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      Regrowth of Legionella pneumophila in a heat-disinfected plumbing system

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      Zentralblatt für Bakteriologie
      Elsevier BV

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          The molecular ecology of legionellae.

          Legionella pneumophila is the most highly characterized member of a genus of bacteria that survive as intracellular parasites of freshwater protozoa. These bacteria can also multiply intracellularly in human phagocytic cells and cause respiratory disease in humans. Comparison of the invasive strategies of L. pneumophila in mammalian and protozoan cells and study of the interactions between Legionella and protozoa should prove useful in development of strategies for the prevention of legionellosis.
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            Isolation of Legionella pneumophila from clinical specimens via amoebae, and the interaction of those and other isolates with amoebae.

            The development of an amoebal enrichment method, for the recovery of viable Legionella pneumophila from clinical materials is described. The method has been used successfully in five of six cases of Legionnaires' disease in which L pneumophila was isolated. Studies on those L pneumophila isolates led to the discovery that virulent legionellae are attracted to, and attack suitable host amoebae, rather than infection following chance ingestion.
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              Intraphagocytic growth induces an antibiotic-resistant phenotype of Legionella pneumophila.

              The antimicrobial susceptibilities of Legionella pneumophila isolates grown either in U937 human monocytic cells or in Acanthamoeba polyphaga were studied after release from the host cells without further subculture. Time-survival studies showed that exposure of L. pneumophila cells, gown exclusively in vitro, to 5 micrograms of rifampin per ml resulted in at least 99% killing after 6 h and no detectable survivors at 24 h. Similar rates of killing were observed for in vitro-grown cells tested by exposure to ciprofloxacin. Conversely, time-survival studies revealed that macrophage-grown and amoeba-grown cells were ca. 1,000-fold more resistant to the activities of both drugs. Macrophage-grown cells treated with 5 micrograms of rifampin per ml showed 70 and 62% survival after 6 and 24 h, respectively. Intracellularly grown legionellae were also highly resistant to erythromycin (8 microgram/ml). After 24 h of exposure to the drug, there was 70 and 60% survival for amoeba-grown and macrophage-grown legionellae, respectively, whereas in vitro-grown cells showed a 2-log10 reduction in viable count. when intracellularly grown L. pneumophila cells were subcultured in broth for 48 h, they reverted to the phenotype characteristic of in vitro growth. Morphologically, the cells were larger than their intracellularly grown counterparts and resistance characteristics were lost. The susceptibilities of the subcultured cells to all three drugs were similar to those of Legionella cells grown exclusively in vitro. In view of these findings, the successful treatment of Legionnaires disease may be related as much to the resistance phenotype induced by intramacrophage growth as to the ability of the antibiotic to enter phagocytic cells.
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                Author and article information

                Journal
                Zentralblatt für Bakteriologie
                Zentralblatt für Bakteriologie
                Elsevier BV
                09348840
                November 1998
                November 1998
                : 288
                : 3
                : 331-342
                Article
                10.1016/S0934-8840(98)80005-4
                cace3909-0336-431d-9eb7-71bc6741a73b
                © 1998

                http://www.elsevier.com/tdm/userlicense/1.0/

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