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      Occurrence of Legionella in UK household showers.

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          Abstract

          Household water systems have been proposed as a source of sporadic, community acquired Legionnaires' disease. Showers represent a frequently used aerosol generating device in the domestic setting yet little is known about the occurrence of Legionella spp. in these systems. This study has investigated the prevalence of Legionella spp. by culture and qPCR in UK household showers. Ninety nine showers from 82 separate properties in the South of England were sampled. Clinically relevant Legionella spp. were isolated by culture in 8% of shower water samples representing 6% of households. Legionella pneumophila sg1 ST59 was isolated from two showers in one property and air sampling demonstrated its presence in the aerosol state. A further 31% of showers were positive by Legionella spp. qPCR. By multi-variable binomial regression modelling Legionella spp. qPCR positivity was associated with the age of the property (p=0.02), the age of the shower (p=0.01) and the frequency of use (p=0.09). The concentration of Legionella spp. detected by qPCR was shown to decrease with increased frequency of use (p=0.04) and more frequent showerhead cleaning (p=0.05). There was no association between Legionella spp. qPCR positivity and the cold water supply or the showerhead material (p=0.65 and p=0.71, respectively). Household showers may be important reservoirs of clinically significant Legionella and should be considered in source investigations. Simple public health advice may help to mitigate the risk of Legionella exposure in the domestic shower environment.

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          Author and article information

          Journal
          Int J Hyg Environ Health
          International journal of hygiene and environmental health
          Elsevier BV
          1618-131X
          1438-4639
          Apr 2017
          : 220
          : 2 Pt B
          Affiliations
          [1 ] Biosafety, Air and Water Microbiology Group, National Infection Service, Public Health England, Porton Down, Salisbury, UK. Electronic address: Samuel.collins@phe.gov.uk.
          [2 ] Biosafety, Air and Water Microbiology Group, National Infection Service, Public Health England, Porton Down, Salisbury, UK.
          Article
          S1438-4639(16)30502-8
          10.1016/j.ijheh.2016.12.001
          27964907
          2a417a88-f0db-4810-85a3-d1ffdaa5a50e
          History

          Aerosol,Domestic,Legionella,Legionnaires’ disease,Shower
          Aerosol, Domestic, Legionella, Legionnaires’ disease, Shower

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