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Epidemiological investigation of a legionellosis outbreak in a Slovenian nursing home, August 2010.
Scand J Infect Dis. 2012 Apr; 44(4):263-9.SJ

Abstract

BACKGROUND

August 2010 marked the beginning of the largest outbreak of legionellosis in a Slovenian nursing home. This article presents our experiences with the outbreak investigation.

METHODS

In order to collect the necessary patient epidemiological data, we used individual epidemiological questionnaires. Samples were available from 15 patients and were subject to laboratory investigation. Urine and sputum samples were difficult to obtain due to the underlying diseases of the patients. Serological diagnostics constituted an important part of the epidemiological investigation. Sixty-four environmental samples were taken to identify the sources of infection. By genotyping, we assessed the affinity of the allelic profile of Legionella pneumophila serogroup 1 in environmental samples and in patient samples.

RESULTS

Legionnaires' disease was diagnosed in 10 patients based on a combination of various tests. Legionella pneumophila serogroup 1, Legionella pneumophila serogroups 2-14, and Legionella sp., in concentrations of < 10 to 61,000 CFU/l, were isolated from 51 out of 64 environmental samples. The source of the outbreak was confirmed by genotyping the isolates from patients and the isolates from the water supply system. The 2 isolates had identical allelic profiles corresponding to that of L. pneumophila serogroup 1 allelic profile 2,3,9,10,2,1,6, designated sequence type 23 (according to the European Working Group for Legionella Infections).

CONCLUSION

We describe a Legionella pneumophila serogroup 1 outbreak in a Slovenian nursing home. The source of infection was demonstrated using sequence-based typing. Water flow disturbances were determined as the most probable cause of Legionella growth. Overall, the risk of a Legionella outbreak is underestimated in Slovenia.

Authors+Show Affiliations

Institute of Public Health Celje, Celje, Slovenia. alenka.skaza@zzv-ce.siNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22339541

Citation

Trop Skaza, Alenka, et al. "Epidemiological Investigation of a Legionellosis Outbreak in a Slovenian Nursing Home, August 2010." Scandinavian Journal of Infectious Diseases, vol. 44, no. 4, 2012, pp. 263-9.
Trop Skaza A, Beskovnik L, Storman A, et al. Epidemiological investigation of a legionellosis outbreak in a Slovenian nursing home, August 2010. Scand J Infect Dis. 2012;44(4):263-9.
Trop Skaza, A., Beskovnik, L., Storman, A., Kese, D., & Ursic, S. (2012). Epidemiological investigation of a legionellosis outbreak in a Slovenian nursing home, August 2010. Scandinavian Journal of Infectious Diseases, 44(4), 263-9. https://doi.org/10.3109/00365548.2011.635313
Trop Skaza A, et al. Epidemiological Investigation of a Legionellosis Outbreak in a Slovenian Nursing Home, August 2010. Scand J Infect Dis. 2012;44(4):263-9. PubMed PMID: 22339541.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidemiological investigation of a legionellosis outbreak in a Slovenian nursing home, August 2010. AU - Trop Skaza,Alenka, AU - Beskovnik,Lucija, AU - Storman,Alenka, AU - Kese,Darja, AU - Ursic,Simona, Y1 - 2012/02/19/ PY - 2012/2/21/entrez PY - 2012/2/22/pubmed PY - 2012/9/20/medline SP - 263 EP - 9 JF - Scandinavian journal of infectious diseases JO - Scand J Infect Dis VL - 44 IS - 4 N2 - BACKGROUND: August 2010 marked the beginning of the largest outbreak of legionellosis in a Slovenian nursing home. This article presents our experiences with the outbreak investigation. METHODS: In order to collect the necessary patient epidemiological data, we used individual epidemiological questionnaires. Samples were available from 15 patients and were subject to laboratory investigation. Urine and sputum samples were difficult to obtain due to the underlying diseases of the patients. Serological diagnostics constituted an important part of the epidemiological investigation. Sixty-four environmental samples were taken to identify the sources of infection. By genotyping, we assessed the affinity of the allelic profile of Legionella pneumophila serogroup 1 in environmental samples and in patient samples. RESULTS: Legionnaires' disease was diagnosed in 10 patients based on a combination of various tests. Legionella pneumophila serogroup 1, Legionella pneumophila serogroups 2-14, and Legionella sp., in concentrations of < 10 to 61,000 CFU/l, were isolated from 51 out of 64 environmental samples. The source of the outbreak was confirmed by genotyping the isolates from patients and the isolates from the water supply system. The 2 isolates had identical allelic profiles corresponding to that of L. pneumophila serogroup 1 allelic profile 2,3,9,10,2,1,6, designated sequence type 23 (according to the European Working Group for Legionella Infections). CONCLUSION: We describe a Legionella pneumophila serogroup 1 outbreak in a Slovenian nursing home. The source of infection was demonstrated using sequence-based typing. Water flow disturbances were determined as the most probable cause of Legionella growth. Overall, the risk of a Legionella outbreak is underestimated in Slovenia. SN - 1651-1980 UR - https://www.unboundmedicine.com/medline/citation/22339541/Epidemiological_investigation_of_a_legionellosis_outbreak_in_a_Slovenian_nursing_home_August_2010_ L2 - https://www.tandfonline.com/doi/full/10.3109/00365548.2011.635313 DB - PRIME DP - Unbound Medicine ER -