Environmental surveillance and spatio-temporal analysis of Legionella spp. In a region of northeastern Italy (2002\u20132017)

Legionella spp. are considered an important cause of potentially preventable morbidity and mortality, making environmental surveillance a crucial component of risk assessment plans. In this work, 20,319 water samples were collected in 3,983 environmental surveys during a 16-year period by ARPA, the Regional Agency for Environmental Protection, Friuli Venezia Giulia, and the results were studied to better understand the diffusion mechanisms of Legionella. The data showed a strong seasonal signal, a prevalence of L. pneumophila serogroup 2-15 in most environments (63% of positive samples), a prevalence of L. pneumophila serogroup 1 in swimming pool-associated environments (82% of positive samples), a persistent presence of Legionella in hospitals and a recurrent presence of Legionella in other facilities such as hotels, possibly years after interventions, highlighting the difficulty of eradicating the bacteria. Retrospective spatio-temporal analyses on geocoded historical data were carried out with SaTScan using an ordinal model with risk as a covariate to identify potential clusters with an excess of cases in the higher-risk categories. Although no outbreaks occurred during the period of study, such analyses identified spatially restricted zones with unusual contamination, which sometimes were also areas in which several surveys triggered by notifications of clinical cases were performed. Simulations of periodic prospective analyses permitted the assessment of the efficacy of the method in early detection of such clusters. The proposed method may be a useful tool in environmental surveillance, prevention and control of Legionella

A management model for Hospital Hygiene Unit: evidence-based pro-active surveillance of potential environmental sources of infection in order to prevent patient’s risk.

Introduction. The aim of this study is to describe a proactive surveillance system of food, water and environmental surfaces, in order to avoid Healthcare-Associated Infections (HAIs) from hospital environment. Methods. It is a retrospective descriptive study. The surveillance system consists of two integrated phases: pre-analytic and post-analytic. The activities are distinguished in ordinary control activities, performed after scheduled and shared surveys, and compliance activities, performed when it is necessary to establish the adequacy of the destination use, for example opening a new ward. Results. A total of 1,470 Samples were collected and 539 Reports were generated across the five-year study period. Water for human consumption procedure: a statistically significant trend was found only in the total number of Samples collected (p < 0.001). Legionella spp. infection water risk procedure: all Samples and Reports, with the exception of Compliance Report Samples, showed a statistically significant trend (p < 0.001). Pseudomonas aeruginosa water risk procedure: only Ordinary Reports and Compliance Report Samples trend were statistically significant (p = 0.002 and p = 0.028 respectively). Effectiveness of surface sanitization procedure: no trend was statistically significant (p < 0.05). Hospital catering and food surfaces procedure: Samples and Reports yearly number was constant, no trend analysis was performed. HAIs prevalence was never over 5% in the hospital under study. Conclusions. This surveillance system of water, food and environmental surfaces represents an innovative way of approaching hospital safety for patients and personnel because it overcomes the limitations due to a classic approach limited to a laboratory analytic phase only, according to the best available scientific evidence

Amoebal pathogens as emerging causal agents of pneumonia

Despite using modern microbiological diagnostic approaches, the aetiological agents of pneumonia remain unidentified in about 50% of cases. Some bacteria that grow poorly or not at all in axenic media used in routine clinical bacteriology laboratory but which can develop inside amoebae may be the agents of these lower respiratory tract infections (RTIs) of unexplained aetiology. Such amoebae-resisting bacteria, which coevolved with amoebae to resist their microbicidal machinery, may have developed virulence traits that help them survive within human macrophages, i.e. the first line of innate immune defence in the lung. We review here the current evidence for the emerging pathogenic role of various amoebae-resisting microorganisms as agents of RTIs in humans. Specifically, we discuss the emerging pathogenic roles of Legionella-like amoebal pathogens, novel Chlamydiae (Parachlamydia acanthamoebae, Simkania negevensis), waterborne mycobacteria and Bradyrhizobiaceae (Bosea and Afipia spp.

Parachlamydiaceae: Potential Emerging Pathogens

Parachlamydiaceae, which naturally infect amoebae, form a sister taxon to the Chlamydiaceae on the basis of the Chlamydia-like cycle of replication and 80% to 90% homology of ribosomal RNA genes. Because intra-amoebal growth could increase the virulence of some intracellular bacteria, Parachlamydiaceae may be pathogenic. Arguments supporting a pathogenic role are that Chlamydia pneumoniae, a well-recognized agent of pneumonia, was shown to infect free-living amoebae and that another member of the Chlamydiales, Simkania negevensis, which has 88% homology with Parachlamydia acanthamoebae, has caused pneumonia in adults and acute bronchiolitis in infants. The recent identification of a 16S rRNA gene sequence of a Parachlamydiaceae from bronchoalveolar lavage is additional evidence supporting potential for pathogenicity

Legionnaires' disease in Italy: results of the epidemiological surveillance from 2000 to 2011

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Biodétection de Legionella pneumophila par biocapteur à photocorrosion digitale à base de peptide antimicrobien

