Molecular Determination of Infection Source of a Sporadic Legionella Pneumonia Case Associated with a Hot Spring Bath

  title={Molecular Determination of Infection Source of a Sporadic Legionella Pneumonia Case Associated with a Hot Spring Bath},
  author={Hiroshi Miyamoto and Siroj Jitsurong and Ryoko Shiota and Koji Maruta and Shin-ichi Yoshida and Eiko Yabuuchi},
  journal={Microbiology and Immunology},
To determine the infection source of a sporadic Legionella pneumonia case associated with a hot spring bath, we used five molecular methods, including repetitive element polymerase chain reaction (rep‐PCR), arbitrarily primed PCR (AP‐PCR), ribotyping, restriction endonuclease analysis (REA), and macrorestriction endonuclease analysis (MREA) by pulsed‐field gel electrophoresis. L. pneumophila serogroup (SG) 3 strain EY 3702, isolated from an intratracheal specimen of a 71‐year‐old Japanese… 
Hot spring bath and Legionella pneumonia: an association confirmed by genomic identification.
When the extracted DNA of these two strains showed identical restriction fragments by pulsed-field gel electrophoresis, it was direct evidence that hot spring spas can be a source of Legionella pneumonia.
A multicenter evaluation of genotypic methods for the epidemiologic typing of Legionella pneumophila serogroup 1: results of a pan-European study.
  • N. Fry, S. Alexiou-Daniel, T. Harrison
  • Biology, Medicine
    Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
  • 1999
OBJECTIVES: To compare genotypic methods for epidemiologic typing of Legionella pneumophila serogroup (sg) 1, in order to determine the best available method within Europe for implementation and
Environmental Survey of Legionella pneumophila in Hot Springs in Taiwan
The presence of Legionella in hot springs in Taiwan may discourage hot springs resort visits by the general public, and disinfection of hot springs for Legionella may be necessary if the risk of contracting legionnaires' disease from hot springs can be validated by an evidence-based approach.
Current and Emerging Legionella Diagnostics for Laboratory and Outbreak Investigations
Historic, current, and emerging technologies that hold promise for increasing LD diagnostic efficiency and detection rates as part of a coherent testing regimen are focused on.
Legionella pneumophila and Other Legionella Species Isolated from Legionellosis Patients in Japan between 2008 and 2016
  • J. Amemura-Maekawa, F. Kura, F. K. S. Y. N. T. A. J. Y. R. N. T. F. Y. K. H. Y. S. Kodama Iwabuchi Fujii Yamaguchi Numata Konno Kanek
  • Biology, Medicine
    Applied and Environmental Microbiology
  • 2018
It is suggested that some ST strains frequently cause legionellosis in Japan and are found under different environmental conditions.
Presence and Persistence of Viable, Clinically Relevant Legionella pneumophila Bacteria in Garden Soil in the Netherlands
The detection of viable, clinically relevant Legionella strains indicates that garden soil is a potential source of Legionella bacteria, and future research should assess the public health implication of the presence of L. pneumophila in garden soil.
Legionella pneumonia associated with adult respiratory distress syndrome caused by Legionella pneumophila serogroup 3.
It is concluded that the water at the hot spring spa could have been the source of infection and Legionella pneumophila serogroup 3 was recovered from an intratracheal specimen.
Alternative sources of Legionella bacteria
It is found that soil and rainwater puddles are reservoirs of Legionella bacteria and therefore potential alternative sources of LD and to target soil in source investigations, in particular in relation to cases that are infected by a soil specific ST.
An outbreak of Legionnaires’ disease associated with a circulating bathwater system at a public bathhouse. I: a clinical analysis
The existence of neurological symptoms, elevated levels of C-reactive protein and transaminases, hyponatremia, a positive urinary antigen test, and serological evidence of Legionella infection were independent risk factors for poor clinical courses in patients with Legionnaires' disease.


Restriction fragment length polymorphism of rRNA genes for molecular typing of members of the family Legionellaceae
Typing of Legionella pneumophila remains important in the investigation of outbreaks of Legionnaires' disease and in the control of organisms contaminating hospital water. We found that the
Genotypic and phenotypic methods for the investigation of a nosocomial Legionella pneumophila outbreak and efficacy of control measures.
Findings indicate that phenotypic variation may interfere with monoclonal antibody typing of legionellae and that waterborne legionellosis can be controlled by physical disinfection.
Comparison of molecular methods for subtyping patients and epidemiologically linked environmental isolates of Legionella pneumophila.
With use of the molecular techniques tested, the subtypes of patients' isolates were identical to those of epidemiologically linked environmental isolates from the same hospital.
Exposure to Legionellaceae at a hot spring spa: a prospective clinical and serological study
Findings have important implications for the maintenance of adequate standards of hygiene, bacteriological sampling and clinical surveillance in this and similar establishments.
Molecular fingerprinting of Legionella species by repetitive element PCR
The results suggest the presence of repetitive extragenic palindromic-like elements within the genomes of members of the family Legionellaceae that can be used to discriminate between strains within a serogroup of L. pneumophila and between different Legionella species.
Typing of Legionella pneumophila strains by polymerase chain reaction-mediated DNA fingerprinting
Fingerprinting of L. pneumophila by polymerase chain reaction appeared to have the potential of being as epidemiologically useful as other genotypic methods.
Relationship between Legionella spp. and antibody titres at a therapeutic thermal spa in Portugal
Summary The presence of Legionella spp. in the water of a Portuguese spa was ascertained during the spa season, between May and November. Simultaneously the prevalance of anti-legionella antibodies
Comparison of arbitrarily primed polymerase chain reaction, ribotyping, and monoclonal antibody analysis for subtyping Legionella pneumophila serogroup 1
Arbitrarily primed polymerase chain reaction was used to characterize Legionella pneumophila serogroup 1 and four strains representing the monoclonal antibody pattern most frequently associated with outbreaks all yielded unique amplicon patterns by AP-PCR.
温泉浴槽内溺水後の肺炎患者から検出されたLegionella pneumophila SG3について
A 71-year-old Japanese female, found unconscious by drawing, in a hot spring spa, and admitted to the Takinomiya General Hospital with adult respiratory distress syndrome (ARDS), developed severe pneumonia accompanied with the second attack of ARDS.
Development of a standardized subgrouping scheme for Legionella pneumophila serogroup 1 using monoclonal antibodies
A panel of monoclonal antibodies to Legionella pneumophila serogroup 1 and a subclassification scheme were developed in a collaborative project among three laboratories and a standard protocol for the indirect fluorescent antibody procedure was developed.