Monday 28 November 2011
The occurrence of Legionella species other than Legionella pneumophila in clinical and environmental samples in Denmark identified by mip gene sequencing and matrix‐assisted laser desorption ionization time‐of‐flight mass spectrometry
Legionnaire's Disease traces found in Playboy Mansion whirlpool
(Source: Monsters and Critics Health News)
Contamination of the cold water distribution system of health care facilities by Legionella pneumophila: Do we know the true dimension?
(Source: Eurosurveillance latest news)
ScotRail finds legionella bacteria in train toilet systems
TRACES of potentially fatal bacteria have been found in the toilet water systems of trains in Scotland. (Source: Scotsman.com News - Health)
Sunday 27 November 2011
Environmental surveillance and molecular characterization of Legionella in tropical Singapore.
In this study, we provided an update on the prevalence of Legionella in mist fans (N=28), household water heaters with storage tanks (N=19) and instantaneous heaters (N=30); and extended the survey to spa pools (N=29) and aerosol-generating fixtures in nursing homes (N=116). The prevalence of Legionella were 21.1% in water heaters with storage tanks, 24.1% in spa pools, 14.2% in mist fans and 3.3% in instantaneous heaters. Legionella was not detected in nursing homes. A total of 37 isolates were subjected to molecular characterization using Sequence-Based Typing (SBT) protocol from the European Working Group on Legionella Infections (EWGLI). This is the first study on the use of SBT protocol on environmental strains isolated from tropical South East Asia. The Legionella flora was very hete...
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TNF Blockers Get Boxed Warning on 2 Bacterial InfectionsTNF Blockers Get Boxed Warning on 2 Bacterial Infections
A recent FDA review of the drug class, prescribed for various forms of arthritis and other disorders, uncovered serious and sometimes fatal infections by Legionella and Listeria. Medscape Medical News (Source: Medscape Today Headlines)
Cell mediated immunity in Legionnaires' disease.
Authors: Hoffman PS, Edelstein PH PMID: 21762750 [PubMed - as supplied by publisher] (Source: Vaccine)
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Inquiry into Legionnaires cases
An investigation is launched following a rise in the number of people with Legionnaires Disease in Glasgow. (Source: BBC News | Health | UK Edition)
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Cluster of travel-associated Legionnaires' disease in Lazise, Italy, July to August 2011
(Source: Eurosurveillance latest news)
Enhanced isolation of Legionella species from composted material
AbstractLegionella pneumophila and Legionella species were isolated from composted material when freshly prepared buffered charcoal yeast extraction (BCYE) was supplemented with glycine (1.5 g/L), polymyxin B sulfate (40000 IU/L), vancomycin hydrochloride (0.5 mg/L) and cycloheximide (40 mg/L) (GVPC medium) and Modified Wadowsky-Yee MWY (Oxoid ™, Cambridge, England) plates were used for cultivation but not with commercially sourced pre-poured GVPC and MWY plates (Oxoid™, Cambridge, England). L. cincinnatiensis and pathogenic L. pneumophila Sg 1 Benidorm and France/Allentown were identified as well as a non-typeable (NT) strain of L. pneumophila. As most laboratories no longer produce their own media, this may contribute to the lack of positive cultures from composted material. Th...
Saturday 26 November 2011
Legionella pneumophila lung abscess associated with immune suppression
We describe Legionella pneumophila pneumonia and abscess formation in an immunosuppressed patient receiving corticosteroid therapy for metastatic breast carcinoma. The predisposing role of corticosteroids is discussed and the management of this complication is reviewed. (Source: Internal Medicine Journal)
Warnings added for TNF-blockers
The Food and Drug Administration (FDA) has updated the boxed warning for all tumor necrosis factor alpha (TNF-alpha) inhibitors to include the risk of infection from the bacteria legionella and listeria, MedPage Today reports. (Source: Modern Medicine)
The immunochromatic kits Xpect(R) Legionella and BinaxNOW(R) Legionella for detection of Legionella pneumophila urinary antigen have low sensitivities for the diagnosis of Legionnaires' disease.
