{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:34:13Z","timestamp":1790872453112,"version":"4.1.0"},"reference-count":28,"publisher":"American Society for Microbiology","issue":"7","license":[{"start":{"date-parts":[[1999,7,1]],"date-time":"1999-07-01T00:00:00Z","timestamp":930787200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[1999,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Five sporadic cases of nosocomial Legionnaires\u2019 disease were documented from 1989 to 1997 in a hospital in northern Italy. Two of them, which occurred in a 75-year-old man suffering from ischemic cardiopathy and in an 8-year-old girl suffering from acute leukemia, had fatal outcomes.\n            <jats:italic>Legionella pneumophila<\/jats:italic>\n            serogroup 6 was isolated from both patients and from hot-water samples taken at different sites in the hospital. These facts led us to consider the possibility that a single clone of\n            <jats:italic>L. pneumophila<\/jats:italic>\n            serogroup 6 had persisted in the hospital environment for 8 years and had caused sporadic infections. Comparison of clinical and environmental strains by monoclonal subtyping, macrorestriction analysis (MRA), and arbitrarily primed PCR (AP-PCR) showed that the strains were clustered into three different epidemiological types, of which only two types caused infection. An excellent correspondence between the MRA and AP-PCR results was observed, with both techniques having high discriminatory powers. However, it was not possible to differentiate the isolates by means of ribotyping and analysis of\n            <jats:italic>rrn<\/jats:italic>\n            operon polymorphism. Environmental strains that antigenically and chromosomally matched the infecting organism were present at the time of infection in hot-water samples taken from the ward where the patients had stayed. Interpretation of the temporal sequence of events on the basis of the typing results for clinical and environmental isolates enabled the identification of the ward where the patients became infected and the modes of transmission of\n            <jats:italic>Legionella<\/jats:italic>\n            infection. The long-term persistence in the hot-water system of different clones of\n            <jats:italic>L. pneumophila<\/jats:italic>\n            serogroup 6 indicates that repeated heat-based control measures were ineffective in eradicating the organism.\n          <\/jats:p>","DOI":"10.1128\/jcm.37.7.2189-2196.1999","type":"journal-article","created":{"date-parts":[[2019,12,31]],"date-time":"2019-12-31T17:46:59Z","timestamp":1577814419000},"page":"2189-2196","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":48,"title":["Multiple Types of\n            <i>Legionella pneumophila<\/i>\n            Serogroup 6 in a Hospital Heated-Water System Associated with Sporadic Infections"],"prefix":"10.1128","volume":"37","author":[{"given":"Paolo","family":"Visca","sequence":"first","affiliation":[{"name":"<!--label omitted: 1-->Laboratorio di Batteriologia e Micologia Medica, Istituto Superiore di Sanita\u0300,1"},{"name":"<!--label omitted: 2-->Dipartimento di Biologia, Universita\u0300 di Roma Tre,2 and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Goldoni","sequence":"additional","affiliation":[{"name":"<!--label omitted: 3-->Istituto di Microbiologia, Universita\u0300 di Roma \u201cLa Sapienza\u201d,300100 Rome, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. Christian","family":"Lu\u0308ck","sequence":"additional","affiliation":[{"name":"<!--label omitted: 4-->Institut fu\u0308r Medinische Mikrobiologie und Hygiene, Universita\u0308tsklinikum TV Dresden, D-01307, Dresden, Germany4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju\u0308rgen H.","family":"Helbig","sequence":"additional","affiliation":[{"name":"<!--label omitted: 4-->Institut fu\u0308r Medinische Mikrobiologie und Hygiene, Universita\u0308tsklinikum TV Dresden, D-01307, Dresden, Germany4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Cattani","sequence":"additional","affiliation":[{"name":"<!--label omitted: 3-->Istituto di Microbiologia, Universita\u0300 di Roma \u201cLa Sapienza\u201d,300100 Rome, and"},{"name":"<!--label omitted: 4-->Institut fu\u0308r Medinische Mikrobiologie und Hygiene, Universita\u0308tsklinikum TV Dresden, D-01307, Dresden, Germany4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Giltri","sequence":"additional","affiliation":[{"name":"<!--label omitted: 5-->Laboratorio di Microbiologia, Ospedale San Gerardo, 20052 Monza,5 Italy, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Bramati","sequence":"additional","affiliation":[{"name":"<!--label omitted: 5-->Laboratorio di Microbiologia, Ospedale San Gerardo, 20052 Monza,5 Italy, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maddalena Castellani","family":"Pastoris","sequence":"additional","affiliation":[{"name":"<!--label omitted: 1-->Laboratorio di Batteriologia e Micologia Medica, Istituto Superiore di Sanita\u0300,1"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.26.2.382-.1988"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(93)90227-G"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.26.9.1695-1703.1988"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.27.3.536-539.1989"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0147-619X(81)90058-5"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01700554"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0195-6701(89)90018-2"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1099\/13500872-142-1-3"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268800059331"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0195-6701(91)90060-L"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.35.11.2841-2845.1997"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0196-6553(93)90203-G"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/aem.57.11.3226-3231.1991"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1099\/00222615-43-1-50"},{"key":"e_1_3_2_16_2","first-page":"533","article-title":"Monoclonal antibodies to Legionella pneumophila serogroup 6: evidence of antigenic diversity","volume":"274","author":"L\u00fcck P. 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