Antimicrobial susceptibility and epidemiological types of Legionella pneumophila human isolates from Italy (1987-2020).

Background: Although antimicrobial resistance has not yet emerged as an overarching problem for Legionella pneumophila (Lp) infection, the description of clinical and environmental strains resistant to fluoroquinolones and macrolides is a cause of concern. This study aimed to investigate the antimicrobial susceptibility of Lp human isolates in Italy.

Methods: A total of 204 Lp clinical isolates were tested for sensitivity to nine antibiotics using the broth microdilution assay (BMD).

Broth microdilution protocol for determining antimicrobial susceptibility of Legionella pneumophila to clinically relevant antimicrobials.

Currently there is no detailed, internationally agreed protocol defined to evaluate antimicrobial susceptibility testing (AST) for Legionella pneumophila (required to establish epidemiological cut-off value or "ECOFF" boundaries); therefore, antimicrobial resistance in these isolates cannot be defined. AST methods utilising media containing activated charcoal as an ingredient, to enable Legionella growth, are unreliable as noted in an internationally authored opinion paper and a new gold standard is required. Here we define a detailed protocol for broth microdilution (BMD) using defined cell culture collection-deposited control reference strains (Philadelphia-1 and Knoxville-1) as well as two accessible reference strains with moderately (lpeAB-carrying) and markedly (23S rRNA mutation-carrying) elevated azithromycin minimum inhibitory concentration (MIC).

Case report: First report of and coinfection in an immunocompromised patient.

Legionnaires' disease (LD) is a serious type of pneumonia, typically contracted by susceptible people through the inhalation of aerosols contaminated with . In this report, the first case of coinfection with - is described. A possible source of the Lp infection may be the hotel in Paris (France) where the patient had stayed before developing the symptoms.

Bilateral Perisylvian Polymicrogyria, Intellectual Disability and Nephronophthisis Associated With Compound Heterozygous Pathogenic Variants in the CEP83 Gene.

The centrosomal protein 83 (CEP83) is a centriolar protein involved in primary cilium assembly, an early and critical step in ciliogenesis. Bi-allelic pathogenic variants in the CEP83 gene have been associated with infantile nephronophthisis and, in a few patients, retinitis pigmentosa. We describe a 5-year-old boy with bilateral perisylvian polymicrogyria, intellectual disability, and nephronophthisis in whom, using exome sequencing, we identified the c.

Double gonosomal mosaicism as an unusual hereditary mechanism in familial -related disorder.

We aim to describe double gonosomal mosaicism in the gene in a mother who passed on two different pathogenic variants at the same nucleotide to her two affected children. We studied a boy with epilepsy and intellectual disability, along with his sister and mother who exhibited language impairment and learning difficulties without epilepsy. We identified in the proband a splice-site variant in (c.

Increasing Detection of Legionnaires' Disease in a Large Italian Hospital in the Period 2016-2023.

The pandemic marked the beginning of an era of dynamic and rapid changes in the diagnosis of respiratory infections. Herein we describe Legionnaires' disease trend in the years 2016-2023 in a large Italian hospital showing how improvements in diagnostic algorithms impact on its detection.

Case series study of nosocomial Legionnaires’ disease in Apulia region (southern Italy): The role of different molecular methods in identifying the infection source.

Background And Aim: Legionnaires' disease is a severe form of pneumonia caused by the inhalation or aspiration of water droplets contaminated with Legionella pneumophila and other Legionella species. These bacteria are commonly found in natural habitats and man-made water systems. Legionnaires' disease is a significant public health problem, especially in healthcare settings where patients may be exposed to contaminated environmental sources.

Case Report: First Report of Fatal and Coinfection in a Kidney Transplant Recipient.

A very rare case of pulmonary coinfection in a double kidney transplanted man affected by the chronic renal disease is described. Cases of Legionnaires' disease with an incubation period of 14 days have rarely been documented. Despite the long period of hospitalization, typing of clinical and environmental strains demonstrated that the patient's home water distribution system was the source of infection, highlighting that house contamination can be a hidden risk, especially for immune-compromised people.

Terpinen-4-ol, the Main Bioactive Component of Tea Tree Oil, as an Innovative Antimicrobial Agent against .

(), responsible for a severe pneumonia called Legionnaires' disease, represents an important health burden in Europe. Prevention and control of contamination in warm water systems is still a great challenge often due to the failure in disinfection procedures. The aim of this study was to evaluate the in vitro activity of Terpinen-4-ol (T-4-ol) as potential agent for control, in comparison with the essential oil of (tea tree) (TTO.

