ArticleInfection control and hospital epidemiology2009
A cluster of cases of nosocomial legionnaires disease linked to a contaminated hospital decorative water fountain.
Article in Infection control and hospital epidemiology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Guidelines for preventing infectious complications among hematopoietic cell transplantation recipients: a global perspective.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2009Guideline
- HAIviz: an interactive dashboard for visualising and integrating healthcare-associated genomic epidemiological data.Microbial genomics · 2024Article
- Improved biosensing of Legionella by integrating filtration and immunomagnetic separation of the bacteria retained in filters.Mikrochimica acta · 2024Article
- Surveillance ofMicroorganisms · 2022Article
- Multistate analysis of prospective Legionnaires' disease cluster detection using SaTScan, 2011-2015.PloS one · 2019Article
- Spatial structuring of a Legionella pneumophila population within the water system of a large occupational building.Microbial genomics · 2018Article
- The Role of Environmental Contamination in the Transmission of Nosocomial Pathogens and Healthcare-Associated Infections.Current infectious disease reports · 2018Review
- Seeding and Establishment of Legionella pneumophila in Hospitals: Implications for Genomic Investigations of Nosocomial Legionnaires' Disease.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Article
- Prevention by Design: Construction and Renovation of Health Care Facilities for Patient Safety and Infection Prevention.Infectious disease clinics of North America · 2016Review
- Legionellosis Outbreak Associated With a Hotel Fountain.Open forum infectious diseases · 2015Article
- Using the Pillars of Infection Prevention to Build an Effective Program for Reducing the Transmission of Emerging and Reemerging Infections.Current environmental health reports · 2015Article
- An unusually long-lasting outbreak of community-acquired Legionnaires' disease, 2005-2008, Italy.Epidemiology and infection · 2015Article
- Current and emerging Legionella diagnostics for laboratory and outbreak investigations.Clinical microbiology reviews · 2015Review
- Lesser-known or hidden reservoirs of infection and implications for adequate prevention strategies: Where to look and what to look for.GMS hygiene and infection control · 2015Review
- Hospital water and opportunities for infection prevention.Current infectious disease reports · 2014Article
- Article
- The role of water in healthcare-associated infections.Current opinion in infectious diseases · 2013Review
- Application of multilocus sequence analysis (MLSA) for accurate identification of Legionella spp. Isolated from municipal fountains in Chengdu, China, based on 16S rRNA, mip, and rpoB genes.Journal of microbiology (Seoul, Korea) · 2012Article
- Distribution of Legionella species from environmental water sources of public facilities and genetic diversity of L. pneumophila serogroup 1 in South Korea.Applied and environmental microbiology · 2010Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundNosocomial outbreaks of Legionnaires disease have been linked to contaminated water in hospitals. Immunocompromised patients are particularly vulnerable and, when infected, have a high mortality rate. We report the investigation of a cluster of cases of nosocomial pneumonia attributable to Legionella pneumophila serogroup 1 that occurred among patients on our stem cell transplantation unit.
methodsWe conducted a record review to identify common points of potential exposure, followed by environmental and water sampling for Legionella species from those sources. We used an air sampler to in an attempt to detect aerosolized Legionella and pulsed-field gel electrophoresis to compare clinical and environmental isolates.
resultsThe most likely sources identified were the water supply in the patients' rooms and a decorative fountain in the radiation oncology suite. Samples from the patients' rooms did not grow Legionella species. Cultures of the fountain, which had been restarted 4 months earlier after being shut off for 5 months, yielded L. pneumophila serogroup 1. The isolates from both patients and the fountain were identical by pulsed-field gel electrophoresis. Both patients developed pneumonia within 10 days of completing radiation therapy, and each reported having observed the fountain at close range. Both patients' infections were identified early and treated promptly, and both recovered.
conclusionsThis cluster was caused by contamination of a decorative fountain despite its being equipped with a filter and ozone generator. Fountains are a potential source of nosocomial Legionnaires disease despite standard maintenance and sanitizing measures. In our opinion, fountains present unacceptable risk in hospitals serving immunocompromised patients.
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