ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2017
Seeding and Establishment of Legionella pneumophila in Hospitals: Implications for Genomic Investigations of Nosocomial Legionnaires' Disease.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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24 citing papers in PubMed, 46 citations in OpenAlex.
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- Population analysis of Legionella pneumophila reveals a basis for resistance to complement-mediated killing.Nature communications · 2021Article
- Local Adaptation of Legionella pneumophila within a Hospital Hot Water System Increases Tolerance to Copper.Applied and environmental microbiology · 2021Article
- Cytotoxicity, Intracellular Replication, and Contact-Dependent Pore Formation of Genotyped EnvironmentalPathogens (Basel, Switzerland) · 2021Article
- Characterization ofPathogens (Basel, Switzerland) · 2020Article
- Transmission of Legionnaires' Disease through Toilet Flushing.Emerging infectious diseases · 2020Article
- Multiple Sources of the Outbreak of Legionnaires' Disease in Genesee County, Michigan, in 2014 and 2015.Environmental health perspectives · 2019Article
- Status and potential of bacterial genomics for public health practice: a scoping review.Implementation science : IS · 2019Article
- Air-conditioner cooling towers as complex reservoirs and continuous source ofEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2019Article
- Spatial structuring of a Legionella pneumophila population within the water system of a large occupational building.Microbial genomics · 2018Article
- Detection ofMicroorganisms · 2018Article
- Population structure of Environmental and Clinical Legionella pneumophila isolates in Catalonia.Scientific reports · 2018Article
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Authors and funding
10 authors at 4 institutions in 3 countries.
Funding
Abstract
Background: Legionnaires' disease is an important cause of hospital-acquired pneumonia and is caused by infection with the bacterium Legionella. Because current typing methods often fail to resolve the infection source in possible nosocomial cases, we aimed to determine whether whole-genome sequencing (WGS) could be used to support or refute suspected links between cases and hospitals. We focused on cases involving a major nosocomial-associated strain, L. pneumophila sequence type (ST) 1. Methods: WGS data from 229 L. pneumophila ST1 isolates were analyzed, including 99 isolates from the water systems of 17 hospitals and 42 clinical isolates from patients with confirmed or suspected hospital-acquired infections, as well as isolates obtained from or associated with community-acquired sources of Legionnaires' disease. Results: Phylogenetic analysis demonstrated that all hospitals from which multiple isolates were obtained have been colonized by 1 or more distinct ST1 populations. However, deep sampling of 1 hospital also revealed the existence of substantial diversity and ward-specific microevolution within the population. Across all hospitals, suspected links with cases were supported with WGS, although the degree of support was dependent on the depth of environmental sampling and available contextual information. Finally, phylogeographic analysis revealed that hospitals have been seeded with L. pneumophila via both local and international spread of ST1. Conclusions: WGS can be used to support or refute suspected links between hospitals and Legionnaires' disease cases. However, deep hospital sampling is frequently required due to the potential coexistence of multiple populations, existence of substantial diversity, and similarity of hospital isolates to local populations.
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