Serotyping of Legionella Bacteria Isolated from Various Water Systems in the Central Anatolia Region

Objective: Legionella bacteria are waterborne environmental pathogens that are considered a public health problem because they cause Legionnaires' disease, which is a nationally notifiable disease. Materials and Methods: Legionella analysis was performed in a total of 651 water samples collected during the years 2015 (450) – 2016 (201). Water samples were collected from hospitals (64.66%), hotels (15.05%), the automotive industry (14.43%) and from the buildings (5.83%) in the Central Anatolia Region. After the isolation of Legionella by the filtration and culturing method, serogroup and subtypes were determined via latex agglutination tests and the direct fluorescent antibody method. Results: In 2015, the Legionella positivity rate was 8.6%, where 28.2% of detections were from L. pneumophila serogroup-1. Six isolates were found to be Philadelphia, four were Olda, and one was Bellingham subgroup. Overall, 64.1% were L. pneumophila serogroup 2-14. Moreover, 14 isolates were SG-5, 10 were SG-6, and one was SG-10. 7.7% were unidentified Legionella species. The Legionella species identified were L. micdadei and L. longbeachae. In 2016, the Legionella positivity rate was 10.4%, with 28.6% of them being from L. pneumophila serogroup-1. Four were found to be Olda and two were Philadelphia subgroups. Overall, 66.6% of them were L. pneumophila serogroup 2-14. Moreover, six of them were SG-5, four were SG-6, and four were SG-2. 4.7% were unidentified Legionella species. There was only one species detected as L. micdadei. Conclusion: It has been observed that the distribution of Legionella has exhibited diversity in different water systems throughout the Central Anatolia Region.

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  • 1. Yavuz CI. Legionnaires’ -disease as a waterborne disease and environmental surveillance. Türk Mikrobiyol Cem Derg 2018; 48(4): 211-27.
  • 2. Graham FF, Hales S, White PS, Baker MG. Review Global seroprevalence of legionellosis - a systematic review and meta-analysis. Sci Rep 2020; 10(1): 7337.
  • 3. Xiao-Yong Z, Chao-Hui H, Qing-Yi Z. Comparative study on sampling methods for monitoring Legionella species in environmental water. Afr J Microbiol Res 2014; 8(10): 974-85.
  • 4. Felice A, Franchi M, De Martin S, Vitacolonna N, Iacumin L, Civilini M. Environmental surveillance and spatio-temporal analysis of Legionella spp. in a region of northeastern Italy (2002–2017). Zhou Z, ed. PLoS ONE 2019; 14(7): e0218687.
  • 5. Fricke C, Xu J, Jiang F, Liu Y, Harms H, Maskow T. Rapid culture-based detection of Legionella pneumophila using isothermal microcalorimetry with an improved evaluation method. Microb Biotechnol 2020; 13(4): 1262-72.
  • 6. Yarom R, Sheinman R, Armon R. Legionella pneumophila serogroup 3 prevalence in drinking water survey in Israel (2003–2007). Water Supply 2010; 10(5): 746-52.
  • 7. Berjeaud JM, Chevalier S, Schlusselhuber M, et al. Legionella pneumophila: the paradox of a highly sensitive opportunistic waterborne pathogen able to persist in the environment. Front Microbiol 2016; 7: 486.
  • 8. Sopena N, Pedro-Botet L, Mateu L, Tolschinsky G, Rey-Joly C, Sabrià M. Community-acquired legionella pneumonia in elderly patients: characteristics and outcome: community legionella pneumonia in elderly patients. J Am Geriatr Soc 2007; 55(1): 114-9.
  • 9. Llewellyn AC, Lucas CE, Roberts SE, Brown EW, Nayak BS, Raphael BH, Winchell JM. Distribution of Legionella and bacterial community composition among regionally diverse US cooling towers. PLoS ONE 2017; 12(12): e0189937.
  • 10. Sikora A, Wójtowicz-Bobin M, Kozioł-Montewka M, Magryś A, Gładysz I. Prevalence of Legionella pneumophila in water distribution systems in hospitals and public buildings of the Lublin region of eastern Poland. Ann Agric Environ Med 2015; 22(2): 195-201.
  • 11. Scaturro M, Poznanski E, Mupo M, Blasior P, Seeber M, Prast AM, Romanin E, Girolamo A, Rota MC, Bella A, Ricci ML, Stenico A. Evaluation of GVPC and BCYE media for Legionella detection and enumeration in water samples by iso 11731: does plating on BCYE medium really improve yield? Pathogens 2020; 9(9): E757.
  • 12. Eisenreich W, Heuner K. The life stage-specific pathometabolism of Legionella pneumophila. FEBS Lett 2016; 590(21): 3868-86.
  • 13. Laganà P, Facciolà A, Palermo R, Delia S. Environmental surveillance of legionellosis within an Italian university hospital-Results of 15 years of analysis. Int J Environ Res Public Health 2019; 16(7): 1103.
  • 14. Gruas C, Álvarez I, Lara C, García CB, Savva D, Arruga MV. Identification of Legionella spp. in environmental water samples by Scan- VIT-LegionellaTM method in Spain. Indian J Microbiol 2013; 53(2): 142-8.
  • 15. Kirschner AKT. Determination of viable legionellae in engineered water systems: Do we find what we are looking for? Water Research 2016; 93: 276-88.
