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As there is limited data available for Portugal, we determined the antibiotic susceptibility profile of Portuguese\n                      <jats:italic>L. pneumophila<\/jats:italic>\n                      serogroup 1 (LpnSg1) isolates against antibiotics used in the clinical practice in Portugal.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Minimum inhibitory concentrations (MICs) were determined for\n                      <jats:italic>LpnSg1<\/jats:italic>\n                      clinical (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009100) and related environmental (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097) isolates, collected between 2006\u20132022 in the context of the National Legionnaire\u00b4s Disease Surveillance Programme, against azithromycin, clarithromycin, erythromycin, levofloxacin, ciprofloxacin, moxifloxacin, rifampicin, doxycycline, tigecycline, and amoxicillin\/clavulanic acid, using three different assays. Isolates were also PCR-screened for the presence of the\n                      <jats:italic>lpeAB<\/jats:italic>\n                      gene.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twelve isolates had azithromycin MICs above the EUCAST tentative highest WT MIC, 9 of which were\n                      <jats:italic>lpeAB<\/jats:italic>\n                      negative; for erythromycin and clarithromycin, all isolates tested within the susceptible range. The number of isolates with MICs above the tentative highest WT MIC for the remaining antibiotics was: ciprofloxacin: 7; levofloxacin: 17; moxifloxacin: 8; rifampicin: 11; doxycycline: 82; tigecycline: 4. EUCAST breakpoints are not available for amoxicillin\/clavulanic acid. We estimated the ECOFFs and one isolate had a MIC eightfold higher than the E-test ECOFF. Additionally, a clinical isolate generated three colonies growing on the E-test inhibition zone that resulted in MICs fourfold higher than for the parental isolate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      We report, for the first time, elevated MICs against first-line and other antibiotics (including azithromycin, fluoroquinolones and amoxicillin\/clavulanic acid commonly used to treat pneumonia patients in Portugal) in Portuguese\n                      <jats:italic>L. pneumophila<\/jats:italic>\n                      strains. Results point towards decreased susceptibility in circulating strains, justifying further investigation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10096-024-04789-9","type":"journal-article","created":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T08:02:02Z","timestamp":1714636922000},"page":"1297-1308","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Antimicrobial susceptibility testing reveals reduced susceptibility to azithromycin and other antibiotics in Legionella pneumophila serogroup 1 isolates from Portugal"],"prefix":"10.1007","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7862-4874","authenticated-orcid":false,"given":"Corrado","family":"Minetti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael","family":"Barton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5309-2991","authenticated-orcid":false,"given":"Caitlin","family":"Farley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9117-6911","authenticated-orcid":false,"given":"Owen Brad","family":"Spiller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4417-9714","authenticated-orcid":false,"given":"Raquel","family":"Rodrigues","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4633-6306","authenticated-orcid":false,"given":"Paulo","family":"Gon\u00e7alves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,2]]},"reference":[{"key":"4789_CR1","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1016\/S0140-6736(15)60078-2","volume":"387","author":"BA Cunha","year":"2016","unstructured":"Cunha BA, Burillo A, Bouza E (2016) Legionnaires\u2019 disease. 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