Bacterial and fungal microflora in surgically removed lung cancer samples
Conclusions:A diversity of pathogens could be identified in surgically extracted tissue samples of patients with lung cancer, with mycoplasma strains being present in all samples. These results point to an etiologic role for chronic infection in lung carcinogenesis. Confirmation of these observations and additional studies are needed to further characterize the etiologic role of inflammation in lung carcinogenesis. (Source: Journal of Cardiothoracic Surgery)
Legionellosis must be kept in mind in case of pneumonia with lung abscesses in children receiving therapeutic steroids
Abstract A 10-year-old boy, who had received recurrent short-course treatments with steroids to control severe autoimmune thrombocytopaenia, developed Legionnaires’ disease as community-acquired pneumonia. Legionella pneumophila pneumonia was complicated by an extended abscess of the right inferior lobe, leading to residual lung cavities. Legionellosis must be kept in mind as the differential diagnosis in the case of severe pneumonia and with lung abscesses in children receiving therapeutic steroids. Legionella-specific diagnostic tests (polymerase chain reaction [PCR] in respiratory samples or urine antigen assay) and, also, specific empirical antibiotic combination therapy are required for the early detection and treatment of L. pneumophila pneumonia in childhood. C...
Friday 25 November 2011
Legionnaires' disease, Pontiac fever up
ATLANTA, Aug. 19 (UPI) -- The number of legionellosis cases reported each year more than tripled from 2000 to 2009 from 1,110 cases to 3,522 cases, U.S. health officials report. (Source: Health News - UPI.com)
FDA issues label change for TNF-alpha blockers to include risk of infection from Legionella and Listeria
FDA has notified healthcare professionals that the Boxed Warning for the entire class of Tumor Necrosis Factor-alpha (TNFα) blockers has been updated to include the risk of infection from 2 bacterial pathogens, Legionella and Listeria. (Source: Modern Medicine)
Recovery of Legionella species from water samples using an internal method based on ISO 11731: suggestions for revision and implementation
Abstract: The study aim was to determine retrospectively whether the parallel use of 2 media [buffered charcoal yeast extract (BCYE) and medium of Wadowsky and Yee (MWY)] to isolate Legionella spp. from water samples taken from hospital water supply systems increased the sensitivity of the culture method as compared with methods/protocols in which only seeding on a selective medium is used. We analyzed the results obtained from 931 positive water samples. In 484 of the 931 positive water samples, Legionella spp. was isolated in the presence of other microorganisms; in 83% (400/484), we used MWY to count suspected colonies, which gave a lower number of unreadable plates. In the 447 samples containing only Legionella spp., the highest frequency of positive samples (93%, 418/447) was obtained...
[Editors' Choice] Modified by Legionella
A Legionella effector protein adds phosphocholine to Rab GTPases to manipulate membrane trafficking in host cells. (Source: Signal Transduction Knowledge Environment)
Tumor Necrosis Factor-alpha (TNFα) Blockers: Label Change - Boxed Warning Updated for Risk of Infection from Legionella and Listeria
including Remicade (infliximab), Enbrel (etanercept), Humira(adalimumab), Cimzia (certolizumab pegol), and Simponi(golimumab)AUDIENCE: Rheumatology, Gastroenterology, OncologyISSUE: FDA notified healthcare professionals that the... (Source: Drugs.com - Pharma News)
In Vitro and In Vivo Profile of ACH-702, an Isothiazoloquinolone, against Bacterial Pathogens.
