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L. feeleii  is one of the most frequent  Legionella  species isolated from natural pools of the central region of Spain. This study aimed to evaluate its ecology and to identify this  Legionella  species as a respiratory pathogen. A PCR assay for detecting the  L. feeleii  mip gene was developed to identify it in clinical and environmental samples. Culture and PCR were performed in environmental samples from four drinking water treatment plants (DWTPs). Free  L. feeleii  was only detected in raw water samples (3.4%), while  L. feeleii  as an  Acanthamoeba  endosymbiont was found in 30.7% of raw water, 11.5% of decanter biofilm, and 32% of finished water samples. Therefore,  Acanthamoeba  spp. plays an essential role in the multiplication, persistence, and spread of  Legionella  species in the environment. The first case of Legionnaires’ disease caused by  L. feeleii  in Spain is described in this study. The case was diagnosed in an older woman through PCR and sequencing from urine and sputum samples. A respiratory infection could be linked with health care procedures, and the patient presented several risk factors (age, insulin-dependent diabetes, and heart disease). The detection of non- L .  pneumophila , such as  L. feeleii , is a factor that must be considered when establishing or reviewing measures for the control and prevention of legionellosis.

Legionella feeleii: Ubiquitous Pathogen in the Environment and Causative Agent of Pneumonia