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Epidemiol Infect 2020 Jun 29:1-24. Epub 2020 Jun 29.

University of Minnesota School of Public Health, Division of Epidemiology and Community Health. Minneapolis, Minnesota, USA.

J Water Health 2020 Jun;18(3):345-357

Phigenics Research and Innovation Team, Nevada Center for Applied Research, Reno, NV, USA E-mail:

The opportunistic, waterborne pathogen Legionella caused 9,933 cases of Legionnaires' disease in 2018 in the United States (CDC.gov). The incidence of Legionnaires' disease can be reduced by maintaining clean building water systems through water management programs (WMPs). Read More

Emerg Infect Dis 2020 Jul;26(7):1526-1528

We describe 2 cases of healthcare-associated Legionnaires' disease in patients in France hospitalized 5 months apart in the same room. Whole-genome sequencing analyses showed that clinical isolates from the patients and isolates from the room's toilet clustered together. Toilet contamination by Legionella pneumophila could lead to a risk for exposure through flushing. Read More

Praxis (Bern 1994) 2020 ;109(8):658-664

Servizio di medicina interna, Ospedale Regionale, Lugano.

CME: Legionella pneumonia Legionnaire's disease is a usually severe form of pneumonia caused by Legionella pneumophila, a Gram-negative bacterium with an airborne transmission. The infection is acquired in the community, but cases of hospital acquisition from hot water systems have been described. The most common clinical features are cough, fever, gastrointestinal symptoms, hyponatremia and altered liver function tests. Read More

Sci Rep 2020 Jun 4;10(1):9145. Epub 2020 Jun 4.

Department of Natural Resource Sciences, Faculty of Agricultural and Environmental Sciences, McGill University, Ste-Anne-de-Bellevue, Quebec, H9X 3V9, Canada.

Legionella pneumophila (Lp) is a water borne bacterium causing Legionnaires' Disease (LD) in humans. Rapid detection of Lp in water system is essential to reduce the risk of LD outbreaks. The methods currently available require expert skills and are time intensive, thus delaying intervention. Read More

Pediatr Infect Dis J 2020 May 28. Epub 2020 May 28.

Institute of Epidemiology, Faculty of Medicine, Comenius University Bratislava, Špitálska 24, 813 72 Bratislava, Slovakia.

Background: Legionnaires' disease (LD) occurs predominantly in adults and elderly people. Its incidence in Europe has been increasing in recent years. It is rare in younger age groups and prone to be reported as healthcare-associated infection with a higher risk of fatal outcome. Read More

Clin Microbiol Infect 2020 May 26. Epub 2020 May 26.

Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.

Objectives: Legionella is a bacterial species able to cause influenza-like illness (Pontiac fever) or severe pneumonia (Legionnaires disease, LD). We assessed Legionella presence and concentration in composting facilities in The Netherlands.

Methods: A total of 142 samples from 23 green waste composting facilities were screened for Legionella DNA using qPCR. Read More

Euro Surveill 2020 May;25(20)

Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.

In July 2018, a large outbreak of Legionnaires' disease (LD) caused by serogroup 1 (Lp1) occurred in Bresso, Italy. Fifty-two cases were diagnosed, including five deaths. We performed an epidemiological investigation and prepared a map of the places cases visited during the incubation period. Read More

Int Microbiol 2020 May 25. Epub 2020 May 25.

Department of Biological Sciences, SUNY Cortland, Cortland, New York, USA.

Human infection by Legionella pneumophila (Lpn) only occurs via contaminated water from man-made sources, and eradication of these bacteria from man-made water systems is complicated by biofilm colonization. Using a continuously fed biofilm reactor model, we grew a biofilm consortium from potable water that was able to prolong recovery of Lpn CFU from biofilms. This effect was recreated using a subset of those species in a simplified consortium composed of eight bacterial isolates from the first biofilm reactor. Read More

Sci Adv 2020 May 15;6(20):eaaz8041. Epub 2020 May 15.

Department of Biochemistry and Signal Transduction, University Medical Centre Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany.