Authors: Pucci MJ, Podos SD, Thanassi JA, Leggio MJ, Bradbury BJ, Deshpande M ACH-702, a novel isothiazoloquinolone, was assessed for antibacterial activity against a panel of gram-positive and gram-negative clinical isolates and found to possess broad-spectrum activity, especially against antibiotic-resistant gram-positive strains including methicillin-resistant Staphylococcus aureus (MRSA). For gram-negative bacteria, ACH-702 showed exceptional potency against Haemophilus influenzae, Moraxella catarrhalis, and Neisseria sp., but was less active against members of the Enterobacteriaceae. Good antibacterial activity was also evident against several anaerobes as well as Legionella pneumophila and Mycoplasma pneumoniae. Excellent bactericidal activity was observed for ACH-702 against sev...
Thursday 24 November 2011
Legionellosis prevention in France.
Authors: Hartemann P, Hautemaniere A Since 1997, both the prevention of legionellosis and the control of Legionella in water networks and cooling towers have greatly improved in France. The epidemiological surveillance of Legionnaires' disease showed an increase, which was followed by a decrease in the incidence after a maximum was reached in 2005 (incidence rate of 2.5 per 10(5)). A steady decrease in the incidence rate has been observed since 2006, mainly due to the efficacy of control measures both for cooling towers and hospital water networks. In hospitals, a proactive approach was proposed in 1998 and quantitative limit values with systematic survey were put into force in 2002. The percentage of nosocomial cases has decreased dramatically and is now around 6-7% of all cases recor...
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U.S. Legionnaires' disease cases tripled in past decade
Cases of Legionnaire's disease have tripled in the last decade, U.S. health officials said Thursday, but the risk of dying from it is lower because of more effective treatment. (Source: CTV Health)
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Profile of bacterial pneumonia during Hajj.
This study was aimed to determine the most common causes of bacterial pneumonia during the 2005 Hajj season and to relate the findings with clinical conditions. Methods : A total of 141 patients with suspected pneumonia from the three main tertiary care hospitals in Makkah, Saudi Arabia, were investigated during Hajj season, 2005. Sputum and serum samples were collected and investigated for the possible presence of typical or atypical causative agents. Results : Of the 141 clinically suspected pneumonia cases, 76 (53.9%) were confirmed positive by microbiological tests. More than 94 per cent of the confirmed cases were in the age group >50 yr, and 56.6 per cent of the cases were men. The most frequent isolates were Candida albicans (28.7%) and Pseudomonas aeruginosa (21.8%), followed by...
Prevention of Legionnaires'disease in hospitals.
We describe the best-known methods of eradicating Legionella in hospitals. Materials and method. The article is based on the authors' experience of measures to prevent Legionnaires' disease in hospitals and on a non-systematic search in PubMed. Results. There are several methods of combating Legionella in hospitals. These include chlorination, heat treatment, and the use of filters. However, recontamination easily re-occurs after eradication. The silver and copper ionisation treatment of water is a well-documented method for the systematic and long-term eradication of Legionella in water. The disadvantages of this method are that it is expensive, that there is a risk of discolouring the water, and that there is a possibility of developing resistance in environmental bacteria. This resistan...
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Modulation of Rab GTPase function by a protein phosphocholine transferase
Authors: Shaeri Mukherjee, Xiaoyun Liu, Kohei Arasaki, Justin McDonough, Jorge E. Galán & Craig R. RoyThe intracellular pathogen Legionella pneumophila modulates the activity of host GTPases to direct the transport and assembly of the membrane-bound compartment in which it resides. In vitro studies have indicated that the Legionella protein DrrA post-translationally modifies the GTPase Rab1 by a process called AMPylation. Here we used mass spectrometry to investigate post-translational modifications to Rab1 that occur during infection of host cells by Legionella. Consistent with in vitro studies, DrrA-mediated AMPylation of a conserved tyrosine residue in the switch II region of Rab1 was detected during infection. In addition, a modification to an adjacent serine residue in Rab1 ...
