To investigate the epidemiologic relatedness of nosocomial infections due to Legionella pneumophila serogroup 1 diagnosed between 1992 and 1994 in six immunocompromised patients of the same hospital and to describe the measures which were developed to control the outbreak.
Legionella strains isolated from patients and from potable hot water were compared using three typing methods : monoclonal antibody analysis, arbitrarily primed PCR and ribotyping.
Environmental investigations revealed the presence of high levels of L. pneumophila serogroup 1 in hot water.
The typing methods gave concordant results for demonstrating (1) the persistence of an epidemic strain of L. pneumophila serogroup 1 in the major water distribution circuit of the hospital over a 3-year period, and (2) the identity between patients'and environmental strains.
Five of the six patients were probably infected via aerosols of hot tap water following inappropriate therapeutic procedures.
Repetitive heat flushings associated with regular bacteriologic surveillance allowed correct disinfection of the water distribution systems.
Specific recommendations concerning aerosol delivery and oxygen therapy were implemented in order to prevent further nosocomial legionellosis.
The same strain of L. (...)
Mots-clés Pascal : Légionellose, Bactériose, Infection, Legionella pneumophila, Legionellaceae, Bactérie, Typage, Epidémiologie moléculaire, Exploration microbiologique, Eau chaude, Infection nosocomiale, Pathogénie, Transmission, Aérosol, Méthode, Prévention, Homme, Hôpital, Hygiène
Mots-clés Pascal anglais : Legionellosis, Bacteriosis, Infection, Legionella pneumophila, Legionellaceae, Bacteria, Typing, Molecular epidemiology, Microbiological investigation, Hot water, Nosocomial infection, Pathogenesis, Transmission, Aerosols, Method, Prevention, Human, Hospital, Hygiene
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0401085
Code Inist : 002B05B02E. Création : 25/01/1999.