The causative agent of Legionnaires disease, , translocates the phosphocholine transferase AnkX during infection and thereby posttranslationally modifies the small guanosine triphosphatase (GTPase) Rab1 with a phosphocholine moiety at S76 using cytidine diphosphate (CDP)-choline as a cosubstrate. The molecular basis for Rab1 binding and enzymatic modification have remained elusive because of lack of structural information of the low-affinity complex with AnkX. We combined thiol-reactive CDP-choline derivatives with recombinantly introduced cysteines in the AnkX active site to covalently capture the heterocomplex. Read More

mBio 2020 May 19;11(3). Epub 2020 May 19.

Institut Pasteur, Biologie des Bactéries Intracellulaires, Paris, France

Despite the importance of pneumonia to public health, little is known about the composition of the lung microbiome during infectious diseases, such as pneumonia, and how it evolves during antibiotic therapy. To study the possible relation of the pulmonary microbiome to the severity and outcome of this respiratory disease, we analyzed the dynamics of the pathogen and the human lung microbiome during persistent infections caused by the bacterium and their evolution during antimicrobial treatment. We collected 10 bronchoalveolar lavage fluid samples from three patients during long-term hospitalization due to pneumonia and performed a unique longitudinal study of the interkingdom microbiome, analyzing the samples for presence of bacteria, archaea, fungi, and protozoa by high-throughput Illumina sequencing of marker genes. Read More

J Mycol Med 2020 May 8:100985. Epub 2020 May 8.

Laboratoire de microbiologie, pôle de biologie-hygiène, centre hospitalier de Valenciennes, avenue Désandrouin, 59322 Valenciennes, France. Electronic address:

Aspergillus fumigatus can cause a wide range of diseases, from hypersensitivity to invasive infection. Invasive disease usually occurs in severely immunocompromised patients with deep and prolonged neutropenia. It is a less well-recognized complication in critically ill patients without traditional risk factors. Read More

3 Biotech 2020 May 6;10(5):232. Epub 2020 May 6.

1Departamento de Microbiologia, Laboratório de Biotecnologia e Biodiversidade Para o Meio Ambiente, Universidade Federal de Viçosa, Peter Henry Rolfs Avenue w/n, Viçosa, MG Brazil.

In this work, we present the draft genome sequence of strain TRPF4 consisting of 2,634,550 bp with a G + C content of 32.4%. The genome sequence includes 2466 protein-coding genes, 11 rRNAs and 62 tRNAs, in 33 contigs. Read More

PLoS Pathog 2020 May 4;16(5):e1008342. Epub 2020 May 4.

Centre for Host-Microbiome Interactions, Dental Institute, King's College London, London, United Kingdom.

Chitinases are important enzymes that contribute to the generation of carbon and nitrogen from chitin, a long chain polymer of N-acetylglucosamine that is abundant in insects, fungi, invertebrates and fish. Although mammals do not produce chitin, chitinases have been identified in bacteria that are key virulence factors in severe respiratory, gastrointestinal and urinary diseases. However, it is unclear how these enzymes are able to carry out this dual function. Read More

Med Hypotheses 2020 Aug 25;141:109781. Epub 2020 Apr 25.

CNC - Center for Neurosciences and Cell Biology, University of Coimbra, Portugal; FMUC - Faculty of Medicine, University of Coimbra, Coimbra, Portugal.

The world is facing a pandemic of unseen proportions caused by a corona virus named SARS-CoV-2 with unprecedent worldwide measures being taken to tackle its contagion. Person-to-person transmission is accepted but WHO only considers aerosol transmission when procedures or support treatments that produce aerosol are performed. Transmission mechanisms are not fully understood and there is evidence for an airborne route to be considered, as the virus remains viable in aerosols for at least 3 h and that mask usage was the best intervention to prevent infection. Read More

Int J Environ Res Public Health 2020 Apr 28;17(9). Epub 2020 Apr 28.

Department for Infectious Disease Epidemiology, Robert Koch Institute, Seestraße 10, 13353 Berlin, Germany.

Legionnaires' disease (LD) shows a seasonal pattern with most cases occurring in summer. We investigate if seasonality can be observed for all three exposure categories (community-acquired (CALD), travel-associated (TALD) and healthcare-associated (HCA)).

