<it>Legionella </it>spp. and legionellosis in southeastern Italy: disease epidemiology and environmental surveillance in community and health care facilities
<p>Abstract</p> <p>Background</p> <p>Following the publication of the Italian Guidelines for the control and prevention of legionellosis an environmental and clinical surveillance has been carried out in Southeastern Italy. The aim of the study is to identify the risk f...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2010-11-01
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| Series: | BMC Public Health |
| Online Access: | http://www.biomedcentral.com/1471-2458/10/660 |
| _version_ | 1819181960938913792 |
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| author | Barbuti Giovanna Iatta Roberta Fasano Fabrizio Napoli Christian Cuna Teresa Montagna Maria |
| author_facet | Barbuti Giovanna Iatta Roberta Fasano Fabrizio Napoli Christian Cuna Teresa Montagna Maria |
| author_sort | Barbuti Giovanna |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Following the publication of the Italian Guidelines for the control and prevention of legionellosis an environmental and clinical surveillance has been carried out in Southeastern Italy. The aim of the study is to identify the risk factors for the disease, so allowing better programming of the necessary prevention measures.</p> <p>Methods</p> <p>During the period January 2000 - December 2009 the environmental surveillance was carried out by water sampling of 129 health care facilities (73 public and 56 private hospitals) and 533 buildings within the community (63 private apartments, 305 hotels, 19 offices, 4 churches, 116 gyms, 3 swimming pools and 23 schools). Water sampling and microbiological analysis were carried out following the Italian Guidelines. From January 2005, all facilities were subject to risk analysis through the use of a standardized report; the results were classified as <it>good </it>(G), <it>medium </it>(M) and <it>bad </it>(B). As well, all the clinical surveillance forms for legionellosis, which must be compiled by physicians and sent to the Regional Centre for Epidemiology (OER), were analyzed.</p> <p>Results</p> <p><it>Legionella </it>spp. was found in 102 (79.1%) health care facilities and in 238 (44.7%) community buildings. The percentages for the contamination levels < 1,000, 1,000-10,000, > 10,000 cfu/L were respectively 33.1%, 53.4% and 13.5% for samples from health care facilities and 33.5%, 43.3% and 23.2% for samples from the community. Both in hospital and community environments, <it>Legionella pneumophila </it>serogroup (<it>L. pn </it>sg) 2-14 was the most frequently isolate (respectively 54.8% and 40.8% of positive samples), followed by <it>L. pn </it>sg 1 (respectively 31.3% and 33%). The study showed a significant association between M or B score at the risk analysis and <it>Legionella </it>spp. positive microbiological test results (p < 0.001). From clinical surveillance, during the period January 2001 - August 2009, 97 cases of legionellosis were reported to the OER: 88 of community origin and 9 nosocomial. The most frequent symptoms were: fever (93.8%), cough (70.1%), dyspnea (58.8%), shivering (56.7%). Radiological evidence of pneumonia was reported in 68%. The laboratory diagnostic methods used were: urinary antigen (54.3%), single antibody titer (19.8%), only seroconversion (11.1%), other diagnostic methods (14.8%).</p> <p>Conclusions</p> <p>Our experience suggests that risk analysis and environmental microbiological surveillance should be carried out more frequently to control the environmental spread of <it>Legionella </it>spp. Furthermore, the laboratory diagnosis of legionellosis cannot be excluded only on the basis of a single negative test: some patients were positive to only one of the diagnostic tests.</p> |
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| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-22T22:38:32Z |
| publishDate | 2010-11-01 |
| publisher | BMC |
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| series | BMC Public Health |
