Evaluation of Legionella Air Contamination in Healthcare Facilities by Different Sampling Methods: An Italian Multicenter Study

Maria Teresa Montagna, Osvalda De Giglio, Maria Luisa Cristina, Christian Napoli, Claudia Pacifico, Antonella Agodi, Tatjana Baldovin, Beatrice Casini, Maria Anna Coniglio, Marcello Mario D’Errico, Santi Antonino Delia, Maria Grazia Deriu, Marco Guida, Pasqualina Laganà, Giorgio Liguori, Matteo Moro, Ida Mura, Francesca Pennino, Gaetano Privitera, Vincenzo Romano Spica, Silvia Sembeni, Anna Maria Spagnolo, Stefano Tardivo, Ida Torre, Federica Valeriani, Roberto Albertini and Cesira Pasquarella
Additional contact information
Maria Teresa Montagna: Department of Biomedical Science and Human Oncology, University of Bari “Aldo Moro”, Piazza G. Cesare 11, 70124 Bari, Italy
Osvalda De Giglio: Department of Biomedical Science and Human Oncology, University of Bari “Aldo Moro”, Piazza G. Cesare 11, 70124 Bari, Italy
Maria Luisa Cristina: Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genova, Italy
Christian Napoli: Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Roma, Via di Grottarossa 1035, 00189 Roma, Italy
Claudia Pacifico: Department of Biomedical Science and Human Oncology, University of Bari “Aldo Moro”, Piazza G. Cesare 11, 70124 Bari, Italy
Antonella Agodi: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Via Sofia 87, 95123 Catania, Italy
Tatjana Baldovin: Department of Cardiac, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padova, Via Loredan 18, 35131 Padova, Italy
Beatrice Casini: Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno 35/39, 56127 Pisa, Italy
Maria Anna Coniglio: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Via Sofia 87, 95123 Catania, Italy
Marcello Mario D’Errico: Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, via Tronto, 10/a Torrette di Ancona, 60020 Ancona, Italy
Santi Antonino Delia: Department of Biomedical Science and Morphological and Functional Images, University of Messina, Via C.Valeria snc, 98125 Messina, Italy
Maria Grazia Deriu: Department of Biomedical Science-Hygiene Section, University of Sassari, Via Padre Manzella 4, 07100 Sassari, Italy
Marco Guida: Department of Biology, University of Napoli “Federico II”, Via Cinthia 26, 80126 Napoli, Italy
Pasqualina Laganà: Department of Biomedical Science and Morphological and Functional Images, University of Messina, Via C.Valeria snc, 98125 Messina, Italy
Giorgio Liguori: Department of Movement Sciences and Wellbeing, University “Parthenope”, Via Medina 40, 80133 Napoli, Italy
Matteo Moro: IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milano, Italy
Ida Mura: Department of Biomedical Science-Hygiene Section, University of Sassari, Via Padre Manzella 4, 07100 Sassari, Italy
Francesca Pennino: Department of Public Health, University of Napoli “Federico II”, Via S.Pansini 5, 80131 Napoli, Italy
Gaetano Privitera: Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno 35/39, 56127 Pisa, Italy
Vincenzo Romano Spica: Department of Movement, Human and Health Sciences, Public Health Unit, University of Roma “Foro Italico”, P.zza Lauro De Bosis 6, 00135 Roma, Italy
Silvia Sembeni: Department of Diagnostic and Public Health, University of Verona, Strada le Grazie 8, 37134 Verona, Italy
Anna Maria Spagnolo: Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genova, Italy
Stefano Tardivo: Department of Diagnostic and Public Health, University of Verona, Strada le Grazie 8, 37134 Verona, Italy
Ida Torre: Department of Public Health, University of Napoli “Federico II”, Via S.Pansini 5, 80131 Napoli, Italy
Federica Valeriani: Department of Movement, Human and Health Sciences, Public Health Unit, University of Roma “Foro Italico”, P.zza Lauro De Bosis 6, 00135 Roma, Italy
Roberto Albertini: Department of Medicine and Surgery, University of Parma, Medical Immunology Unit, University Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy
Cesira Pasquarella: Department of Medicine and Surgery, University of Parma, Via Volturno 39, 43125 Parma, Italy

IJERPH, 2017, vol. 14, issue 7, 1-12

Abstract: Healthcare facilities (HF) represent an at-risk environment for legionellosis transmission occurring after inhalation of contaminated aerosols. In general, the control of water is preferred to that of air because, to date, there are no standardized sampling protocols. Legionella air contamination was investigated in the bathrooms of 11 HF by active sampling (Surface Air System and Coriolis ® ?) and passive sampling using settling plates. During the 8-hour sampling, hot tap water was sampled three times. All air samples were evaluated using culture-based methods, whereas liquid samples collected using the Coriolis ® ? were also analyzed by real-time PCR. Legionella presence in the air and water was then compared by sequence-based typing (SBT) methods. Air contamination was found in four HF (36.4%) by at least one of the culturable methods. The culturable investigation by Coriolis ® ? did not yield Legionella in any enrolled HF. However, molecular investigation using Coriolis ® ? resulted in eight HF testing positive for Legionella in the air. Comparison of Legionella air and water contamination indicated that Legionella water concentration could be predictive of its presence in the air. Furthermore, a molecular study of 12 L. pneumophila strains confirmed a match between the Legionella strains from air and water samples by SBT for three out of four HF that tested positive for Legionella by at least one of the culturable methods. Overall, our study shows that Legionella air detection cannot replace water sampling because the absence of microorganisms from the air does not necessarily represent their absence from water; nevertheless, air sampling may provide useful information for risk assessment. The liquid impingement technique appears to have the greatest capacity for collecting airborne Legionella if combined with molecular investigations.

Keywords: Coriolis ® ?; Surface Air System; settle plates; index microbial air (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2017
References: View complete reference list from CitEc
Citations: View citations in EconPapers (9)

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