Use of Fourier-Transform Infrared Spectroscopy With IR Biotyper® System for Serogroups Identification.

spp. are Gram-negative bacteria that inhabit freshwater environments representing a serious risk for human health. () is the species most frequently responsible for a severe pneumonia known as Legionnaires' disease.

Antibiotic Susceptibility of Environmental Strains Isolated in Northern Italy.

is ubiquitous in aquatic environments and responsible for severe pneumonia in humans through inhalation of aerosol containing spp. Macrolides and fluoroquinolones are frequently used antimicrobials, but treatment failures are increasingly being reported. As susceptibility testing is not routinely performed, this study aimed to determine the minimum inhibitory concentrations (MICs) on 58 environmental strains (24 of serogroup 1 and 34 of non-serogroup 1) isolated in Northern Italy.

Evaluation of an Environmental Transport Medium for Recovery.

The collection and storage of water-related matrices such as biofilm from collection to processing are critical for the detection of by cultural and molecular tests. SRK™ is a liquid medium that acts both as an antimicrobial neutralizing agent and a transport medium for bacterial culture enumeration and is useful to maintain the stability of the sample from collection to analysis. The aims of this study were to evaluate viability and bacterial nucleic acids' stability in SRK™ medium over time at different storage conditions.

A Legionnaires' Disease Cluster in a Private Building in Italy.

Legionnaires' disease (LD) is a severe pneumonia caused by bacteria belonging to the genus . This is a major public health concern and infections are steadily increasing worldwide. Several sources of infection have been identified, but they have not always been linked to human isolates by molecular match.

: .

In September 2018 in Brescia province, northern Italy, an outbreak of Legionnaires' disease (LD) caused by serogroup 2 () occurred. The 33 cases (two fatal) resided in seven municipalities along the Chiese river. All cases were negative by urinary antigen test (UAT) and most were diagnosed by real-time PCR and serology.

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.

Management of Microbiological Contamination of the Water Network of a Newly Built Hospital Pavilion.

The good installation, as well as commissioning plan, of a water network is a crucial step in reducing the risk of waterborne diseases. The aim of this study was to monitor the microbiological quality of water from a newly built pavilion before it commenced operation. Overall, 91 water samples were tested for coliforms, , enterococci, and at three different times: T0 (without any water treatment), T1 (after treatment with hydrogen peroxide and silver ions at initial concentration of 20 mg/L and after flushing of water for 20 min/day for seven successive days) and T2 (15 days later).

Impact of lockdown on the microbiological status of the hospital water network during COVID-19 pandemic.

The COVID-19 pandemic started in China in early December 2019, and quickly spread around the world. The epidemic gradually started in Italy at the end of February 2020, and by May 31, 2020, 232,664 cases and 33,340 deaths were confirmed. As a result of this pandemic, the Italian Ministerial Decree issued on March 11, 2020, enforced lockdown; therefore, many social, recreational, and cultural centers remained closed for months.

Evaluation of GVPC and BCYE Media for Detection and Enumeration in Water Samples by ISO 11731: Does Plating on BCYE Medium Really Improve Yield?

are the causative agents of Legionnaires' diseases, which is a pneumonia of important public health concern. Ubiquitous freshwater and soil inhabitants can reach man-made water systems and cause illness. enumeration and quantification in water systems is crucial for risk assessment and culture examination is the gold standard method.

Performance of Legiolert Test vs. ISO 11731 to Confirm Contamination in Potable Water Samples.

Detection and enumeration of in water samples is of great importance for risk assessment analysis. The plate culture method is the gold standard, but has received several well-known criticisms, which have induced researchers to develop alternative methods. The purpose of this study was to compare counts obtained by the analysis of potable water samples through the plate culture method and through the IDEXX liquid culture Legiolert method.

Improvement of Legionnaires' disease diagnosis using real-time PCR assay: a retrospective analysis, Italy, 2010 to 2015.

AimTo evaluate real-time PCR as a diagnostic method for Legionnaires' disease (LD). Detection of DNA is among the laboratory criteria of a probable LD case, according to the European Centre for Disease Prevention and Control, although the utility and advantages, as compared to culture, are widely recognised.MethodsTwo independent laboratories, one using an in-house and the other a commercial real-time PCR assay, analysed 354 respiratory samples from 311 patients hospitalised with pneumonia between 2010-15.