| spelling | doaj.art-b1bb792983cd4ce6b18e751c1a38a9c82022-12-21T18:10:15ZengBMCBMC Public Health1471-24582010-11-0110166010.1186/1471-2458-10-660<it>Legionella </it>spp. and legionellosis in southeastern Italy: disease epidemiology and environmental surveillance in community and health care facilitiesBarbuti GiovannaIatta RobertaFasano FabrizioNapoli ChristianCuna TeresaMontagna Maria<p>Abstract</p> <p>Background</p> <p>Following the publication of the Italian Guidelines for the control and prevention of legionellosis an environmental and clinical surveillance has been carried out in Southeastern Italy. The aim of the study is to identify the risk factors for the disease, so allowing better programming of the necessary prevention measures.</p> <p>Methods</p> <p>During the period January 2000 - December 2009 the environmental surveillance was carried out by water sampling of 129 health care facilities (73 public and 56 private hospitals) and 533 buildings within the community (63 private apartments, 305 hotels, 19 offices, 4 churches, 116 gyms, 3 swimming pools and 23 schools). Water sampling and microbiological analysis were carried out following the Italian Guidelines. From January 2005, all facilities were subject to risk analysis through the use of a standardized report; the results were classified as <it>good </it>(G), <it>medium </it>(M) and <it>bad </it>(B). As well, all the clinical surveillance forms for legionellosis, which must be compiled by physicians and sent to the Regional Centre for Epidemiology (OER), were analyzed.</p> <p>Results</p> <p><it>Legionella </it>spp. was found in 102 (79.1%) health care facilities and in 238 (44.7%) community buildings. The percentages for the contamination levels < 1,000, 1,000-10,000, > 10,000 cfu/L were respectively 33.1%, 53.4% and 13.5% for samples from health care facilities and 33.5%, 43.3% and 23.2% for samples from the community. Both in hospital and community environments, <it>Legionella pneumophila </it>serogroup (<it>L. pn </it>sg) 2-14 was the most frequently isolate (respectively 54.8% and 40.8% of positive samples), followed by <it>L. pn </it>sg 1 (respectively 31.3% and 33%). The study showed a significant association between M or B score at the risk analysis and <it>Legionella </it>spp. positive microbiological test results (p < 0.001). From clinical surveillance, during the period January 2001 - August 2009, 97 cases of legionellosis were reported to the OER: 88 of community origin and 9 nosocomial. The most frequent symptoms were: fever (93.8%), cough (70.1%), dyspnea (58.8%), shivering (56.7%). Radiological evidence of pneumonia was reported in 68%. The laboratory diagnostic methods used were: urinary antigen (54.3%), single antibody titer (19.8%), only seroconversion (11.1%), other diagnostic methods (14.8%).</p> <p>Conclusions</p> <p>Our experience suggests that risk analysis and environmental microbiological surveillance should be carried out more frequently to control the environmental spread of <it>Legionella </it>spp. Furthermore, the laboratory diagnosis of legionellosis cannot be excluded only on the basis of a single negative test: some patients were positive to only one of the diagnostic tests.</p>http://www.biomedcentral.com/1471-2458/10/660 |
| spellingShingle | Barbuti Giovanna Iatta Roberta Fasano Fabrizio Napoli Christian Cuna Teresa Montagna Maria <it>Legionella </it>spp. and legionellosis in southeastern Italy: disease epidemiology and environmental surveillance in community and health care facilities BMC Public Health |
| title | <it>Legionella </it>spp. and legionellosis in southeastern Italy: disease epidemiology and environmental surveillance in community and health care facilities |
| title_full | <it>Legionella </it>spp. and legionellosis in southeastern Italy: disease epidemiology and environmental surveillance in community and health care facilities |
| title_fullStr | <it>Legionella </it>spp. and legionellosis in southeastern Italy: disease epidemiology and environmental surveillance in community and health care facilities |
| title_full_unstemmed | <it>Legionella </it>spp. and legionellosis in southeastern Italy: disease epidemiology and environmental surveillance in community and health care facilities |
| title_short | <it>Legionella </it>spp. and legionellosis in southeastern Italy: disease epidemiology and environmental surveillance in community and health care facilities |
| title_sort | it legionella it spp and legionellosis in southeastern italy disease epidemiology and environmental surveillance in community and health care facilities |
| url | http://www.biomedcentral.com/1471-2458/10/660 |
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