Palavras-chave
L. pneumophila
sorogrupos
cultura bacteriológica
água sanitária
Como Citar
Resumo
A Legionella é a bactéria causadora da legionelose e constitui um importante problema de saúde pública. O objetivo deste estudo é estabelecer a distribuição e frequência das diferentes espécies e sorogrupos de Legionella obtidos das amostras analisadas no Laboratório de Saúde Pública de L’Hospitalet durante o período 2002-2019. Foram analisadas 3 935 amostras de água de instalações com probabilidade de proliferação e dispersão de Legionella, segundo o método ISO 11731:1998. O número e a porcentagem de Legionella spp., L. pneumophila sorogrupo Sg 1 e L. pneumophila Sg 2-14 foram determinados por tipo de instalação e por ano. Os resultados indicam que as instalações com maior presença de Legionella são as que integram sistemas de água quente sanitária (AQS, 36.4 %). Os sistemas de água sanitária fria (SAF) também devem ser considerados locais propícios ao crescimento da Legionella (17 %), juntamente com os sistemas de irrigação por aspersão (13.5%). De todas as amostras positivas encontradas nas unidades (21.5 %), a L. pneumophila é a mais isolada nas culturas (70.5 %) e o sorogrupo mais encontrado é o 2-14 (34.2 %), seguido do Sg 1 (26.4 %). Isso é contrário ao encontrado na maioria dos estudos publicados, pois citam o Sg 1 como o mais frequente em amostras ambientais. Esses aspectos sustentariam a necessidade de ampliar o espectro diagnóstico da doença nos pacientes, uma vez que a maioria dos hospitais utiliza antígeno na urina, cuja principal limitação é detectar apenas L. pneumophila Sg 1.
Referências
Burillo A, Pedro-Botet ML, Bouza E. Microbiology and Epidemiology of Legionnaire’s Disease. Infect. Dis. Clin. North Am 2017; 31:7–27.
Gomez-Valero L et al. More than 18,000 effectors in the Legionella genus genome provide multiple, independent combinations for replication in human cells. Proc. Natl. Acad. Sci. U. S. A. 2019; 116:2265–73.
Llewellyn A et al. Distribution of Legionella and bacterial community composition among regionally diverse US cooling towers. PLoS One 12, e0189937 (2017).
Palmer A et al. Legionella clemsonensis sp. nov.: a green fluorescing Legionella strain from a patient with pneumonia. Microbiol. Immunol. 2016; 60:694–701.
Hookey JV, Saunders NA, Fry NK., Birtles RJ, Harrison TG. Phylogeny of Legionellaceae based on small-subunit ribosomal DNA sequences and proposal of Legionella lytica comb. nov. for Legionella-like amoebal pathogens. Int. J. Syst. Bacteriol. 1996; 46:526–31.
Graells T. Estudi epidemiològic i dels patrons antimicrobians del bacteri intracel·lular facultatiu Legionella a l’ambient. TDX (Tesis Doctorals en Xarxa) (Universitat Autònoma de Barcelona, 2018).
Kozak-Muiznieks NA et al. Prevalence of sequence types among clinical and environmental isolates of Legionella pneumophila serogroup 1 in the United States from 1982 to 2012. J. Clin. Microbiol.2014; 52:201–11.
Checa J, Carbonell S, Manero N, Martí I. Comparative study of Legiolert with ISO 11731-1998 Standard method-Conclusions from a Public Health Laboratory. J. Microbiol. Methods. 2020; 186:106242.
Cattan S et al. Legionella spp: An update. Revue de Medecine Interne. 2019; 40:791–8.
Eisenreich W, Heuner K. The life stage-specific pathometabolism of Legionella pneumophila. FEBS Lett. 2016; 590:3868–86.
Garrity GM, Brown A, Vickers RM. Tatlockia and Fluoribacter: Two new genera of organisms resembling Legionella pneumophila. Int. J. Syst. Bacteriol. 1980; 30:609–14.
McKinney RM et al. Legionella longbeachae species nova, another etiologic agent of human pneumonia. Ann. Intern. Med. 1981; 94:739–43.
Phin N et al. Epidemiology and clinical management of Legionnaires’ disease. Lancet Infect. Dis. 2014; 14:1011–21.
Beauté J. Legionnaires’ disease in Europe, 2011 to 2015. Eurosurveillance 22, (2017).
