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Potable water and nosocomial Legionnaires' disease – check water from all rooms in which patient has stayed

Published online by Cambridge University Press:  15 May 2009

T. J. Marrie ,
W. Johnson ,
S. Tyler ,
G. Bezanson ,
D. Haldane ,
S. Burbridge  and
J. Joly
T. J. Marrie*
Affiliation:
Departments of MedicineDalhousie University and Victoria General Hospital, Halifax, Nova Scotia Microbiology, Dalhousie University and Victoria General Hospital, Halifax, Nova Scotia
W. Johnson
Affiliation:
Laboratory Center for Disease Control, Tunney's Pasture, Ottawa, Ontario
S. Tyler
Affiliation:
Laboratory Center for Disease Control, Tunney's Pasture, Ottawa, Ontario
G. Bezanson
Affiliation:
Microbiology, Dalhousie University and Victoria General Hospital, Halifax, Nova Scotia
D. Haldane
Affiliation:
Microbiology, Dalhousie University and Victoria General Hospital, Halifax, Nova Scotia
S. Burbridge
Affiliation:
Departments of MedicineDalhousie University and Victoria General Hospital, Halifax, Nova Scotia
J. Joly
Affiliation:
Université Laval, Québec City, Québec
*
* Correspondence to: Dr T.J.Marie, Room 5014 ACC, Victoria General Hospital, 1278 Tower Road. Halifax, N.S., B3H 2Y9.
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We studied 7 patients with nosocomial Legionnaires' disease to determine the relationship between isolates of Legionella pneumophila recovered from potable water and those recovered from patients. Potable water was cultured from all rooms in which patients had stayed prior to the diagnosis of Legionnaires' disease. The 38 isolates of L. pneumophila (31 environmental, 7 patient) were resolved into 9 distinct patterns by pulse-field gel electrophoresis (PFGE), 3 by plasmid content and 2 each with monoclonal antibodies and conventional agarose gel electrophoresis of small fragments of DNA.

Using PFGE it was determined that 4 of the 7 patients were infected with L. pneumophila identical to an isolate recovered from the potable water supply in one of the rooms each had occupied prior to the diagnosis of Legionnaires' disease. Patients had resided in a mean of 3·57 rooms before a diagnosis of nosocomial Legionnaires' disease. We conclude that in the setting of contaminated potable water and nosocomial Legionnaires' disease water from all the rooms which the patient has occupied prior to this diagnosis should be cultured. PFGE of large DNA fragments discriminated best among the isolates of L. pneumophila.

Type
Research Article
Information
Epidemiology & Infection , Volume 114 , Issue 2 , April 1995 , pp. 267 - 276
Copyright
Copyright © Cambridge University Press 1995

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