Legionella pneumophila contamination of hospital dishwashers.

In a tertiary hospital, Legionella spp were isolated from taps and from ward dishwashers connected to contaminated tap piping. Our investigation revealed favorable conditions for growth of Legionella, and showed that Legionella pneumophila SG6 isolates from the taps and dishwashers were all genetically identical by repetitive-element polymerase chain reaction. These results suggest that contaminated dishwashers might be a potential reservoir for the spread of Legionella in health care facilities.

Clinical evaluation of high mobility group box 1 protein in Legionella pneumophila pneumonia.

High mobility group box 1 (HMGB-1) protein is involved in acute lung injury due to various etiologies. We evaluated HMGB-1 levels in sera and bronchoalveolar fluids in patients with pneumonia caused by Legionella pneumophila. Levels of HMGB-1 in the sera of patients with L.

Role of Brevundimonas vesicularis in supporting the growth of Legionella in nutrient-poor environments.

In 1986, we encountered the first case of Legionella micdadei pneumonia in Japan. In the follow-up study to determine the infection route of L. micdadei, we isolated Brevundimonas vesicularis from the shower hose of the patient�s home.

Identification of Legionella pneumophila serogroups and other Legionella species by mip gene sequencing.

The virulence factor known as the macrophage infectivity potentiator (mip) is responsible for the intracellular survival of Legionella species. In this study, we investigated the potential of the mip gene sequence to differentiate isolates of different species of Legionella and different serogroups of Legionella pneumophila. We used 35 clinical L.

Hepatocyte growth factor levels in Legionella pneumonia: a retrospective study.

Background: Hepatocyte growth factor (HGF) is known to be involved in the resolution of pulmonary inflammation and repair of acute lung injury. Legionella pneumonia is sometimes complicated by acute lung injury. Our study aimed to determine the role of serum HGF levels in Legionella pneumonia.

Repetitive element-polymerase chain reaction for genotyping of clinical and environmental isolates of Legionella spp.

Genotyping of Legionella strains is important for the epidemiologic survey of Legionnaires' disease infections. In this study, we investigated the potential of repetitive element-polymerase chain reaction (rep-PCR) for differentiating various isolates of Legionella spp. We used 38 Legionella pneumophila isolates (collected in clinics all over Japan between 1980 and 2007), 19 environmental Legionella anisa isolates (collected in Okinawa, Nara, Osaka, and Hyogo prefecture between 1987 and 2007), and 2 Legionella-type strains.

Lung abscess caused by Legionella species: implication of the immune status of hosts.

Legionella pneumonia typically presents as lobar pneumonia with multiple-lobe involvement, but Legionella lung abscess is rare. To identify the predisposing factors for Legionella abscess, we analyzed 62 of the 79 case reports on Legionella abscess found in literature; 28 (45.2%) were of hospital-acquired infection and 28 (45.

Epidemiology of influenza from 2007 to 2008 in naha area, okinawa prefecture: surveillance of rapid antigen test results.

The incidence of influenza in the Naha city area in the southernmost part of Japan was surveyed in 2007 and 2008. Patients who had influenza-like symptoms and visited one of four general hospitals in Naha City, Okinawa, Japan were included in this study. The nasal or throat swab samples were applied to the rapid test for detecting influenza A and B virus antigens.

Characteristics of Legionella pneumophila serogroup 2 strains by colony morphology.

The isolation rate of Legionella pneumophila serogroup 2 from clinical samples is low. In 2007, we encountered the second case known to occur in Japan. As the L.

Legionella pneumonia caused by Legionella pneumophila serogroup 2: second case report in Japan.

A 56-year-old man with a 3-day history of a chilly sensation and general fatigue presented to a hospital in his neighborhood. He was diagnosed as having pneumonia and immediately treated with intravenous ceftriaxone sodium, but his respiratory condition deteriorated and he developed symptoms of restlessness. Although Legionella urinary antigen detection tests were negative, his clinical course suggested Legionella pneumonia.

[A-DROP system might result in underestimation of severity of cases with Legionnaires' disease].

Fifteen cases of legionella pneumonia experienced in our department or associated hospital were included in this study. Each case was classified with the A-DROP system of the Japanese Respiratory Society Guidelines, and guidelines from the Infectious Diseases Society of America (IDSA) (1998) and then we compared the severity of the cases of pneumonia. Although 10 cases were classified as intermediate, 3 as severe, and 2 as extremely severe with the A-DROP system, most cases were classified as severe according to the IDSA guidelines.

Legionella pneumophila infection induces programmed cell death, caspase activation, and release of high-mobility group box 1 protein in A549 alveolar epithelial cells: inhibition by methyl prednisolone.

