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A Proactive Environmental Approach for Preventing Legionellosis in Infants: Water Sampling and Antibiotic Resistance Monitoring, a 3-Years Survey Program

1
Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Campus (Dragana) Building 5, 68131 Alexandroupolis, Greece
2
Microbiology Laboratory, Medical School, Democritus University of Thrace, Campus (Dragana), 68131 Alexandroupolis, Greece
*
Author to whom correspondence should be addressed.
Healthcare 2019, 7(1), 39; https://doi.org/10.3390/healthcare7010039
Received: 27 January 2019 / Revised: 2 March 2019 / Accepted: 6 March 2019 / Published: 8 March 2019
(This article belongs to the Special Issue Water Quality and Public Health)
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Abstract

A proactive environmental monitoring program was conducted to determine the risk and prevent nosocomial waterborne infections of Legionella spp. in infants. Sink taps in a neonatal intensive care unit (NICU) and two obstetric clinics were monitored for Legionella spp. A total of 59 water samples were collected during a 3-year period and 20 of them were found colonized with Legionella pneumophila. Standard culture, molecular, and latex agglutination methods were used for the detection and identification of Legionella bacteria. Hospital personnel also proceeded with remedial actions (hyperchlorination and thermal shock treatment) in the event of colonization. The minimal inhibitory concentration (MIC) values of erythromycin, ciprofloxacin was determined for Legionella isolates using the e-test method. Our data indicate that the majority of neonatal sink-taps were colonized at least once during the study with Legionella spp. Among 20 isolates, 5 were considered as low-level resistant, 3 in erythromycin and 2 in ciprofloxacin, while no resistant strains were detected. Environmental surveillance in neonatal and obstetric units is suggested to prevent waterborne infections, and thus to reduce the risk of neonatal nosocomial infections. View Full-Text
Keywords: infant; Legionella spp.; environmental monitoring; waterborne pathogens; antibiotic; e-test; water distribution system; health care facilities; public health infant; Legionella spp.; environmental monitoring; waterborne pathogens; antibiotic; e-test; water distribution system; health care facilities; public health
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Alexandropoulou, I.; Parasidis, T.; Konstantinidis, T.; Panopoulou, M.; Constantinidis, T.C. A Proactive Environmental Approach for Preventing Legionellosis in Infants: Water Sampling and Antibiotic Resistance Monitoring, a 3-Years Survey Program. Healthcare 2019, 7, 39.

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