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Chemical parameters (hardness, free chlorine concentration, and trace element concentrations), water systems, and building characteristics were evaluated to study risk factors for colonization. The hot water systems of Italian hotels were strongly colonized by\n                    <jats:italic>Legionella<\/jats:italic>\n                    ; 75% of the buildings examined and 60% of the water samples were contaminated, mainly at levels of \u226510\n                    <jats:sup>3<\/jats:sup>\n                    CFU liter\n                    <jats:sup>\u22121<\/jats:sup>\n                    , and\n                    <jats:italic>Legionella pneumophila<\/jats:italic>\n                    was the most frequently isolated species (87%).\n                    <jats:italic>L. pneumophila<\/jats:italic>\n                    serogroup 1 was isolated from 45.8% of the contaminated sites and from 32.5% of the hotels examined. When a multivariate logistic model was used, only hotel age was associated with contamination, but the risk factors differed depending on the contaminating species and serogroup. Soft water with higher chlorine levels and higher temperatures were associated with\n                    <jats:italic>L.\u2002pneumophila<\/jats:italic>\n                    serogroup 1 colonization, whereas the opposite was observed for serogroups 2 to 14. In conclusion, Italian hotels, particularly those located in old buildings, represent a major source of risk for Legionnaires' disease due to the high frequency of\n                    <jats:italic>Legionella<\/jats:italic>\n                    contamination, high germ concentration, and major\n                    <jats:italic>L. pneumophila<\/jats:italic>\n                    serogroup 1 colonization. The possible role of chlorine in favoring the survival of\n                    <jats:italic>Legionella<\/jats:italic>\n                    species is discussed.\n                  <\/jats:p>","DOI":"10.1128\/aem.71.10.5805-5813.2005","type":"journal-article","created":{"date-parts":[[2005,10,4]],"date-time":"2005-10-04T15:29:23Z","timestamp":1128439763000},"page":"5805-5813","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":129,"title":["<i>Legionella<\/i>\n                    Contamination in Hot Water of Italian Hotels"],"prefix":"10.1128","volume":"71","author":[{"given":"Paola","family":"Borella","sequence":"first","affiliation":[{"name":"Department of Hygiene, Microbiology and Biostatistics, University of Modena and Reggio E, Modena"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa","family":"Montagna","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Public Health, University of Bari, Bari"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Stampi","sequence":"additional","affiliation":[{"name":"Department of Public Medicine and Health, University of Bologna, Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Stancanelli","sequence":"additional","affiliation":[{"name":"S. Raffaele Hospital, Milan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Romano-Spica","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University Institute of Movement Sciences, Rome"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Triassi","sequence":"additional","affiliation":[{"name":"Hygiene and Preventive Medicine Institute, University Federico II of Naples, Naples"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Marchesi","sequence":"additional","affiliation":[{"name":"Department of Hygiene, Microbiology and Biostatistics, University of Modena and Reggio E, Modena"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Bargellini","sequence":"additional","affiliation":[{"name":"Department of Hygiene, Microbiology and Biostatistics, University of Modena and Reggio E, Modena"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Tato\u0300","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Public Health, University of Bari, Bari"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Napoli","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Public Health, University of Bari, Bari"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franca","family":"Zanetti","sequence":"additional","affiliation":[{"name":"Department of Public Medicine and Health, University of Bologna, Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Leoni","sequence":"additional","affiliation":[{"name":"Department of Public Medicine and Health, University of Bologna, Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Moro","sequence":"additional","affiliation":[{"name":"S. 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