Detection of microorganisms in exhaled breath condensate during acute exacerbations of COPD
Conclusions: Bacterial nucleic acids can be identified in EBCs of COPD patients with exacerbations. The results obtained from EBC and sputum did not correlate well. (Source: Respirology)
Wednesday 23 November 2011
The occurrence of Legionella species other than L. pneumophila in clinical and environmental samples in Denmark identified by mip‐gene‐sequencing and MALDI‐TOF‐MS
AbstractIn Denmark, several laboratories use PCR as a routine diagnostic method for Legionnaires’ disease, and almost all PCR positive samples have been investigated by culture.From 1993-2010, we obtained isolates of Legionella species other than Legionella pneumophila (L. non- pneumophila) from respiratory samples from 33 patients, and from 1997-2010, 42 isolates of L. non- pneumophila were obtained and saved from water samples from 39 different sites in Denmark. mip-sequencing was used as a reference method to identify the L. non- pneumophila species. Only one of the 75 isolates did not pass the acceptance criteria with a similarity of = 98% to sequences in the database. The Species distribution between clinical and environmental isolates varied. For the former, four spec...
Legionnaires' Disease
Title: Legionnaires' DiseaseCategory: Diseases and ConditionsCreated: 10/24/1999 9:06:00 AMLast Editorial Review: 10/21/2011 (Source: MedicineNet Crohn's Disease General)
Use of rifampicin in pregnancy
Source: UK Teratology Information ServiceArea: Evidence > Drugs in Pregnancy SUMMARY: Rifampicin is an antibacterial drug used in the treatment of tuberculosis, leprosy, brucellosis, Legionnaire's disease and serious staphylococcal infections. Rifampicin is also used as prophylaxis against meningococcal meningitis. Animal studies have demonstrated teratogenicity after exposure to rifampicin during pregnancy. There is currently very little published data available concerning fetal risks following human exposure to rifampicin during the first trimester of pregnancy, but those few published so far do not indicate an increase in risk of congenital malformations. There have been reports of low birth weight in exposed infants, however this is likely due to the unde...
Anchoring of bacterial effectors to host membranes through host-mediated lipidation by prenylation: a common paradigm.
Authors: Al-Quadan T, Price CT, London N, Schueler-Furman O, Abukwaik Y Abstract Post-translational lipidation by prenylation of the CaaX-box C-terminal motif in eukaryotic proteins facilitates anchoring of hydrophilic proteins, such as Ras and Rab, to membranes. A large cadre of bacterial effectors injected into host cells is anchored to host membranes by unknown mechanisms. As already documented for Legionella and Salmonella, we propose a common paradigm of microbial exploitation of the host prenylation machinery for anchoring of injected effectors to host membranes. This is supported by numerous potential microbial CaaX-box-containing proteins identified using refined bioinformatic tools. We also propose utilization of the CaaX motif as a membrane-targeting tag for proteins expr...
Legionella bug found at hotel
Health officials investigating a potential outbreak of Legionnaire's disease at a Dundee hotel confirmed yesterday that legionella bacteria had been identified in samples (Source: Scotsman.com News - Health)
Usefulness of real‐time PCR as a complementary tool to the monitoring of Legionella spp. and Legionella pneumophila by culture in industrial cooling systems
Conclusions: These results suggest that, if some methodological steps designed to reduce inhibitory problems and thus decrease the quantification limits, could be developed to quantify Legionella in complex waters, the real-time PCR could be a valuable complementary tool to monitor the evolution of L. pneumophila concentrations.Significance and Impact of the Study: This study shows the possibility of using real-time PCR to monitor L. pneumophila proliferations in cooling systems and the importance to adapt nucleic acid extraction and purification protocols to raw waters. (Source: Journal of Applied Microbiology)
Tuesday 22 November 2011
Highlights from this issue
This study was clearly not designed to detect differences in either scald rates or Legionella infection. This paper neatly complements one we carried in March which demonstrated the effectiveness of thermostatic mixer valves in reducing water temperatures to a safe level.1... (Source: Archives of Disease in Childhood)
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Diagnosis of Fulminant Pneumonia Caused by Legionella pneumophila Serogroup 8 with the Sequence Analysis of the 16S rRNA Gene.