Methods: LD cases (2005-2015) were classified by exposure categories and we calculated the relative case ratio for each month from February to December using January as reference. Read More

Epidemiol Infect 2020 Apr 29:1-21. Epub 2020 Apr 29.

Interuniversity Institute for Biostatistics and statistical Bioinformatics, Data Science Institute, Hasselt University, Hasselt, Belgium.

Pathogens 2020 Apr 15;9(4). Epub 2020 Apr 15.

College of Science and Engineering, Flinders University, GPO Box 2100, Adelaide 5001, Australia.

is an opportunistic waterborne pathogen of public health concern. It is the causative agent of Legionnaires' disease (LD) and Pontiac fever and is ubiquitous in manufactured water systems, where protozoan hosts and complex microbial communities provide protection from disinfection procedures. This review collates the literature describing interactions between and protozoan hosts in hospital and municipal potable water distribution systems. Read More

Intern Med 2020 Apr 23. Epub 2020 Apr 23.

Department of Nephrology, National Center for Global Health and Medicine, Japan.

We herein report a case of fulminant Legionnaires' disease with autopsy findings in a patient on maintenance hemodialysis (HD). Chronic kidney disease is a strong risk factor for Legionnaires' disease, although there have been only a few reports in HD patients. Because most patients on HD are anuric, the use of rapid assay kits to detect antigens in urine samples for the diagnosis of Legionnaires' disease is not always feasible. Read More

Eur J Clin Microbiol Infect Dis 2020 Apr 17. Epub 2020 Apr 17.

Centre National de Références des Légionelles, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France.

Detection of Legionella pneumophila serogroup 1 urinary antigens is the most widely used technique for the diagnosis of Legionnaires' disease (LD). The aim of this study was to evaluate the performance of the Legionella K-set® immunochromatographic test, in comparison with the BinaxNOW® Legionella urinary antigen card (UAC) on concentrated urine samples (US). A total of 250 concentrated US including 200 prospective US sent to the laboratory for urinary antigens' testing and 50 frozen US from patients with confirmed LD were tested. Read More

J Travel Med 2020 05;27(3)

Division of Respiratory Internal Medicine, Department of Internal Medicine, Asahi General Hospital, I 1326, Asahi City, Chiba 289-2511, Japan.

JAMA 2020 Apr;323(14):1337

Pol Merkur Lekarski 2020 Feb;48(283):60-64

Poznań University of Medical Sciences, Poland: Cardiac Magnetic Resonance Unit, 1st Department of Cardiology.

Extrapulmonary manifestations of Legionnaires' disease (LD) include, inter alia cardiac, brain, abdominal, joints and skin involvement.

A Case Report: The authors describe a case of a 41-year-old immunocompetent female admitted due to a high fever, chills and fatigue. She negated cough and chest or abdominal pain. Read More

mBio 2020 03 24;11(2). Epub 2020 Mar 24.

Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland

governs its interactions with host cells by secreting >300 different "effector" proteins. Some of these effectors contain eukaryotic domains such as the RCC1 (regulator of chromosome condensation 1) repeats promoting the activation of the small GTPase Ran. In this report, we reveal a conserved pattern of RCC1 repeat genes, which are distributed in two main clusters of strains. Read More

FEMS Microbiol Lett 2020 Apr;367(7)

Division of Biology, Kansas State University, 1717 Claflin Road, Manhattan, Kansas, 66506 USA.

Polyphenols derived from a variety of plants have demonstrated antimicrobial activity against diverse microbial pathogens. Legionella pneumophila is an intracellular bacterial pathogen that opportunistically causes a severe inflammatory pneumonia in humans, called Legionnaires' Disease, via replication within macrophages. Previous studies demonstrated that tea polyphenols attenuate L. Read More

BMJ Case Rep 2020 Mar 10;13(3). Epub 2020 Mar 10.

Internal Medicine, Wayne State University, Detroit, Michigan, USA.

We present a case of Legionnaires' disease complicated by cerebellar ataxia. A 60-year-old man was diagnosed with Legionnaires' disease by urine antigen after presenting to the hospital with a main problem of headache and gait instability. He also had a productive cough, as well as nausea, vomiting and diarrhoea. Read More

Int J Infect Dis 2020 Apr 5;93:300-304. Epub 2020 Mar 5.

