title: Molecular typing of a Legionella pneumophila outbreak in Ontario, Canada.
abstract: An outbreak of Legionnaires' disease at a long-term care facility in Ontario, Canada from September to October 2005 resulted in the death of 23 residents and the illness of 112 other people. In response, molecular methods were developed to detect Legionella pneumophila in clinical lung samples and to subtype isolates from clinical and environmental samples. The targeted genetic loci included Legionella-specific virulence determinants (mip, icmO, sidA and lidA) and core bacterial determinants (ftsZ, trpS and dnaX). An established amplified fragment length polymorphism typing method provided the first indication of genetic relatedness between strains recovered from clinical samples and strains cultured from environmental samples taken from the outbreak site. These associations were verified using the European Working Group for Legionella Infections sequence-based typing protocol targeting the flaA, pilE, asd, mip, mompS and proA loci. These molecular typing methods confirmed the outbreak source as a contaminated air conditioning cooling tower.
authors.affiliation: Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada.|National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba R3E 3R2, Canada.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Gilmour
authors.affiliation: Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada.|National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba R3E 3R2, Canada.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Bernard
authors.affiliation: National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba R3E 3R2, Canada.
authors.forename: Dobryan M
authors.initials: DM
authors.lastname: Tracz
authors.affiliation: National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba R3E 3R2, Canada.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Olson
authors.affiliation: National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba R3E 3R2, Canada.
authors.forename: Cindi R
authors.initials: CR
authors.lastname: Corbett
authors.affiliation: National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba R3E 3R2, Canada.
authors.forename: Tamara
authors.initials: T
authors.lastname: Burdz
authors.affiliation: National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba R3E 3R2, Canada.
authors.forename: Betty
authors.initials: B
authors.lastname: Ng
authors.affiliation: National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba R3E 3R2, Canada.
authors.forename: Deborah
authors.initials: D
authors.lastname: Wiebe
authors.affiliation: Central Public Health Laboratory, Ministry of Health and Long Term Care, Toronto, Ontario, Canada.
authors.forename: George
authors.initials: G
authors.lastname: Broukhanski
authors.affiliation: Central Public Health Laboratory, Ministry of Health and Long Term Care, Toronto, Ontario, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Boleszczuk
authors.affiliation: Central Public Health Laboratory, Ministry of Health and Long Term Care, Toronto, Ontario, Canada.
authors.forename: Patrick
authors.initials: P
authors.lastname: Tang
authors.affiliation: Central Public Health Laboratory, Ministry of Health and Long Term Care, Toronto, Ontario, Canada.
authors.forename: Frances
authors.initials: F
authors.lastname: Jamieson
authors.affiliation: National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba R3E 3R2, Canada.
authors.forename: Gary
authors.initials: G
authors.lastname: Van Domselaar
authors.affiliation: Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada.|National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba R3E 3R2, Canada.
authors.forename: Francis A
authors.initials: FA
authors.lastname: Plummer
authors.affiliation: National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba R3E 3R2, Canada.
authors.forename: Jody D
authors.initials: JD
authors.lastname: Berry
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics; D015373:Bacterial Typing Techniques; D016000:Cluster Analysis; D016172:DNA Fingerprinting / Q000379:methods; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004196:Disease Outbreaks; D006801:Humans; D016952:Legionella pneumophila / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D007876:Legionellosis / Q000453:epidemiology* / Q000382:microbiology*; D008168:Lung / Q000382:microbiology; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D021141:Nucleic Acid Amplification Techniques; D009864:Ontario / Q000453:epidemiology; D017422:Sequence Analysis, DNA; D012866:Skilled Nursing Facilities; D037521:Virulence Factors / Q000235:genetics
chemical_list: D001426:Bacterial Proteins; D004269:DNA, Bacterial; D037521:Virulence Factors