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Clinical treatment guidelines for legionellosis are primarily based on data from <jats:italic>L. pneumophila<\/jats:italic> and recommend macrolides and fluoroquinolones. However, the intrinsic antimicrobial susceptibility of <jats:italic>L. gormanii<\/jats:italic> is not well-defined, creating uncertainty about whether these guidelines are directly applicable. Establishing a baseline understanding of its susceptibility patterns is a prerequisite for effective epidemiological surveillance and for identifying non-wild-type resistance. This study aims to address this fundamental knowledge gap by characterizing the in vitro susceptibility profiles of a large collection of environmental <jats:italic>L. gormanii<\/jats:italic> isolates.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This study systematically evaluated the in vitro activity of ten representative antimicrobials against 207 environmental <jats:italic>L. gormanii<\/jats:italic> isolates collected in China between 2019 and 2021. Minimum inhibitory concentrations (MICs) were determined by the broth microdilution (BMD) method, and species-specific epidemiological cutoff values (ECOFFs) were established using the ECOFFinder tool.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Most tested agents demonstrated good in vitro activity. Rifampin was the most potent agent, while clarithromycin was the most active macrolide. Conversely, tetracyclines showed limited activity. Comparative analysis revealed that <jats:italic>L. gormanii<\/jats:italic> exhibited markedly higher MICs for rifampin (approximately 9.58-fold) than typically reported for <jats:italic>L. pneumophila<\/jats:italic>. Species-specific ECOFFs were determined for nine antimicrobials: rifampin (0.016\u00a0mg\/L); ciprofloxacin, levofloxacin, and clarithromycin (0.063\u00a0mg\/L); moxifloxacin (0.125\u00a0mg\/L); erythromycin (0.25\u00a0mg\/L); azithromycin (0.5\u00a0mg\/L); trimethoprim-sulfamethoxazole (4\u00a0mg\/L); and tigecycline (16\u00a0mg\/L).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>This study establishes the first large-scale susceptibility dataset and species-specific ECOFFs for <jats:italic>L. gormanii<\/jats:italic>. The findings highlight key inter-species differences in susceptibility, particularly for rifampin, underscoring that treatment paradigms cannot be safely extrapolated from <jats:italic>L. pneumophila<\/jats:italic>. These ECOFFs provide a critical tool for surveillance of non-wild-type resistance. However, these data, derived from environmental isolates, are intended for epidemiological and hypothesis-generating purposes and must be supplemented with clinical and pharmacokinetic\/pharmacodynamic (PK\/PD) studies before informing changes to clinical practice.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12941-025-00813-8","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T12:53:10Z","timestamp":1756731190000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antimicrobial susceptibility of Legionella gormanii: species-specific ECOFFs, distinct MICs for rifampin versus Legionella pneumophila"],"prefix":"10.1186","volume":"24","author":[{"given":"Jun-Wei","family":"Xu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan-Tong","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5809-7904","authenticated-orcid":false,"given":"Xiao-Yong","family":"Zhan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"issue":"2","key":"813_CR1","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1128\/jcm.26.2.380-381.1988","volume":"26","author":"ME Griffith","year":"1988","unstructured":"Griffith ME, Lindquist DS, Benson RF, Thacker WL, Brenner DJ, Wilkinson HW. 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