In conclusion, this cultivation-independent method is a potential diagnostic modality for pneumonia, especially in patients with rapidly progressive pneumonia or those who are immunocompromised. PMID: 21878746 [PubMed - in process] (Source: The Tohoku Journal of Experimental Medicine)
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Listeria monocytogenes engineered to activate the Nlrc4 inflammasome are severely attenuated and are poor inducers of protective immunity [Immunology]
Inflammasomes are intracellular multiprotein signaling complexes that activate Caspase-1, leading to the cleavage and secretion of IL-1ß and IL-18, and ultimately host cell death. Inflammasome activation is a common cellular response to infection; however, the consequences of inflammasome activation during acute infection and in the development of long-term protective immunity is not well understood. To investigate the role of the inflammasome in vivo, we engineered a strain of Listeria monocytogenes that ectopically expresses Legionella pneumophila flagellin, a potent activator of the Nlrc4 inflammasome. Compared with wild-type L. monocytogenes, strains that ectopically secreted flagellin induced robust host cell death and IL-1ß secretion. These strains were highly attenuated both in bo...
Covalent Coercion by Legionella pneumophila.
Authors: Itzen A, Goody RS Abstract Adenylylation of Rab proteins appears to be an intriguing mechanism that Legionella pneumophila uses to modulate their activity during infection. Now the reverse reaction (deadenylylation) (Neunuebel et al., 2011; Tan and Luo, 2011) and a new posttranslational modification (phosphocholination) of Rab1 (Mukherjee et al., 2011) have been reported. PMID: 21843863 [PubMed - in process] (Source: Cell Host and Microbe)
Protein expression, crystallization and preliminary X-ray crystallographic studies of LidA from Legionella pneumophila
LidA, a translocated substrate of the Legionella pneumophila Dot/Icm type IV secretion system, is associated with maintenance of bacterial integrity and interferes with the early secretory pathway. However, the precise mechanism of LidA in these processes remains elusive. To further investigate the structure and function of LidA, the full-length protein was successfully expressed in Escherichia coli and purified. LidA was crystallized using sitting-drop vapour diffusion and diffracted to a resolution of 2.75 Å. The crystal belonged to space group P212121, with unit-cell parameters a = 57.5, b = 64.5, c = 167.3 Å, a = ß = ? = 90°. There is one molecule per asymmetric unit. (Source: Acta Crystallographica Section F)
Monday 21 November 2011
Adult outpatient experience of the 2009 H1N1 pandemic: Clinical course, pathogens, and evaluation of case definitions
Conclusions: Influenza A (H1N1) and human rhinovirus were the major pathogens responsible for respiratory disease. The 2009 H1N1 pandemic in Amsterdam followed a mild course. Test characteristics of 4 different clinical case definitions seemed comparable but rather useless. (Source: Journal of Infection)
Contamination of the cold water distribution system of health care facilities by Legionella pneumophila: Do we know the true dimension?
(Source: Eurosurveillance latest news)
Legionella steelei sp. nov. isolated from human respiratory specimens in California and South Australia.
Authors: Edelstein PH, Edelstein MA, Shephard LJ, Ward KW, Ratcliff RM Abstract Legionella-like bacteria were isolated from the respiratory tract of two humans in California and South Australia, but not thought to cause disease. These bacteria, strains F2632 and IMVS-3376, were found to have identical Legionella macrophage infectivity potentiator (mip) sequences, and were therefore further characterized to determine their genetic and phenotypic relatedness and properties. Both of these Gram-negative bacterial strains grew on buffered charcoal yeast extract medium, were cysteine auxotrophs, and made a characteristic diffusible bright yellow fluorescent pigment, with one strain making a late appearing colony bound blue white fluorescent pigment. Optimal in vitro growth temperature wa...
