Cluster of legionnaires’ disease in an Italian prison

Teresa Maria Assunta Fasciana, Paola Di Carlo, Anna Giammanco, Cinzia Cala', Giuseppina Capra, Cinzia Calà, Chiara Mascarella, Mario Palermo, Angela Rampulla, Giuseppina Capra, Anna Giammanco, Salvatore Antonino Distefano, Salvatore Antonino Distefano

Research output: Contribution to journalArticle

Abstract

Background: Legionella pneumophila (Lp) is the most common etiologic agent causing Legionnaires’ Disease (LD). Water systems offer the best growth conditions for Lp and support its spread by producing aerosols. From 2015 to 2017, the Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis of Palermo monitored the presence of Lp in nine prisons in Western Sicily. During this investigation, we compared Lp isolates from environmental samples in a prison located in Palermo with isolates from two prisoners in the same prison. Methods: We collected 93 water samples from nine Sicilian prisons and the bronchoalveolar lavages (BALs) of two prisoners considered cases of LD. These samples were processed following the procedures described in the Italian Guidelines for the Prevention and Control of Legionellosis of 2015. Then, genotyping was performed on 19 Lp colonies (17 from water samples and 2 from clinical samples) using the Sequence-Based Typing (SBT) method, according to European Study Group for Legionella Infections (ESGLI) protocols. Results: Lp serogroup (sg) 6 was the most prevalent serogroup isolated from the prisons analyzed (40%), followed by Lp sg 1 (16%). Most of all, in four penitentiary institutions, we detected a high concentration of Lp >104 Colony Forming Unit/Liter (CFU/L). The environmental molecular investigation found the following Sequence Types (STs) in Lp sg 6: ST 93, ST 292, ST 461, ST 728, ST 1317 and ST 1362, while most of the isolates in sg 1 belonged to ST 1. We also found a new ST that has since been assigned the number 2451 in the ESGLI-SBT database. From the several Lp sg 1 colonies isolated from the two BALs, we identified ST 2451. Conclusions: In this article, we described the results obtained from environmental and epidemiological investigations of Lp isolated from prisons in Western Sicily. Furthermore, we reported the first cluster of Legionnaires’ in an Italian prison and the molecular typing of Lp sg 1 from one prison’s water system and two BALs, identified the source of the contamination, and discovered a new ST.
Original languageEnglish
Pages (from-to)2062-
Number of pages7
JournalInternational Journal of Environmental Research and Public Health
Volume16
Publication statusPublished - 2019

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Legionnaires' Disease
Legionella pneumophila
Prisons
Bronchoalveolar Lavage
Legionellosis
Sicily
Legionella
Prisoners
Water
Molecular Typing
Environmental Monitoring
Infection
Serogroup
Aerosols

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

Cite this

Cluster of legionnaires’ disease in an Italian prison. / Fasciana, Teresa Maria Assunta; Di Carlo, Paola; Giammanco, Anna; Cala', Cinzia; Capra, Giuseppina; Calà, Cinzia; Mascarella, Chiara; Palermo, Mario; Rampulla, Angela; Capra, Giuseppina; Giammanco, Anna; Distefano, Salvatore Antonino; Distefano, Salvatore Antonino.

In: International Journal of Environmental Research and Public Health, Vol. 16, 2019, p. 2062-.

Research output: Contribution to journalArticle

Fasciana, TMA, Di Carlo, P, Giammanco, A, Cala', C, Capra, G, Calà, C, Mascarella, C, Palermo, M, Rampulla, A, Capra, G, Giammanco, A, Distefano, SA & Distefano, SA 2019, 'Cluster of legionnaires’ disease in an Italian prison', International Journal of Environmental Research and Public Health, vol. 16, pp. 2062-.
Fasciana, Teresa Maria Assunta ; Di Carlo, Paola ; Giammanco, Anna ; Cala', Cinzia ; Capra, Giuseppina ; Calà, Cinzia ; Mascarella, Chiara ; Palermo, Mario ; Rampulla, Angela ; Capra, Giuseppina ; Giammanco, Anna ; Distefano, Salvatore Antonino ; Distefano, Salvatore Antonino. / Cluster of legionnaires’ disease in an Italian prison. In: International Journal of Environmental Research and Public Health. 2019 ; Vol. 16. pp. 2062-.
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abstract = "Background: Legionella pneumophila (Lp) is the most common etiologic agent causing Legionnaires’ Disease (LD). Water systems offer the best growth conditions for Lp and support its spread by producing aerosols. From 2015 to 2017, the Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis of Palermo monitored the presence of Lp in nine prisons in Western Sicily. During this investigation, we compared Lp isolates from environmental samples in a prison located in Palermo with isolates from two prisoners in the same prison. Methods: We collected 93 water samples from nine Sicilian prisons and the bronchoalveolar lavages (BALs) of two prisoners considered cases of LD. These samples were processed following the procedures described in the Italian Guidelines for the Prevention and Control of Legionellosis of 2015. Then, genotyping was performed on 19 Lp colonies (17 from water samples and 2 from clinical samples) using the Sequence-Based Typing (SBT) method, according to European Study Group for Legionella Infections (ESGLI) protocols. Results: Lp serogroup (sg) 6 was the most prevalent serogroup isolated from the prisons analyzed (40{\%}), followed by Lp sg 1 (16{\%}). Most of all, in four penitentiary institutions, we detected a high concentration of Lp >104 Colony Forming Unit/Liter (CFU/L). The environmental molecular investigation found the following Sequence Types (STs) in Lp sg 6: ST 93, ST 292, ST 461, ST 728, ST 1317 and ST 1362, while most of the isolates in sg 1 belonged to ST 1. We also found a new ST that has since been assigned the number 2451 in the ESGLI-SBT database. From the several Lp sg 1 colonies isolated from the two BALs, we identified ST 2451. Conclusions: In this article, we described the results obtained from environmental and epidemiological investigations of Lp isolated from prisons in Western Sicily. Furthermore, we reported the first cluster of Legionnaires’ in an Italian prison and the molecular typing of Lp sg 1 from one prison’s water system and two BALs, identified the source of the contamination, and discovered a new ST.",
keywords = "Cluster, Legionella pneumophila, Prison, Systems, Water",
author = "Fasciana, {Teresa Maria Assunta} and {Di Carlo}, Paola and Anna Giammanco and Cinzia Cala' and Giuseppina Capra and Cinzia Cal{\`a} and Chiara Mascarella and Mario Palermo and Angela Rampulla and Giuseppina Capra and Anna Giammanco and Distefano, {Salvatore Antonino} and Distefano, {Salvatore Antonino}",
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T1 - Cluster of legionnaires’ disease in an Italian prison