  • 16. Borges V, Nunes A, Sampaio DA, Vieira L, Machado J, Simões MJ, Gonçalves P, Gomes JP. Legionella pneumophila strain associated with the first evidence of person-to-person transmission of Legionnaires’ disease: a unique mosaic genetic backbone. Sci Rep 2016; 6(1): 26261.
  • 17. Amemura-Maekawa J, Kura F, Helbig JH, et al. Characterization of Legionella pneumophila isolates from patients in Japan according to serogroups, monoclonal antibody subgroups and sequence types. J Med Microbiol 2010; 59(Pt 6): 653-9.
  • 18. Amemura-Maekawa J, Kikukawa K, Helbig JH, Kaneko S, Suzuki- Hashimoto A, Furuhata K, et al.; Working Group for Legionella in Japan. Distribution of monoclonal antibody subgroups and sequence- based types among Legionella pneumophila serogroup 1 isolates derived from cooling tower water, bathwater, and soil in Japan. Appl Environ Microbiol 2012; 78(12): 4263-70.
  • 19. Akbaş E. Basic principles in investigation of Legionella in hospital water systems. Türk Mikrobiyol Cem Derg 2013; 43(1): 1-11.
  • 20. Leoni E, De Luca G, Legnani PP, Sacchetti R, Stampi S, Zanetti F. Legionella waterline colonization: detection of Legionella species in domestic, hotel and hospital hot water systems. J Appl Microbiol 2005; 98(2): 373-9.
  • 21. Prashar A, Bhatia S, Tabatabaeiyazdi Z, Duncan C, Garduño RA, Tang P, Low DE, Guyard C, Terebiznik MR. Mechanism of invasion of lung epithelial cells by filamentous Legionella pneumophila. Cell Microbiol 2012; 14(10): 1632-55.
  • 22. Oliva G, Sahr T, Buchrieser C. The life cycle of L. Pneumophila: cellular differentiation is linked to virulence and metabolism. Front Cell Infect Microbiol 2018; 8: 3.
  • 23. Akbaş E, Nar Ötgün S, Turan M. Ulusal mikrobiyoloji standartları, suda Legionella türlerinin tanımlanması. 2014. T.C. Sağlık Bakanlığı, Türkiye Halk Sağlığı Kurumu, Sağlık Bakanlığı Yayın No: 965.
  • 24. Winn WC, Cherry WB, Frank RO, Casey CA, Broome CV. Direct immunofluorescent detection of Legionella pneumophila in respiratory specimens. J Clin Microbiol 1980; 11(1): 59-64.
  • 25. Afacan G, Yumuk Z, Baskın Y, Balıkcı E. Frequency of Legionella pneumophila serogroup 2-14 isolated from water samples at touristic regions. Türk Mikrobiyol Cem Derg 2006; 36(4): 214-8.
  • 26. Tesauro M, Bianchi A, Consonni M, Pregliasco F, Galli MG. Environmental surveillance of Legionella pneumophila in two Italian hospitals. Ann Ist Super Sanita 2010; 46(3): 274-8.
  • 27. Akkaya Z, Özbal Y. Legionella researching in water depots’ of different buildings in Kayseri. Sağlık Bilimleri Dergisi (Journal of Health Sciences); 2011; 20(1): 9-17.
  • 28. Burak DM, Zeybek Z. Investigation of Legionella pneumophila and free living amoebas in the domestic hot water systems in Istanbul. Turk J Biol 2011; 35: 679-85.
  • 29. İğnak S. and Gürler B. An investigation of Legionella species in the water system of a university hospital. Türk Mikrobiyol Cem Derg 2012; 42(3): 110-4.
  • 30. Ulleryd P, Hugosson A, Allestam G, Bernander S, Claesson BEB, Eilertz I. Legionnaires’ disease from a cooling tower in a community outbreak in Lidköping, Sweden- epidemiological, environmental and microbiological investigation supported by meteorological modelling. BMC Infectious Diseases 2012; 12(1): 313.
  • 31. Erdoğan H, Arslan H. Evaluation of a Legionella outbreak emerged in a recently opening hotel. Mikrobiyol Bul 2013;47(2):240-9.
  • 32. Sepin Özen N, Tuğlu Ataman Ş, Emek M. Exploring the Legionella pneumophila positivity rate in hotel water samples from Antalya, Turkey. Environ Sci Pollut Res 2017; 24(13): 12238-42.
  • 33. Quero S, Párraga-Niño N, Barrabeig I, Sala MR, Pedro-Botet ML, Monsó E, et al. Population structure of environmental and clinical Legionella pneumophila isolates in Catalonia. Sci Rep 2018; 8(1): 6241.
  • 34. Zeybek Z, Türkmen A. Investigation of the incidence of legionella and free-living amoebae in swimming pool waters and biofilm specimens in Istanbul by different methods. Mikrobiyol Bul 2020; 54(1): 50-65.
  • 35. Papadakis A, Keramarou M, Chochlakis D, Sandalakis V, Mouchtouri VA, Psaroulaki A. Legionella spp. colonization in water systems of hotels linked with travel-associated legionnaires’ disease. Water 2021; 13(16): 2243.
  • 36. Yılmaz A, Orhan F. Investigation of the presence of Legionella pneumophila in water samples from Erzurum and surrounding provinces in Turkey. Ann Agric Environ Med 2021; 28(2): 255-9.