Mcdade JE et al. Legionnaires’ Disease: Isolation of a Bacterium and Demonstration of Its Role in Other Respiratory Disease N. Engl. J. Med. 1997; 297:1197–203.
Fraser DW et al. Legionnaires’ Disease: Description of an Epidemic of Pneumonia. N. Engl. J. Med. 1977; 297:1189–97.
Legionella Species - Special Pathogens Laboratory. Disponible en: https://specialpathogenslab.com/legionella-species/.
Health A.GD. of. Australia’s notifiable disease status, 2014: Annual report of the National Notifiable Diseases Surveillance System: Part 1. Commun. Dis. Intell. Q. Rep. 40, (2016).
Dooling KL et al. Active bacterial core surveillance for legionellosis - United States, 2011-2013. Morb. Mortal. Wkly. Rep.2015; 64:1190–3.
ECDC. Legionnaires’ disease Annual epidemiological report for 2017. Eur. Cent. Dis. Prev. Control 7 (2019).
World Health Organization. Legionellosis. Newsroom, Fact sheet, Detail. 2018. Disponible en: https://www.who.int/news-room/fact-sheets/detail/legionellosis.
Departament de Sanitat i Seguretat Social. Guia per a la prevenció i el control de la legionel·losi. (2002).
Garcia-Nuñez M et al. Characterization of unrelated clinical Legionella pneumophila isolates in Catalonia by monoclonal subgrouping and sequence-based typing. Future Microbiol. 2016; 11:865–75.
España. Real Decreto 865/2003, de 4 de julio, por el que se establecen los criterios higiénico-sanitarios para la prevención y control de la legionelosis. Boletión Oficial del Estado, 4 de julio de 2003, núm. 171, pp. 28055 a 28069.
España. Guía técnica para la Prevención y Control de la Legionelosis en instalaciones. Ministerio de Sanidad, Consumo y Bienestar Social. (2005).
Asociación Española de Normalización, 2017. Norma Española UNE 100030:2017. Prevencion y control de la proliferación y diseminación de Legionella en instalaciones. AENOR Internacional, Madrid.
España. Decreto 352/2004, de 27 de julio, por el que se establecen las condiciones higienico-sanitarias para la prevencion y el control de la legionelosis. Diari Oficial de la Generalitat de Catalunya, 27 de julio de 2004, nú. 4185, pp. 14726 a 14732.
Del Hoyo R, Manero N. Programa de control de torres de refrigeración y condensadores evaporativos en el municipio de L’Hospitalet para la prevención de la legionelosis. Rev. Salud Ambient. 5, 11 (2005).
España. Real Dereto 742/2013, de 27 de septiembre, por el que se establecen los criterios técnico-sanitarios de las piscinas. Boletín oficial del Estado, 11 de octubre de 2013, nú. 244, pp. 83123 a 83135.
Asociación Española de Normalización, 1998. Norma Española UNE ISO 11731, 1998. Calidad del Agua-Detección y enumeración de Legionella. AENOR Internacional, Madrid.
Wéry N et al. Dynamics of Legionella spp. and bacterial populations during the proliferation of L. pneumophila in a cooling tower facility. Appl. Environ. Microbiol. 2008; 74:3030-7.
Pereira RPA, Peplies J, Höfle MG, Brettar I. Bacterial community dynamics in a cooling tower with emphasis on pathogenic bacteria and Legionella species using universal and genus-specific deep sequencing. Water Res.2017; 122:363–76.
Paranjape K et al. Presence of Legionella spp. in cooling towers: the role of microbial diversity, Pseudomonas, and continuous chlorine application. Water Res. 2020; 169:115252.
Abdalla AI, Saidan MN, Alami N Al, Al-Naimat H. Comparative assessment of Legionella pneumophila prevalence among hospitals and hotels water systems. Desalin. Water Treat. 193, 432–41 (2020).
Sepin Özen N, Tuğlu Ataman Ş, Emek M. Exploring the Legionella pneumophila positivity rate in hotel water samples from Antalya, Turkey. Environ. Sci. Pollut. Res. 2017 2413 24, 12238–42 (2017).
Bonadonna L et al. Microbial characterization of water and biofilms in drinking water distribution systems at sport facilities. Cent. Eur. J. Public Health. 2009; 17:99–102.