Department of Medicine, International University of Health and Welfare Narita, 4-3, Kouzunomori, Narita-shi, Chiba, 162-8640, Japan. Electronic address:

Objective: The feasibility of the decontamination procedure for Legionella pneumophila of water systems in healthcare facilities varies by water purification and disinfection methods in each country. We evaluated the efficacy of feasible decontamination strategies in Japan.

Methods: This study was conducted at Tokyo Medical University Hospital (1015 beds) between 2015 and 2018. Read More

Microb Drug Resist 2020 Mar 3. Epub 2020 Mar 3.

Laboratory of Water Microbiology and Environmental Hygiene, Food Safety & Environment Department, Institut Pasteur du Maroc, Casablanca, Morocco.

is a waterborne pathogen that causes a severe form of pneumonia called Legionnaires' diseases, which is normally acquired by inhalation of aerosols containing originating from natural and man-made water systems. The aim of this study was to describe the level of antimicrobial susceptibility of environmental spp. strains to preferred and recommended therapeutic agents to treat disease. Read More

Infect Immun 2020 Apr 20;88(5). Epub 2020 Apr 20.

Division of Biology, Kansas State University, Manhattan, Kansas, USA

, the etiological agent of Legionnaires' disease, employs an arsenal of hundreds of Dot/Icm-translocated effector proteins to facilitate replication within eukaryotic phagocytes. Several effectors, called metaeffectors, function to regulate the activity of other Dot/Icm-translocated effectors during infection. The metaeffector Lpg2505 is essential for intracellular replication only when its cognate effector, SidI, is present. Read More

Front Immunol 2020 30;11:25. Epub 2020 Jan 30.

Faculty of Medicine, Institute of Medical Microbiology, University of Zürich, Zurich, Switzerland.

is the causative agent of a severe pneumonia called Legionnaires' disease. The environmental bacterium replicates in free-living amoebae as well as in lung macrophages in a distinct compartment, the -containing vacuole (LCV). The LCV communicates with a number of cellular vesicle trafficking pathways and is formed by a plethora of secreted bacterial effector proteins, which target host cell proteins and lipids. Read More

MMWR Morb Mortal Wkly Rep 2020 Feb 28;69(8):207-211. Epub 2020 Feb 28.

In January 2018, the Wisconsin Department of Health Services, Division of Public Health (DPH), received a report of a culture-confirmed case of Legionnaires' disease. The patient, who was immunocompromised, had died at a local hospital 10 days after being admitted. DPH and an infection preventionist from the hospital investigated to determine the source of the infection and prevent additional cases. Read More

Epidemiol Infect 2020 Feb 19;148:e33. Epub 2020 Feb 19.

Public Health England, Manor Farm Road, Porton Down, Salisbury, SP4 0JG, UK.

In the event of a Legionnaires' disease outbreak, rapid location and control of the source of bacteria are crucial for outbreak management and regulation. In this paper, we describe an enhancement of the traditional wind rose for epidemiological use; shifting the focus of measurement from relative frequency of the winds speeds and directions to the relative volume of air carried, whilst also incorporating probability distributions of disease incubation periods to refine identification of the important wind directions during a cases window of exposure, i.e. Read More

Nursing 2020 03;50(3):54-57

Dorothy Borton is an infection preventionist at Albert Einstein Medical Center in Philadelphia, Pa.

Front Cell Dev Biol 2019 28;7:390. Epub 2020 Jan 28.

Department of Molecular Biology, Genetic Engineering and Biotechnology Research Institute, University of Sadat City, Sadat City, Egypt.

() is a Gram-negative bacterium that infects the human respiratory tract causing Legionnaires' disease, a severe form of pneumonia. Recently, rising evidence indicated the ability of to regulate host defense via its type 4 secretion system including hundreds of effectors that promote intracellular bacterial replication. The host defense against such invaders includes autophagic machinery that is responsible for degradation events of invading pathogens and recycling of cell components. Read More

Zhonghua Jie He He Hu Xi Za Zhi 2020 Feb;43(2):126-131

Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China.

