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Chapter 34 : 10 Years of Legionella Surveillance: Change of Legionella Subtype Preceded Epidemic of Nosocomial Legionnaires’ Disease
10 Years of Legionella Surveillance: Change of Legionella Subtype Preceded Epidemic of Nosocomial Legionnaires’ Disease, Page 1 of 2< Previous page Next page > /docserver/preview/fulltext/10.1128/9781555815660/9781555813901_Chap34-1.gif /docserver/preview/fulltext/10.1128/9781555815660/9781555813901_Chap34-2.gif
This chapter evaluates the changing patterns of strains causing nosocomial Legionella infections (nLD) from a university hospital water system during a decade of active surveillance. All bronchoalveolar lavage specimens were routinely screened for Legionella. Bronchial secretions and urine probes from patients with suspicious atypical pneumonia were processed by routine culture methods. Isolates of Legionella spp. from patients and available corresponding environmental ones were genotyped using an AFLP technique previously described by EWGLI and further subtyped by monoclonal antibody analysis. Legionella-positive clinical specimens were reported to the infection control team, and every case was carefully followed up. Detection of Legionella was defined as nLD if the patient was admitted to the university hospital at least 10 days before and no other source of infection could be observed. Currently, the majority of Legionella infections in Germany are detected by a urine antigen test, and consequently the utilization rate of culture methods to detect Legionella has decreased over the past years to 11% in 2004, but only the latter method allows comparison of patient isolates with the ones isolated from the water system.