+91 8617752708

Journal of Advances in Medicine and Medical Research, ISSN: 2456-8899, ISSN: 2231-0614 (Past),Vol.: 28, Issue.: 10


Prevalence of Nosocomial Legionella pneumophila in a Liver Transplant Unit: Clinical and Environmental Study

Dalia Moemen1*, Weaam Shakra2, Ashraf Elshawadfy2, Abdou El-Mougithand Mohamed Elsaadany3

1Department of Microbiology and Immunology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

2Department of Botany, Faculty of Science, Zagazig University, Zagazig, Egypt.

3Department of Gastroentrology Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

Article Information


(1) Dr. Kate S Collison, Department of Cell Biology, King Faisal Specialist Hospital & Research Centre, Saudi Arabia.

(2) Dr. Chan-Min Liu, School of Life Science, Xuzhou Normal University, Xuzhou City, China.


(1) Maria Antonietta Toscano, University of Catania, Italy.

(2) Andrea J. Grisold, Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz,Austria.

(3) Jorge Roig, Hospital Nostra Senyora de Meritxell, Andorra.

Complete Peer review History:


Aims: Legionella pneumophila (L. pneumophila) is a human pathogenic bacteria associated with aquatic habitat. It is a causative agent of sever pneumonia known as Legionnaires’ disease (LD). LD among liver transplant recipients (LTRs) is difficult to diagnose with routine methods.

Study Design: Thus the current study was designed to detect Legionella in clinical samples as well as environmental samples in the liver transplant unit of Gastroenterology Surgical Center (GEC), from November, 2014 till June, 2016.

Methods: Respiratory, urine and blood samples were collected from 30 LTRs who were hospitalized with signs and symptoms of lower respiratory tract infections. The specimens were screened for Legionella by plate culture method, urinary antigen detection and serological investigation. A total of 40 environmental samples from hospital water and air ventilation system of the same unit were collected and analyzed for the occurrence of Legionella. The minimum inhibitory concentration (MICs) of L. pneumophila isolates against 8 antimicrobials were determined. 

Results: The prevalence of nosocomial Legionella pneumonia was 20%. Six patients were positive for L. pneumophila by culture, among those, urine antigen was detected in five patients and serum investigation yielded positive in three patients. L. pneumophila was recovered from five water samples (12.5%). Azithromycin was found to be the most active against Legionella isolates in vitro. Chlorine (2 mg/L) and superheating (70°C) of hospital water successfully eradicated L. pneumophila.

Conclusion: For hospital with transplant units, periodic monitoring of Legionella in hospital water supply and introducing diagnostic tests for LD for patients with nosocomial pneumonia is necessary.

Keywords :

Nosocomial pneumonia; Legionella pneumophila; Legionnaires’ disease; liver transplant recipients; hospital water contamination.

Full Article - PDF    Page 1-11

DOI : 10.9734/JAMMR/2018/37397

Review History    Comments

Our Contacts

Guest House Road, Street no - 1/6,
Hooghly, West Bengal,

+91 8617752708


Third Floor, 207 Regent Street
London, W1B 3HH,

+44 20-3031-1429