Background: Legionella pneumophila pneumonia often exacerbates acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Apoptosis of alveolar epithelial cells is considered to play an important role in the pathogenesis of ALI and ARDS. In this study, we investigated the precise mechanism by which A549 alveolar epithelial cells induced by L.

Detection of Legionella pneumophila serogroup 1 antigen in respiratory samples using an immunochromatographic membrane test.

The immunochromatographic membrane test (ICT) efficacy of Legionella antigen detection (Binax Now Legionella) was evaluated using respiratory samples, including bronchial washings (44 cases) and sputum (128 cases), from suspected Legionella pneumonia patients. The ICT results using respiratory samples agreed well with isolation of L. pneumophila SG1 and ICT using urines.

Clinical features of two cases of Legionnaires' disease with persistence of Legionella urinary antigen excretion.

The advantages of diagnosing legionellosis by urinary antigen detection are widely recognized, and include early detection, rapidity of testing, and ease of specimen collection. However, the persistence of Legionella urinary antigen excretion has been suggested in some selected patients, although the clinical features of these patients have not yet been clearly described. Here, we describe the clinical features of two patients with Legionnaires' disease with persistence of Legionella urinary antigen excretion (117 days and 247 days).

Mechanism of formation of the orange-colored sputum in pneumonia caused by Legionella pneumophila.

It has been said that the color of sputum from patients with Legionella pneumophila pneumonia is orange. However, why the color is orange has not been clarified. First, orange-colored sputum obtained from a patient with L.

Comparative evaluation of Duopath Legionella lateral flow assay against the conventional culture method using Legionella pneumophila and Legionella anisa strains.

Duopath Legionella is a new immunochromatographic assay for the identification of Legionella pneumophila and Legionella spp. As excellent specificity has been previously reported for this kit, we attempted an evaluation of its sensitivity using L. pneumophila serogroup 1 and Legionella anisa strains.

Intravenous ciprofloxacin versus erythromycin in the treatment of Legionella pneumonia.

Background: Erythromycin (EM) and rifampicin (RFP) have mainly been used to treat patients with Legionella pneumonia. Since intravenous ciprofloxacin (CPFX) became available in Japan from 2000, many reports have been published detailing successful treatment of Legionella pneumonia with CPFX. In this study, we compared the evolution of patients with Legionella pneumonia treated with CPFX to those treated with EM.

Prospective monitoring study: isolating Legionella pneumophila in a hospital water system located in the obstetrics and gynecology ward after eradication of Legionella anisa and reconstruction of shower units.

We previously reported on the sporadic contamination by Legionella anisa of shower units and sink taps at Ryukyu University Hospital. Starting in July 2003, the neonatal area underwent an 8-month reconstruction, and in March 2005, the boiler system was replaced. We therefore examined shower water and tap water for the presence of Legionella just after replacement of the boiler system.

Influence of temperature on growth of Legionella pneumophila biofilm determined by precise temperature gradient incubator.

Bacterial growth is influenced by several different culture conditions. Temperature is one of an essential component which regulates bacterial growth and their morphology. The influence of temperature on the length of bacteria was investigated in broth and on agar in a temperature range from 30.

[Legionnaires' disease with acute renal failure caused by Legionella pneumophilla serogroup 4].

A 77-year-old man who had fever and chest pain was admitted to a neighboring hospital on a diagnosis of pneumonia. Chest X-ray film finding deteriorated despite treatment with 2 g cefotaxime per day. Because of accompanying acute renal failure, he was transferred to our hospital.

In vitro activity of pazufloxacin, tosufloxacin and other quinolones against Legionella species.

Objectives: The activities of pazufloxacin and tosufloxacin against Legionella spp. were evaluated in vitro and compared with those of other quinolones, macrolides and azithromycin.

Methods: The conventional MICs were determined by the microbroth dilution method.

Whipple's disease: the first Japanese case diagnosed by electron microscopy and polymerase chain reaction.

A 52-year-old man presented with diarrhea and 20 kg weight loss in one year. Enteroscopy showed diffuse yellow-white shaggy mucosa in the duodenum and jejunum. Biopsies of the duodenal mucosa revealed massive infiltration within the lamina propria by foamy macrophages strongly positive for periodic acid-Schiff stain.

In vitro and in vivo activity of olamufloxacin (HSR-903) against Legionella spp.

The activity of the fluoroquinolone olamufloxacin (HSR-903) against Legionella spp. was studied in vitro and in vivo. The olamufloxacin MIC at which 50% of isolates are inhibited (MIC50) for 81 different Legionella spp.