To summarize the clinical course, neuroimaging and cerebrospinal fluid (CSF) analyses of cerebellar dysfunction in Legionnaires' disease. A case of Legionnaires' disease with pronounced cerebellar involvement was reported. The related literatures published up to February 2019 were reviewed with "Legionella, legionellosis, legionnaires' disease, cerebellum, cerebellar" as the keywords in CNKI, Wanfang and PubMed databases. Read More

Microbiol Resour Announc 2020 Jan 30;9(5). Epub 2020 Jan 30.

Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand

is the predominant cause of Legionnaires' disease (LD) in New Zealand. Although serogroup 2 (sg2) does not contain the most clinically significant strain, it is an important cause of disease. Here, we report the complete genome sequence of an sg2 isolate from a patient who was hospitalized with LD. Read More

Mol Microbiol 2020 Jun 12;113(6):1070-1084. Epub 2020 Feb 12.

Institute of Medical Microbiology, University of Zürich, Zürich, Switzerland.

The water-borne bacterium Legionella pneumophila replicates in environmental protozoa and upon inhalation destroys alveolar macrophages, thus causing a potentially fatal pneumonia termed 'Legionnaires' disease'. L. pneumophila employs the Legionella quorum sensing (Lqs) system to control its life cycle, pathogen-host cell interactions, motility and natural competence. Read More

Int J Hyg Environ Health 2020 03 24;224:113425. Epub 2019 Dec 24.

Health and Safety Executive, Liverpool, L20 7HS, UK. Electronic address:

Legionella bacteria can colonise and proliferate in water systems in the built environment and can be spread by aerosol generation. If inhaled by a susceptible individual, this can lead to respiratory infections such as Legionnaires' Disease (LD), or the generally milder Pontiac fever. Evaporative cooling systems (ECS), including cooling towers, used in industrial processes to dissipate excessive heat are prone to contamination by Legionella. Read More

Int J Hyg Environ Health 2020 03 2;224:113441. Epub 2020 Jan 2.

Laboratory of Hygiene and Epidemiology, School of Health Sciences, Department of Medicine, Larissa, Greece. Electronic address:

Background: The majority of Legionnaires' disease cases is attributed to Legionella pneumophila serogroup 1 (Lp1). Moreover, pathogenicity loci lvh and rtxA were associated with the ability of Lp strains to cause the disease. Consequently, except from serogroup assignment the detection of the aforementioned virulence genes during Legionella detection in water samples, could help environmental risk assessment and the implementation of targeted control measures. Read More

Int J Environ Res Public Health 2020 01 15;17(2). Epub 2020 Jan 15.

Statcore, VA Pittsburgh Healthcare System, Pittsburgh, PA 15240, USA.

The rapid identification of pneumonia is essential to optimize patient treatment and outcomes, and to identify potential public health risks. Previous studies have identified clinical factors which are more common in than non- pneumonia, and scores have been developed to assist in diagnosing cases. Since a pneumonia outbreak at VA Pittsburgh in 2012, nearly all patients with pneumonia have been tested for . Read More

Int J Environ Res Public Health 2020 01 3;17(1). Epub 2020 Jan 3.

Humber River Hospital, Toronto, ON M3M 0B2, Canada.

Legionnaires' disease (LD) is a severe pneumonia with a mortality rate of about 10%. The illness remains largely underdiagnosed with outbreaks occurring with alarming incidence. In this study, we assessed the frequency of Legionnaires' disease among pneumonia cases treated at a large community hospital over a summer season. Read More

Water Res 2020 Mar 2;171:115439. Epub 2020 Jan 2.

Virginia Tech, Civil and Environmental Engineering, Blacksburg, VA, USA. Electronic address:

After the Federal emergency in Flint, MI was declared in early 2016 in response to elevated lead-in-water and incidence of Legionnaires' disease, concerns arose that contaminants in residential water heaters could continue to contribute to poor quality tap water. Here, a comprehensive field survey of residential water heaters (n = 30) and associated water quality was conducted and the subsequent effects of an aggressive manual water heater clean-out was determined, including draining the tank and removing sediments via brushing and flushing. Before cleaning, inorganics accumulated in the tank sediments did not serve as a source of metals measured at hot water outlets. Read More

PLoS One 2020 15;15(1):e0227574. Epub 2020 Jan 15.