La détection de bactéries pathogènes par culture microbienne est lente, nécessite un milieu de culture spécifique pour garantir la croissance de certaines souches bactériennes fastidieuses telle que Legionella pneumophila (L. pneumophila) et en plus pourrait ne pas déceler les bactéries viables mais non cultivables mais restant dangereuse en termes de pathogénicité. Par conséquent, l’usage de biocapteurs pour la détection de L. pneumophila serait, potentiellement, une approche attrayante permettant une détection précise et rapide. Cependant, la sensibilité et la spécificité des biocapteurs dépendent fortement des molécules de bioreconnaissance utilisées. Jusqu'à présent, différents ligands tels que les anticorps, les enzymes, les acides nucléiques fonctionnels (aptamères) et les bactériophages ont été utilisés comme éléments de bioreconnaissance. En raison de leur haute spécificité, Les anticorps de mammifères ont été largement employés pour le développement de divers biocapteurs. Cependant, les anticorps sont connus pour souffrir de la variabilité des lots produits et d'une stabilité limitée, ce qui réduit l'usage et la constance des performances des biocapteurs à base d'anticorps. Au cours des dernières années, les peptides antimicrobiens (PAM) ont été de plus en plus investigués pour des applications thérapeutiques en plus d’être considérés comme des ligands de bioreconnaissance prometteurs en raison de leur grande stabilité et leurs fortes réactivités aux bactéries. Dans le but d’améliorer les performances du biocapteur à DIP, notre hypothèse reposait sur l’usage de bioarchitectures à base de PAM à courte séquence pour une capture efficace des bactéries et une détection considérablement améliorée en raison du transfert de charge plus facilitée vers dans la biopuce à base de semiconducteur III-V. Dans la première phase du projet, nous avons évalué un biocapteur à DIP consistant en une puce d’arséniure de gallium/arséniure de gallium aluminium (GaAs/AlGaAs) fonctionnalisée par le warnericine RK pour la détection directe in situ de L. pneumophila dans l’eau. Nous avons démontré une détection linéaire de L. pneumophila pour des concentrations allant de 103 à 106 CFU/mL. De plus, le nombre relativement important d'interfaces constituant la bioarchitecture d’un tel biocapteur pourrait affecter sa reproductibilité et sa sensibilité. Dans ce cas, la couche de bioreconnaissance est plus mince (~ 2 nm) permettant une distance plus courte entre les bactéries et la surface du biocapteur, ce qui pourrait jouer un rôle important dans la promotion du transfert de charge entre les bactéries et la biopuce, et ainsi nous avons pu démontrer une détection efficace de L. pneumophila à une concentration de 2 x 102 CFU/mL. Cette configuration a permis d’atteindre des LODs de 50 et 100 UFC/mL, respectivement pour de légionnelle dans du PBS et collectées d’échantillons d’eau de tour de refroidissement. Nous avons observé une détection sélective de L. pneumophila sérogroupe 1 (SG1) comparé au sérogroupe 5 (SG 5). Les biocapteurs à photocorrosion digitale (DIP) en configuration sandwich PAM et Ab pourraient être une approche prometteuse pour développer un biocapteur à faible coût, hautement sensible et spécifique pour la détection rapide de L. pneumophila dans l’eau.Abstract: Culture based detection of pathogenic bacteria is time consuming, and needs specific culture medium to identify bacterial strains such as Legionella pneumophila (L. pneumophila) which does not flourish in typical growth medium. Culture based methods cannot detect viable but unculturable bacteria. Therefore, the detection of L. pneumophila with biosensors potentially could be an attractive approach enabling accurate and rapid detection. The sensitivity and specificity of biosensors depend critically on the biorecognition probes employed for the detection. Until now, different elements such as antibodies, enzymes, functional nucleic acids (aptamers) and bacteriophages have been utilized as biorecognition elements. Due to high specificity of antibodies, and the advanced technology of their production, mammalian antibodies have been widely investigated for the development of various biosensors. However, mammalian antibodies are known to suffer from batch-to-batch variation, as well as limited stability, which could reduce the consistent utility of the proposed biosensors. In recent years, antimicrobial peptides (AMPs) have been increasingly investigated for their therapeutic applications. At the same time, AMPs are considered as promising biorecognition ligands due to their high stability and multiple niches for capturing bacteria. The hypothesis was that AMP-based bioarchitectures allows for highly efficient capturing of bacteria, and the short length of the AMP would significantly enhance detection due to limited obstructive charge transfer in the charge sensing biosensor. In the first phase of the project, we investigated a warnericin RK AMP functionalized gallium arsenide/aluminum gallium arsenide (GaAs/AlGaAs) photonic biosensor for direct detection of L. pneumophila in water environments. This approach allowed for detecting a low to high concentration of L. pneumophila (103 to 106 CFU/mL) with a 103 CFU/mL limit of detection (LOD). In addition, a relatively large number of interfaces constituting the architecture of such biosensors could affect their reproducibility and sensitivity. A thinner biorecognition layer (~2 nm) resulted in a shorter distance between bacteria and the biosensor surface, which played important role in promoting charge transfer between bacteria and biochip. L. pneumophila was detected at concentrations as low of 2 x 102 CFU/mL. This configuration allowed the detection sensitivity of L. pneumophila as low as 50 CFU/mL and 100 CFU/mL in clean water and water originated from cooling tower, respectively, along with the selective detection of whole cell L. pneumophila serogroup 1 (SG1) and serogroup 5 (SG5). The proposed AMP and Ab conjugated sandwich architecture with digital photocorrosion (DIP) biosensors is a promising approach for developing low cost, highly sensitive and specific biosensors for rapid detection of L. pneumophila in water environments

Jefferson Digital Commons quarterly report: January-March 2020

This quarterly report includes: New Look for the Jefferson Digital Commons Articles COVID-19 Working Papers Educational Materials From the Archives Grand Rounds and Lectures JeffMD Scholarly Inquiry Abstracts Journals and Newsletters Master of Public Health Capstones Oral Histories Posters and Conference Presentations What People are Saying About the Jefferson the Digital Common