Survey on Legionella pneumophila in Water Supply Systems of Qazvin Hospitals

محورهای موضوعی :

Shaghayegh Mousavi ¹ , Mohadesse Choubdar ² , Masoud Panahifard ³ , Fatemeh Fotohi ⁴

1 - Department of Molecular Medicine, Faculty of Medical Sciences, Qazvin University of Medical Sciences, Qazvin, Iran
2 - M.Sc. in Occupational Health Engineering, School of Health, Qazvin University of Medical Science, Qazvin, Iran
3 - Research Committee and Department of Environmental Health Engineering, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
4 - Department of Microbiology, Faculty of Medical Sciences, Qazvin University of Medical Sciences, Qazvin, Iran

تاریخ دریافت : 1398/11/14 تاریخ پذیرش : 1400/11/12 تاریخ انتشار : 1401/09/10

کلید واژه: infection, Hospital, Legionella pneumophila,

چکیده مقاله :

Hospital infections are one of the important causes of hospital mortality and Legionella pneumophila bacteria is considered as one of the common causes of hospital infection. The natural habitat of these bacteria in aquatic environments and can tolerate different environmental conditions in terms of pH, temperature, oxygen content and nutrients. Therefore, this study aimed to identify Legionella pneumophila in aquatic systems of hospital environments. This descriptive cross-sectional study was performed in the summer of 2017 to identify Legionella pneumophila in hot and cold water systems of important and critical parts of Qods and Kosar Hospital. A total of 120 samples were collected, and after filtration, heat treatment, and acidic treatment, all the samples are cultured on BCYE agar enriched with GPVC supplement, and after incubation, the bacterial growth is investigated. Legionella suspected colonies were approved by complementary tests and their assignment to Legionella was confirmed. The water samples were also investigated for temperature, pH, and residual chlorine (using a DPD kit). The frequency of Legionella pneumophila bacteria in water supply systems of Qods Hospital was zero in all hot and cold water showers of NICU, PICU 1, PICU 2, Hematology and Oncology sectors. The frequency of this bacterium was zero in postpartum, childbirth, and women's surgery sectors, but it was positive in the hot and cold water showers of the prenatal sector (8 CFU ml-1 and 8.33 CFU ml-1, respectively) and neonatal sector (4 CFU ml-1 and 4.16 CFU ml-1, respectively). Although Qods and Kosar Hospitals use the treated water of urban distribution network, 24 cases (40%) of contamination were found in water supply systems of Kosar Hospital, and this contamination can be attributed to reasons such as low residual chlorine content, and appropriate temperature range for growth of this bacteria.

منابع و مأخذ:

1. Thornley C., Harte D., Weir R., Allen L., Knightbridge K., Wood P., 2017. Legionella longbeachae detected in an industrial cooling tower linked to a legionellosis outbreak, New Zealand, possible waterborne transmission? Epidemiology & Infection. 145 (11), 2382-2389.


2. Kanatani J.I., Isobe J., Norimoto  S., Kimata  K., Mitsui C., Amemura-Maekawa J., Kura F., Sata T., Watahiki M., 2017. Prevalence of Legionella species isolated from shower water in public bath facilities in Toyama Prefecture, Japan. Journal of Infection and Chemotherapy. 23(5), 265-270.


3. Sánchez-Busó L., Guiral ., Crespi S., Moya V., Camaró M L., Olmos M.P., Adrián F., Morera V., González-Morán, F.,Vanaclocha H., 2016. Genomic investigation of a legionellosis outbreak in a persistently colonized hotel. Frontiers in Microbiology. 6, 1556.


4. Marchesi I., Ferranti G., Mansi A., Marcelloni A M., Proietto A. R., Saini N., Borella P., Bargellini A., 2016. Control of Legionella contamination and risk of corrosion in hospital water networks following various disinfection procedures. Appl Environ Microbiol. 82(10), 2959-2965.


5. Cunha B.A., Burillo A., Bouza E., 2016. Legionnaires' disease. The Lancet. 387(10016), 376-385.


6. Kyritsi M.A., Mouchtouri V.A., Katsioulis A., Kostara E., Nakoulas V., Hatzinikou M., Hadjichristodoulou C., 2018. Legionella Colonization of Hotel Water Systems in Touristic Places of Greece: Association with System Characteristics and Physicochemical Parameters. International Journal of Environmental Research and Public Health. 15(12), 2707.


7. Richardson K., Grigoryeva L., Corsini P., White R., Shaw R., Portlock T., Dorgan B., Fornili A., Cianciotto N., Garnett J., 2019. Structure and functional analysis of the Legionella chitinase ChiA reveals a novel mechanism of metal-dependent mucin degradation. BioRxiv, 687871.


8. Lévesque S., Lalancette C., Bernard K., Pacheco A. L., Dion R., Longtin J., Tremblay C., 2016. Molecular Typing of Legionella pneumophila Isolates in the Province of Quebec from 2005 to 2015. PloS One. 11(10), e0163818.


9. Springston J. P., Yocavitch L., 2017. Existence and control of Legionella bacteria in building water systems: A review. Journal of Occupational and Environmental Hygiene. 14(2), 124-134.


10. Khaledi A., Bahrami A., Nabizadeh E., Amini Y., Esmaeili D., 2018. Prevalence of Legionella species in water resources of Iran: a systematic review and meta-analysis. Iranian Journal of Medical Sciences. 43(6), 571.


11. Panahifard M., Mahvi A., Asgari A., Nazemi S., Moradnia M., 2017. A Survey on drinking water quality in qazvin in 2015. Journal of Rafsanjan University of Medical Sciences. 16(1), 3-16.


12. Danila R.N., Koranteng N., Como-Sabetti K.J., Robinson T.J., Laine E.S., 2018. Hospital water management programs for Legionella prevention, Minnesota, 2017. Infection Control & Hospital Epidemiology. 39(3), 336-338.


13. Feazel L.M., Baumgartner L.K., Peterson K.L.; Frank D.N.; Harris J.K.; Pace N.R., 2009. Opportunistic pathogens enriched in showerhead biofilms. Proceedings of the National Academy of Sciences. 106(38), 16393-16399.


14. Bentham R., 1993. Environmental factors affecting the colonization of cooling towers by Legionella spp. in South Australia. International Biodeterioration & Biodegradation. 31(1), 55-63.


15. Yong S.F.Y., Goh F.N., Ngeow Y.F., 2010. Legionella species and serogroups in Malaysian water cooling towers: identification by latex agglutination and PCR-DNA sequencing of isolates. Journal of Water and Health. 8(1), 92-100.


16. Moghadam M.A.J., Honarmand H., Meshginshahr S.A., 2016. Contamination of tap water with Pseudomonas aeruginosa, Legionella pneumophila, and Escherichia coli in Guilan, Iran. Journal of Medical Bacteriology. 21-28.


17. Eslami A., Momayyezi M., Esmaili D., Joshani G., 2012.Presence of Legionella pneumophila and environmental factors affecting its growth, in the water distribution system in Taleghani hospital, Tehran. Pajoohande. 17(1), 32-37.


18. Ghanizadeh G., Mirmohammadlou A., Esmaeili D., 2016. Survey of legionella water resources contamination in Iran and foreign countries: A Systematic Review. Iranian Journal of Medical Microbiology. 9(4), 1-15.