The Contribution of Legionella anisa to Legionella Contamination of Water in the Built Environment
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Overview of Data Sets Provided for Analysis and Limitations of the Data Obtained
3.2. Legionella Data Set 1
3.3. Legionella Data Set 2
3.4. Legionella Data Set 3
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Parameter | Summary | References |
---|---|---|
L. anisa as a colonizer of water distribution systems | After L. pneumophila, L. anisa is the species most frequently detected in the environment, including from both hot water systems and cooling-tower systems | [14,21,22,23,24,25,26,27,28,29] |
Case reports of colonization of cooling towers, hotel decorative fountain, and restaurant water feature | [5,6,30,31] | |
Colonization in cooling towers associated with protozoan Acanthamoeba | [5,32] | |
9/20 (45%) hospital water systems in 14 US states colonized with L. anisa—sample positivity rate of 57/674 (8.5%) | [33] | |
29/108 (27%) electronic tap-water samples are L. anisa-positive compared to 25/108 (23%) L. pneumophila-positive (USA) | [34] | |
Japanese studies >40% samples from public buildings contaminated with L. pneumophila and L. anisa; L. anisa persisted in hospital water for at least 6 years, causing sporadic contamination of shower heads | [25,35] | |
Frequency of environmental detection of L. anisa | 13.8% of environmental water sample isolates, but only 0.8% of clinical isolates | [21] |
10/8066 (<0.1%) confirmed clinical cases of legionellosis in New Zealand, Australia, Europe, USA, and Japan attributable to L. anisa | [9] | |
In 508 community-acquired pneumonia cases, 0.2% cases were attributable to L. anisa, and 91.5% to L. pneumophila | [17] | |
Non-pneumonic conditions attributable to L. anisa infection | Chronic endocarditis, pleural infection, osteomyelitis, and mycotic aortic aneurysm | [11,36,37,38] |
Clinical testing for L. anisa by urinary antigen tests (UATs) | UAT-sensitive and -specific but target L. pneumophila Sg1, possibly missing up to 40% of cases, and limited for matching environmental samples | [2,9,33,39,40,41] |
Clinical testing for L. anisa by polymerase chain reaction (PCR) | >80% LD cases in Denmark diagnosed by PCR—likely to increase detection in non-Sg1 cases; thus, non-L. pneumophila species found to cause at least 4.5% of all LD cases | [22,42] |
Spanish study of 210 urine samples from suspected pneumonia, and only 4 (1.9%) tested positive for Sg1 by UAT, while by PCR, these 4 tested positive for Sg1 plus 10 more positive for unidentifiable Legionella species and 1 positive for L. anisa | [8] | |
In a Colombian study of HIV-associated pneumonia patients, 17 had Legionella co-infection—all culture negative, but 6/17 PCR positive for L. anisa and 3/17 for L. pneumophila | [43] |
Post-Cleaning Sample | Grand Total | |||||
---|---|---|---|---|---|---|
Anisa | Pneumophila | Other | ND | |||
Pre-Cleaning Sample | Anisa | 18 | 6 | 3 | 34 | 61 |
Pneumophila | 8 | 54 | 4 | 15 | 81 | |
Other | 6 | 6 | 4 | 9 | 25 | |
None Detected | 6 | 5 | 1 | 103 | 116 | |
Grand Total | 38 | 71 | 12 | 162 | 283 |
Date | Pre-Cleaning Sample Colonies | Post-Cleaning Sample Colonies | ||||||
---|---|---|---|---|---|---|---|---|
Anisa | Pneumophila | Other | Total | Anisa | Pneumophila | Other | Total | |
Jan 2020 | 40 | 1520 | 0 | 1560 | ||||
Feb 2020 | 12,920 | 80 | 1268 | 14,268 | ||||
Mar 2020 | 5820 | 360 | 2400 | 8580 | ||||
May 2020 | 2920 | 2120 | 1460 | 6500 | ||||
Jun 2020 | 4762 | 7630 | 0 | 12,392 | 3081 | 1540 | 0 | 4621 |
Jul 2020 | 3180 | 460 | 6400 | 10,040 | 3340 | 0 | 180 | 3520 |
Nov 2020 | 11,080 | 25,080 | 4200 | 40,360 | 1260 | 10,820 | 1400 | 13,480 |
Dec 2020 | 2520 | 8280 | 0 | 10,800 | 120 | 3180 | 0 | 3300 |
Feb 2021 | 2821 | 26,496 | 0 | 29,317 | 408 | 19,635 | 4400 | 24,443 |
Mar 2021 | 11,673 | 50,127 | 2120 | 63,920 | 8937 | 37,380 | 0 | 46,317 |
Apr 2021 | 28,875 | 39,480 | 17,260 | 85,615 | 940 | 11,540 | 3860 | 16,340 |
May 2021 | 3400 | 111,440 | 0 | 114,840 | 0 | 20,880 | 200 | 21,080 |
Jun 2021 | 6680 | 53,540 | 9700 | 69,920 | 11,460 | 15,240 | 3160 | 29,860 |
Total | 74,991 | 322,533 | 39,680 | 437,204 | 51,246 | 124,295 | 18,328 | 193,869 |
Species Detected | Count | (Proportion) |
---|---|---|
Legionella pneumophila | 17,617 | (29.3%) |
Legionella anisa | 32,517 | (54.1%) |
Legionella species | 4162 | (6.9%) |
Other | 1992 | (3.3%) |
Blank (no species identified) | 3787 | (6.3%) |
Total | 60,075 |
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Crook, B.; Young, C.; Rideout, C.; Smith, D. The Contribution of Legionella anisa to Legionella Contamination of Water in the Built Environment. Int. J. Environ. Res. Public Health 2024, 21, 1101. https://doi.org/10.3390/ijerph21081101
Crook B, Young C, Rideout C, Smith D. The Contribution of Legionella anisa to Legionella Contamination of Water in the Built Environment. International Journal of Environmental Research and Public Health. 2024; 21(8):1101. https://doi.org/10.3390/ijerph21081101
Chicago/Turabian StyleCrook, Brian, Charlotte Young, Ceri Rideout, and Duncan Smith. 2024. "The Contribution of Legionella anisa to Legionella Contamination of Water in the Built Environment" International Journal of Environmental Research and Public Health 21, no. 8: 1101. https://doi.org/10.3390/ijerph21081101