AU - Fasciana, Teresa Maria Assunta

AU - Di Carlo, Paola

AU - Giammanco, Anna

AU - Cala', Cinzia

AU - Capra, Giuseppina

AU - Calà, Cinzia

AU - Mascarella, Chiara

AU - Palermo, Mario

AU - Rampulla, Angela

AU - Capra, Giuseppina

AU - Giammanco, Anna

AU - Distefano, Salvatore Antonino

AU - Distefano, Salvatore Antonino

PY - 2019

Y1 - 2019

N2 - Background: Legionella pneumophila (Lp) is the most common etiologic agent causing Legionnaires’ Disease (LD). Water systems offer the best growth conditions for Lp and support its spread by producing aerosols. From 2015 to 2017, the Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis of Palermo monitored the presence of Lp in nine prisons in Western Sicily. During this investigation, we compared Lp isolates from environmental samples in a prison located in Palermo with isolates from two prisoners in the same prison. Methods: We collected 93 water samples from nine Sicilian prisons and the bronchoalveolar lavages (BALs) of two prisoners considered cases of LD. These samples were processed following the procedures described in the Italian Guidelines for the Prevention and Control of Legionellosis of 2015. Then, genotyping was performed on 19 Lp colonies (17 from water samples and 2 from clinical samples) using the Sequence-Based Typing (SBT) method, according to European Study Group for Legionella Infections (ESGLI) protocols. Results: Lp serogroup (sg) 6 was the most prevalent serogroup isolated from the prisons analyzed (40%), followed by Lp sg 1 (16%). Most of all, in four penitentiary institutions, we detected a high concentration of Lp >104 Colony Forming Unit/Liter (CFU/L). The environmental molecular investigation found the following Sequence Types (STs) in Lp sg 6: ST 93, ST 292, ST 461, ST 728, ST 1317 and ST 1362, while most of the isolates in sg 1 belonged to ST 1. We also found a new ST that has since been assigned the number 2451 in the ESGLI-SBT database. From the several Lp sg 1 colonies isolated from the two BALs, we identified ST 2451. Conclusions: In this article, we described the results obtained from environmental and epidemiological investigations of Lp isolated from prisons in Western Sicily. Furthermore, we reported the first cluster of Legionnaires’ in an Italian prison and the molecular typing of Lp sg 1 from one prison’s water system and two BALs, identified the source of the contamination, and discovered a new ST.

AB - Background: Legionella pneumophila (Lp) is the most common etiologic agent causing Legionnaires’ Disease (LD). Water systems offer the best growth conditions for Lp and support its spread by producing aerosols. From 2015 to 2017, the Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis of Palermo monitored the presence of Lp in nine prisons in Western Sicily. During this investigation, we compared Lp isolates from environmental samples in a prison located in Palermo with isolates from two prisoners in the same prison. Methods: We collected 93 water samples from nine Sicilian prisons and the bronchoalveolar lavages (BALs) of two prisoners considered cases of LD. These samples were processed following the procedures described in the Italian Guidelines for the Prevention and Control of Legionellosis of 2015. Then, genotyping was performed on 19 Lp colonies (17 from water samples and 2 from clinical samples) using the Sequence-Based Typing (SBT) method, according to European Study Group for Legionella Infections (ESGLI) protocols. Results: Lp serogroup (sg) 6 was the most prevalent serogroup isolated from the prisons analyzed (40%), followed by Lp sg 1 (16%). Most of all, in four penitentiary institutions, we detected a high concentration of Lp >104 Colony Forming Unit/Liter (CFU/L). The environmental molecular investigation found the following Sequence Types (STs) in Lp sg 6: ST 93, ST 292, ST 461, ST 728, ST 1317 and ST 1362, while most of the isolates in sg 1 belonged to ST 1. We also found a new ST that has since been assigned the number 2451 in the ESGLI-SBT database. From the several Lp sg 1 colonies isolated from the two BALs, we identified ST 2451. Conclusions: In this article, we described the results obtained from environmental and epidemiological investigations of Lp isolated from prisons in Western Sicily. Furthermore, we reported the first cluster of Legionnaires’ in an Italian prison and the molecular typing of Lp sg 1 from one prison’s water system and two BALs, identified the source of the contamination, and discovered a new ST.

KW - Cluster

KW - Legionella pneumophila

KW - Prison

KW - Systems

KW - Water

UR - http://hdl.handle.net/10447/365248

UR - https://www.mdpi.com/1660-4601/16/11/2062/pdf

M3 - Article

VL - 16

SP - 2062-

JO - International Journal of Environmental Research and Public Health

JF - International Journal of Environmental Research and Public Health

SN - 1661-7827

ER -