Napoli C et al. Legionella spp. and legionellosis in southeastern Italy: Disease epidemiology and environmental surveillance in community and health care facilities. BMC Public Health. 2010; 10:660.
De Filippis P et al. Occurrence of Legionella in showers at recreational facilities. J. Water Health. 2017; 15:402–9.
Declerck P et al. Replication of Legionella pneumophila in biofilms of water distribution pipes. Microbiol. Res. 2009;164:593–603.
Borella P. et al. Legionella contamination in hot water of Italian hotels. Appl. Environ. Microbiol. 2005; 71:5805–13.
Leoni E et al. Legionella waterline colonization: Detection of Legionella species in domestic, hotel and hospital hot water systems. J. Appl. Microbiol. 2005; 98:373–9.
Ciesielski CA, Blaser MJ, Wang WLL. Role of stagnation and obstruction of water flow in isolation of Legionella pneumophila from hospital plumbing. Appl. Environ. Microbiol. 1984; 48:984–7.
Lipphaus P. et al. Microbiological tap water profile of a medium-sized building and effect of water stagnation. Environ. Technol. 2014; 35:620–8.
Valero N et al. Street Cleaning Trucks as Potential Sources of Legionella pneumophila. Emerg. Infect. Dis. 2017; 23:1880–2.
Haupt TE et al. An Outbreak of Legionnaires Disease Associated with a Decorative Water Wall Fountain in a Hospital. Infect. Control Hosp. Epidemiol. 2012; 33:185–91.
Barrabeig I et al. Outbreak of Legionnaires’ disease associated with a supermarket mist machine. Epidemiol. Infect. 2010; 138:1823-8.
Euser SM et al. Legionnaires’ disease associated with a car wash installation. Lancet. 2013; 382:2114.
García-Fulgueiras A. et al. Legionnaires’ Disease Outbreak in Murcia, Spain. Emerg. Infect. Dis. 2003; 9:915.
Parrilla F, Chacón S, Pérez A. Estudio de las torres de refrigeración asociadas a brotes comunitarios de legionelosis. Gac. Sanit.2007; 21:357–60.
Sabria M et al. A community outbreak of Legionnaires’ disease: evidence of a cooling tower as the source. Clin. Microbiol. Infect. 2006; 12:642–7.
Legionnaires’ disease - Annual Epidemiological Report for 2017. Disponible en: https://www.ecdc.europa.eu/en/publications-data/legionnaires-disease-annual-epidemiological-report-2017(2017).
Vaqué Rafart J, Martínez Gómez X. Epidemiología de la legionelosis. Med. Clin. (Barc). 2002; 119:14–24.
Currie SL, Beattie TK. Compost and Legionella longbeachae: An emerging infection? Perspect. Public Health. 2015; 135:309–15.
Amodeo MR, Murdoch DR, Pithie AD. Legionnaires’ disease caused by Legionella longbeachae and Legionella pneumophila: comparison of clinical features, host-related risk factors, and outcomes. Clin. Microbiol. Infect. 2010; 16:1405–7.
Kenagy E et al. Risk factors for Legionella longbeachae Legionnaires’ disease, New Zealand. Emerg. Infect. Dis. 2017; 23:1148–54.
Whiley H, Bentham R. Legionella longbeachae and legionellosis. Emerg. Infect. Dis. 2011; 17:579–83.
Álvarez Merchán E, Fernández Gallego JM, Montero Rubio JC. Verificación de un método alternativo de detección y cuantificación de Legionella spp. en un laboratorio de salud
pública: separación inmunomagnética (SIM) e identificación mediante reacción colorimétrica. Rev. Salud Ambient. ISSN-e1697-2791, Vol. 21, No. 1, 2021 (Ejemplar Dedic. a Salud y bienestar en el entorno construido una Perspect. Integr. págs. 4-15 21, 4–15 (2021).
Van Kenhove E, Dinne K, Janssens A, Laverge J. Overview and comparison of Legionella reGulations worldwide. Am. J. Infect. Control.2019; 47:968-78.
Directive (EU) 2020/2184 of the European Parliament and of the Council on the quality of water intended for human consumption. OJ L 435, 1–62 (2020).
Ito A et al. Evaluation of a novel urinary antigen test kit for diagnosing Legionella pneumonia. Int. J. Infect. Dis. 2021; 103:42–7.
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