Institute of Food Safety Feed and Environment, University of Ljubljana, Veterinary Faculty, Ljubljana, Slovenia.

Legionella pneumophila can cause a potentially fatal form of humane pneumonia (Legionnaires' disease), which is most problematic in immunocompromised and in elderly people. Legionella species is present at low concentrations in soil, natural and artificial aquatic systems and is therefore constantly entering man-made water systems. The environment temperature for it's ideal growth range is between 32 and 42°C, thus hot water pipes represent ideal environment for spread of Legionella. Read More

Sci Total Environ 2020 Apr 28;712:136131. Epub 2019 Dec 28.

Department of Natural Resource Sciences, McGill University, 21111 Lakeshore Drive, Ste-Anne-de-Bellevue, Quebec, H9X 3V9, Canada. Electronic address:

Legionella pneumophila is a waterborne bacterium known for causing Legionnaires' Disease, a severe pneumonia. Cooling towers are a major source of outbreaks, since they provide ideal conditions for L. pneumophila growth and produce aerosols. Read More

Heliyon 2020 Jan 3;6(1):e03149. Epub 2020 Jan 3.

EA7352 CHROME, Rue du Dr G. Salan, University of Nîmes, 30021 Nîmes cedex 1, France.

risk assessment is nowadays based on the presence and concentration of either . Many species of can cause Legionnaires' disease, indeed about half of the known species have been associated with infection. The aim of this work was to develop a method to assess the composition of the species community in an environmental sample in order to have a better understanding of the contamination of the ecosystem by pathogenic strains. Read More

BMJ Case Rep 2020 Jan 7;13(1). Epub 2020 Jan 7.

MetroHealth Medical Center, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA

A 44-year-old right-handed man with a 5-day history of non-productive cough associated with subjective fevers/chills and night sweats presented to the emergency department with slurred speech. Radiography and urine antigen testing confirmed the diagnosis of The hospital course was complicated by acute hypoxic respiratory failure that required 7 days of invasive mechanical ventilation. Following extubation, the patient had dysarthria and developed new parkinsonism features. Read More

Prehosp Disaster Med 2020 Feb 9;35(1):109-114. Epub 2020 Jan 9.

Boston MedFlight, Bedford, MassachusettsUSA.

Hypoxemic patients often desaturate further with movement and transport. While inhaled epoprostenol does not improve mortality, improving oxygenation allows for transport of severely hypoxemic patients to tertiary care centers with a related improvement in mortality rates. Extracorporeal membrane oxygenation (ECMO) use is increasing in frequency for patients with refractory hypoxemia, and with increasing regionalization of care, safe transport of hypoxemic patients only becomes more important. Read More

J Biol Chem 2020 Feb 6;295(6):1646-1657. Epub 2020 Jan 6.

Key Laboratory of Zoonosis, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun, China

is the causative agent of the lung malady Legionnaires' disease, it modulates host function to create a niche termed the -containing vacuole (LCV) that permits intracellular replication. One important aspect of such modulation is the co-option of the host ubiquitin network with a panel of effector proteins. Here, using recombinantly expressed and purified proteins, analytic ultracentrifugation, structural analysis, and computational modeling, along with deubiquitinase (DUB), and bacterial infection assays, we found that the bacterial defective in organelle trafficking/intracellular multiplication effector Ceg23 is a member of the ovarian tumor (OTU) DUB family. Read More

Lett Appl Microbiol 2020 Apr 24;70(4):232-240. Epub 2020 Jan 24.

Virginia Tech, Civil and Environmental Engineering, Blacksburg, VA, USA.

Unregulated private wells are understudied potential sources of community-acquired Legionnaires' disease. Here we conducted a comprehensive survey of 44 homes supplied by private wells in Wake County, North Carolina, quantifying Legionella spp. DNA, Legionella pneumophila DNA, and total bacterial 16S rRNA genes via real-time polymerase chain reaction in hot and cold drinking water samples, along with culturable L. Read More