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Molecular Determination of Infection Source of a Sporadic Legionella Pneumonia Case Associated with a Hot Spring Bath
Author(s) -
Miyamoto Hiroshi,
Jitsurong Siroj,
Shiota Ryoko,
Maruta Koji,
Yoshida ShinIchi,
Yabuuchi Eiko
Publication year - 1997
Publication title -
microbiology and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.664
H-Index - 70
eISSN - 1348-0421
pISSN - 0385-5600
DOI - 10.1111/j.1348-0421.1997.tb01190.x
Subject(s) - ecori , ribotyping , biology , microbiology and biotechnology , polymerase chain reaction , legionella pneumophila , restriction enzyme , molecular epidemiology , hindiii , virology , serotype , genotype , bacteria , genetics , dna , gene
To determine the infection source of a sporadic Legionella pneumonia case associated with a hot spring bath, we used five molecular methods, including repetitive element polymerase chain reaction (rep‐PCR), arbitrarily primed PCR (AP‐PCR), ribotyping, restriction endonuclease analysis (REA), and macrorestriction endonuclease analysis (MREA) by pulsed‐field gel electrophoresis. L. pneumophila serogroup (SG) 3 strain EY 3702, isolated from an intratracheal specimen of a 71‐year‐old Japanese female who developed pneumonia after nearly drowning in a hot spring spa bath, produced rep‐PCR and AP‐PCR fingerprints identical to those of L. pneumophila SG 3 strains EY 3768 and EY 3769 isolated from the bath water. Four epidemiologically unrelated L. pneumophila SG 3 strains showed different rep‐PCR or AP‐PCR fingerprints from those of the three EY strains (EY 3702, 3768, and 3769). The three EY strains were also genotypically indistinguishable by ribotyping with Eco RI and Pst I, by REA with Eco BI or Hin dIII, and by MREA with Not I. Based on these results, we identified the bath water of the hot spring spa as the source of infection of this patient, even though the viable number of the organisms in the bath water was low (3 CFU/100 ml) when determined 27 days after her nearly drowning.