Legionella antibiotic susceptibility testing: is it time for international standardization and evidence-based guidance?

Legionella pneumophila, a Gram-negative bacillus, is the causative agent of Legionnaire's disease, a form of severe community-acquired pneumonia. Infection can have high morbidity, with a high proportion of patients requiring ICU admission, and up to 10% mortality, which is exacerbated by the lack of efficacy of typical empirical antibiotic therapy against Legionella spp. The fastidious nature of the entire Legionellaceae family historically required inclusion of activated charcoal in the solid medium to remove growth inhibitors, which inherently interferes with accurate antimicrobial susceptibility determination, an acknowledged methodological shortfall, now rectified by a new solid medium that gives results comparable to those of microbroth dilution.

Notes from the Field: Concerns of Health-Related Higher Education Students in Brazil Pertaining to Distance Learning During the Coronavirus Pandemic.

This survey aimed to assess the concerns of students of health-related higher education in Brazil regarding distance learning during the coronavirus pandemic. A Google Forms anonymous questionnaire was sent by WhatsApp Messenger to students at a private university. Seven hundred and four students answered the questionnaire (566 female, 138 male, mean age = 23.

A multicenter study of viable PCR using propidium monoazide to detect Legionella in water samples.

Legionella quantification in environmental samples is overestimated by qPCR. Combination with a viable dye, such as Propidium monoazide (PMA), could make qPCR (named then vPCR) very reliable. In this multicentre study 717 artificial water samples, spiked with fixed concentrations of Legionella and interfering bacterial flora, were analysed by qPCR, vPCR and culture and data were compared by statistical analysis.

Trends and variations in breast and colorectal cancer incidence from 1995 to 2011: a comparative study between Texas Cancer Registry and National Cancer Institute's Surveillance, Epidemiology and End Results data.

Few studies have examined the cancer incidence trends in the state of Texas, and no study has ever been conducted to compare the temporal trends of breast and colorectal cancer incidence in Texas with those of the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) in the United States. This study aimed to conduct a parallel comparison between the Texas Cancer Registry and the National Cancer Institute's SEER on cancer incidence from 1995 to 2011. A total of 951,899 breast and colorectal cancer patients were included.

Legionella pneumonia and serum procalcitonin.

Procalcitonin is a specific marker of severe bacterial infections with systemic inflammation. Quantitative evaluation of serum procalcitonin was performed in 140 patients with Legionella pneumonia. Positive values (>0.

One-year surveillance of legionellosis in burned patients and Legionella environmental monitoring.

Burned patients have a theoretically high risk of Legionella infection because burns produce a compromised immune system. Cutaneous surfaces are without protective barriers, and bathing tank water is frequently used for washing and caring. A one-year surveillance study was performed on 65 burned patients by antibody determination and by culture of bronchial aspirates.

Microbiological investigations on a nosocomial case of Legionella pneumophila pneumonia associated with water birth and review of neonatal cases.

A case of Legionella pneumophila 1 pneumonia, confirmed by positive serology and urinary antigen, occurred in a 7-day old neonate after water birth in hospital. As respiratory samples were not available for culture, further microbiological investigations were performed in neonate and environment, in order to recognize the source of infection. The hospital water supply was contaminated by L.

Designation of the European Working Group on Legionella Infection (EWGLI) amplified fragment length polymorphism types of Legionella pneumophila serogroup 1 and results of intercentre proficiency testing Using a standard protocol.

The utility of amplified fragment length polymorphism (AFLP) analysis as a genotyping method for the epidemiological typing of Legionella pneumophila serogroup 1 has been previously demonstrated. This study (i). reports recommendations for the designation of the European Working Group on Legionella Infections (EWGLI) AFLP types, (ii).

Culture proven Legionella pneumophila pneumonia in a HIV-infected patient: case report and review.

We report the first culture proven case of Legionella pneumonia in a HIV-positive patient in Italy. The laboratory diagnosis was obtained by isolation of Legionella pneumophila serogroup 1, serology, urinary antigen detection and PCR. Culture first allowed diagnosis of the infection, that probably would have been unrecognized.

Evaluation of the efficacy of ultraviolet irradiation for disinfection of hospital water contaminated by Legionella.

We evaluated the efficacy of the ultraviolet irradiation on hospital water colonized by Legionella pneumophila serogroup 3, by inserting a lamp system on a hot water pipe supplying a small area. Cultures were performed for four months from 5L samples of water, collected before and after the ultraviolet treatment at the lamp unit and from two distal points. Irradiation was effective immediately after disinfection (<10 cfu/L), even when the incoming water was highly contaminated.

