title: Hospital-acquired legionellosis originating from a cooling tower during a period of thermal inversion.
abstract: A case of hospital-acquired legionellosis occurred in a 75-year-old male patient who underwent surgery due to malignant melanoma. Legionellosis was proven by culture of Legionella pneumophila serogroup 1 from bronchoalveolar lavage (BAL) fluid. Being a chronic smoker the patient used to visit the sickroom balcony that was located about 90 m to the west of a hospital cooling tower. Routine cooling tower water samples drawn during the presumed incubation period revealed 1.0x10(4) CFU/100 ml (L. pneumophila serogroup 1). One of three isolates from the cooling tower water matched the patient's isolate by monoclonal antibody (mab)- and genotyping (sequence-based typing). Horizontal transport of cooling tower aerosols probably was favoured by meteorological conditions with thermal inversion. The case report stresses the importance of routine maintenance and microbiological control of hospital cooling towers.
authors.affiliation: Institute of Hygiene and Public Health, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany. steffen.engelhart@ukb.uni-bonn.de
authors.forename: Steffen
authors.initials: S
authors.lastname: Engelhart
authors.forename: Stefan
authors.initials: S
authors.lastname: Pleischl
authors.forename: Christian
authors.initials: C
authors.lastname: Lück
authors.forename: Günter
authors.initials: G
authors.lastname: Marklein
authors.forename: Edith
authors.initials: E
authors.lastname: Fischnaller
authors.forename: Sybille
authors.initials: S
authors.lastname: Martin
authors.forename: Arne
authors.initials: A
authors.lastname: Simon
authors.forename: Martin
authors.initials: M
authors.lastname: Exner
mesh_terms: D000336:Aerosols / Q000009:adverse effects; D000368:Aged; D000389:Air Conditioning; D000911:Antibodies, Monoclonal; D003080:Cold Temperature; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D005838:Genotype; D005858:Germany / Q000453:epidemiology; D006761:Hospitals; D006801:Humans; D016952:Legionella pneumophila / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D007876:Legionellosis / Q000453:epidemiology; D007877:Legionnaires' Disease / Q000453:epidemiology / Q000382:microbiology*; D008297:Male; D008545:Melanoma / Q000150:complications / Q000601:surgery; D017421:Sequence Analysis; D012878:Skin Neoplasms / Q000150:complications / Q000601:surgery; D014871:Water Microbiology; D014887:Weather
chemical_list: D000336:Aerosols; D000911:Antibodies, Monoclonal