Clinical and economic burden of community-acquired pneumonia amongst adults in the Asia-Pacific region
Abstract: Community-acquired pneumonia (CAP) is an important cause of mortality and morbidity amongst adults in the Asia-Pacific region. Literature published between 1990 and May 2010 on the clinical and economic burden of CAP amongst adults in this region was reviewed. CAP is a significant health burden with significant economic impact in this region. Chronic obstructive pulmonary disease, cardiovascular disease, diabetes mellitus and advanced age were risk factors for CAP. Aetiological agents included Streptococcus pneumoniae, Klebsiella pneumoniae, Gram-negative bacteria, Mycobacterium tuberculosis, Burkholderia pseudomallei, Staphylococcus aureus and atypical pathogens (Mycoplasma pneumoniae, Chlamydophila pneumoniae and Legionella spp.), with important differences in the prevalence of...
Electronic faucets unsafe for use in high-risk patient hospital settings
(Society for Healthcare Epidemiology of America) Researchers at the Johns Hopkins University School of Medicine have determined that electronic faucets are more likely to become contaminated with unacceptably high levels of bacteria, including Legionella spp., compared with traditional manually operated faucets. The study will be presented on Saturday at the annual meeting of the Society for Healthcare Epidemiology of America. (Source: EurekAlert! - Medicine and Health)
Sunday 20 November 2011
Study Shows Automatic Faucets Carry High Levels Of Bacteria, Unsafe For Use In High-Risk Patient Hospital Settings
Researchers at The Johns Hopkins University School of Medicine have determined that electronic faucets are more likely to become contaminated with unacceptably high levels of bacteria, including Legionella spp., compared with traditional manually operated faucets. The study will be presented on Saturday at the annual meeting of the Society for Healthcare Epidemiology of America (SHEA). Electronic-eye, non-touch faucets have been increasingly utilized in healthcare settings to lower water consumption and in an attempt to reduce recontamination of the hands of healthcare personnel... (Source: Health News from Medical News Today)
Epidemiology of Respiratory Infections Caused by Atypical Bacteria in Two Kenyan Refugee Camps
Abstract Chlamydia pneumoniae, Mycoplasma pneumoniae, and Legionella spp. are common causes of atypical pneumonia; however, data about these atypical pathogens are limited in the refugee setting. Paired nasopharyngeal and oropharyngeal specimens were collected from patients with respiratory illness presenting to healthcare centers in two refugee camps in Kenya. The specimens were tested for C. pneumoniae, M. pneumoniae, and Legionella spp. as well as eight respiratory viruses. Atypical pathogens were detected in 5.5% of the specimens of which 54% were co-infected with at least one of the eight viruses tested. Patients positive for atypical bacteria co-infected with virus were significantly more likely to have severe acute respiratory illness than patients infected with onl...
FDA Warns of New Infections With TNF Blockers
(MedPage Today) -- The Food and Drug Administration has updated the boxed warning for all tumor necrosis factor-alpha inhibiting drugs to reflect the risk of infection from the bacteria Legionella and Listeria. (Source: MedPage Today Rheumatology)
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Illness traced to Playboy Mansion hot tub
Los Angeles County health officials say the bacteria that causes Legionnaires' disease was found in a hot tub at the Playboy Mansion where scores ... (Source: USATODAY.com Health)
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Two signal models in innate immunity
Summary: Two-signal models have a rich history in immunology. In the classic two-signal model of T-cell activation, signal one consists of engagement of the T-cell receptor by antigen/major histocompatibility complex, whereas signal two arises from costimulatory ligands on antigen-presenting cells. A requirement for two independent signals helps to ensure that T-cell responses are initiated only in response to bona fide infectious threats. Our studies have led us to conclude that initiation of innate immune responses to pathogens also often requires two signals: signal one is initiated by a microbe-derived ligand, such as lipopolysaccharide (LPS) or flagellin, whereas signal two conveys additional contextual information that often accompanies infectious microbes. Although ...
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