Legionella pneumophila pneumonia in a newborn after water birth: a new mode of transmission.

We report a case of Legionella pneumophila pneumonia in a 7-day old neonate. Because the hospital water, and particularly the pool water for water birthing, was contaminated by L. pneumophila serogroup 1, the newborn was infected following prolonged delivery in contaminated water, perhaps by aspiration.

Comparative evaluation of two commercially available antigen enzyme immunoassays (EIA) for the detection of Legionella pneumophila urinary antigen in frozen non-concentrated urine samples.

We evaluated two commercial enzyme immunoassay kits, Binax EIA (for detection of soluble antigen of Legionella pneumophila serogroup 1) and Biotest EIA (for detection of antigens of Legionella pneumophila serogroups and other Legionella spp.) in order to introduce this test routinely for the diagnosis of Legionnaires' disease (LD) in our Laboratory. Frozen non-concentrated urine samples belonging to 45 patients with and without LD were tested.

Epidemiological trend of human leptospirosis in Italy between 1994 and 1996.

In the three-year period 1994 1996, 222 reports on human cases of leptospirosis were received by the Italian Ministry of Health. The average annual number of reports was 29.2% lower than in the preceding eight years.

Clarithromycin and amoxicillin susceptibility of Helicobacter pylori strains isolated from adult patients with gastric or duodenal ulcer in Italy.

Helicobacter pylori strains, isolated from 100 gastric biopsies from 49 previously untreated adult patients with endoscopy and histology-confirmed gastric or duodenal ulcer, were tested for in vitro antimicrobial susceptibility. Strains were isolated from biopsies of 75.5% (37 of 49) patients before therapy and of 13.

Prevalence of Legionella pneumophila serogroup 1 antibodies in blood donors.

The prevalence of anti-Legionella pneumophila serogroup 1 antibodies in 777 blood donors of the Turin area was determined by the indirect immunofluorescence assay (IFA) and by the microagglutination test (MA). Low titers (IFA of 1/16 and MA of 1/8) were found in 0.3% of the subjects.

Prevalence of Yersinia antibodies in blood donors.

Agglutinins titers against Y. enterocolitica 0:3, 0:5, 0:9 and Y. pseudotuberculosis I were determined by the microagglutination method in 777 blood donor sera.

Growth of Yersinia species in artificially contaminated blood bags.

Transfusion blood bags were inoculated with less than 0.1 colony-forming units (CFU) of Yersinia enterocolitica (serotypes O:3, O:5, and O:9) and Yersinia pseudotuberculosis I per mL and stored at 4 degrees C for 41 days. During storage, samples were collected periodically and colony counts of serial dilutions were performed by plating on tryptic soy agar.

Endemicity of Legionella pneumophila serogroup 3 in a hospital water supply.

A microbiological and epidemiological investigation at the Infectious Diseases Hospital in Turin, Italy, demonstrated Legionella pneumophila serogroup 3 at 10(2) to greater than 4 X 10(3) cfu l-1 from 24 of 32 hot water samples collected from hand-basins in six separate buildings. A sample taken from the public water supply, and a hot water sample (80 degrees C) collected from hot water tanks, did not yield legionellas. Legionella pneumophila serogroup 3 was found in samples taken at the first point of mixed hot and cold water (50 degrees C) at 3 X 10(2) cfu l-1.

[Yersinia and infantile gastroenteritis].

Fecal samples and intestinal mucosal biopsies of 16 patients in paediatric age, with protracted diarrhoea with blood and mucus, were examined for intestinal pathogens including Yersinia. Yersinia enterocolitica 1/5/XZ and Yersinia intermedia 1/18/XZ were isolated from fecal samples of two patients. In another child, Yersinia enterocolitica, 1/5/XZ was isolated from fecal sample, while Yersinia enterocolitica 1/self-agglutinable/XZ from colon biopsy.

Attempt of Yersinia enterocolitica isolation from human feces in Senegal.

One-hundred-eight stool samples, collected in a fishing village of Senegal from 72 apparently healthy subjects and from 36 patients with gastrointestinal disorders, were examined for the presence of Y. enterocolitica. After 1, 2, 3 weeks of cold enrichment with PBS 1/15M, pH 7.