University Hospital (Wedding), Freie Universität, Berlin, Federal Republic of Germany (FRG)
I. Horbrach
Affiliation:
Department of Microbiology, Robert Koch Institute, Federal Health Office, Berlin, FRG
K. Seodel
Affiliation:
Institute for Water, Soil and Air Hygiene, Federal Health Office, Berlin, FRG
H. D. Pohle
Affiliation:
II. Department of Internal Medicine, Rudolf Virchow University Hospital (Wedding), Freie Universität, Berlin, Federal Republic of Germany (FRG)
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From January 1983 until December 1985, 35 cases of sporadic nosocomial legionella pneumonia, all caused by Legionella pneumophila, were diagnosed in a university hospital. L. pneumophila serogroup (SG) 1 was cultured from 12 of the 35 cases and compared to corresponding L. pneumophila SG 1 isolates from water outlets in the patients' immediate environment by subtyping with monoclonal antibodies. The corresponding environmental isolates were identical to 9 out of 12 (75%) of those from the cases. However, even in the remaining three cases identical subtypes were found distributed throughout the hospital water supply. From the hospital water supply four different subtypes of L. pneumophila SG 1 were isolated, three of which were implicated in legionella pneumonia. Of 453 water samples taken during the study 298 (65.8%) were positive for legionellae. Species of Legionella other than L. pneumophila have not been isolated. This may explain the exclusiveness of L. pneumophila as the legionella pneumonia-causing agent. Our results suggest that the water supply system was the source of infection.

Type
Research Article
Information
Epidemiology & Infection , Volume 101 , Issue 3 , December 1988 , pp. 647 - 654
Copyright
Copyright © Cambridge University Press 1988

References

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