{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T13:42:06Z","timestamp":1791121326959,"version":"4.1.0"},"reference-count":29,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2016,6,21]],"date-time":"2016-06-21T00:00:00Z","timestamp":1466467200000},"content-version":"unspecified","delay-in-days":3704,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2006,5]]},"abstract":"<jats:sec id=\"S0899823X00195248_abs1\"><jats:title>Objectives.<\/jats:title><jats:p>To perform a 3-year, prospective surveillance program for legionnaires disease (LD) in a large university hospital in Rome, and to assess the usefulness of the hospital water monitoring program in predicting the risk of nosocomial LD.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X00195248_abs2\"><jats:title>Methods.<\/jats:title><jats:p>Samples from patients with new cases of nosocomial pneumonia were sent for legionella laboratory investigations. Meanwhile, water samples for bacteriological analysis were collected every 6 months from high- and medium-risk hospital wards (10 in total).<jats:italic>Legionella pneumophila<\/jats:italic>isolates collected were serotyped and analyzed by pulsed-field gel electrophoresis.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X00195248_abs3\"><jats:title>Results.<\/jats:title><jats:p>From June 2001 through May 2004, the pneumonia surveillance identified one case of nosocomial LD among 43 cases of nosocomial pneumonia (2.3%). Environmental investigations detected<jats:italic>L. pneumophila<\/jats:italic>in 12 (18.7%) of the 64 water samples, of which 50% belonged to serogroup 1. The<jats:italic>L. pneumophila<\/jats:italic>count and the percentage of positive locations never exceeded 10<jats:sup>2<\/jats:sup>colony-forming units\/L and 20%, respectively, except when the LD nosocomial case occurred (positive water samples, 40%; I. pneumophila count, &lt;10<jats:sup>2<\/jats:sup>colony-forming units\/L). Genotyping showed 3 prevalent clones of<jats:italic>L. pneumophila<\/jats:italic>in the water distribution network, of which one persisted over the 3 years. One clone contained 3 different<jats:italic>L. pneumophila<\/jats:italic>serogroups (2, 4, and 6).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X00195248_abs4\"><jats:title>Conclusions.<\/jats:title><jats:p>The low incidence of nosocomial cases of LD appears to be associated with a low percentage (&lt;20%) of positive water samples per semester and with a low contamination level (&lt;10<jats:sup>2<\/jats:sup>colony-forming units\/L). An infection control system for nosocomial LD should, therefore, be based on both environmental and clinical surveillance, together with the appropriate maintenance of the hospital water distribution system.<\/jats:p><\/jats:sec>","DOI":"10.1086\/503642","type":"journal-article","created":{"date-parts":[[2006,5,2]],"date-time":"2006-05-02T21:02:01Z","timestamp":1146603721000},"page":"459-465","source":"Crossref","is-referenced-by-count":37,"title":["Prospective 3-Year Surveillance for Nosocomial and Environmental<i>Legionella pneumophila<\/i>: Implications for Infection Control"],"prefix":"10.1017","volume":"27","author":[{"given":"S.","family":"Boccia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Laurenti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Borella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Moscato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Capalbo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Cambieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Amore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Quaranta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Boninti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Orsini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Branca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Fadda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. 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