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Garcia-Nuñez M, Garcia-Gonzalez M, Pomares X, Montón C, Millares L, Quero S, Prina E, Asensio O, Bosque M, Capilla S, Cuevas O, Monsó E. The Respiratory Microbiome in Cystic Fibrosis: Compartment Patterns and Clinical Relationships in Early Stage Disease. Front Microbiol 2020; 11:1463. [PMID: 32695090 PMCID: PMC7339930 DOI: 10.3389/fmicb.2020.01463] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 06/04/2020] [Indexed: 11/28/2022] Open
Abstract
We compared the bacterial microbiomes lodged in the bronchial tree, oropharynx and nose of patients with early stage cystic fibrosis (CF) not using chronic antibiotics, determining their relationships with lung function and exacerbation frequency. CF patients were enrolled in a cohort study during stability and were checked regularly over the following 9 months. Upper respiratory samples (sputum [S], oropharyngeal swab [OP] and nasal washing [N]) were collected at the first visit and every 3 months. 16S rRNA gene amplification and sequencing was performed and analyzed with QIIME. Seventeen CF patients were enrolled (16.6 SD 9.6 years). Alpha-diversity of bacterial communities between samples was significantly higher in S than in OP (Shannon index median 4.6 [IQR: 4.1–4.9] vs. 3.7 [IQR: 3-1-4.1], p = 0.003/Chao 1 richness estimator median 97.75 [IQR: 85.1–110.9] vs. 43.9 [IQR: 31.7–59.9], p = 0.003) and beta-diversity analysis also showed significant differences in the microbial composition of both respiratory compartments (Adonis test of Bray Curtis dissimilarity matrix, p = 0.001). Dominant taxa were found at baseline in five patients (29.4%), who showed lower forced expiratory volume in the first second (FEV1%, mean 74.8 [SD 19] vs. 97.2 [SD 17.8], p = 0.035, Student t test). The Staphylococcus genus had low RAs in most samples (median 0.26% [IQR 0.01–0.69%]), but patients with RA > 0.26% of Staphylococcus in bronchial secretions suffered more exacerbations during follow-up (median 2 [IQR 1–2.25] vs. 0 [0–1], p = 0.026. Mann–Whitney U test), due to S. aureus in more than a half of the cases, microorganism that often persists as bronchial colonized in these patients (9/10 [90%] vs. 2/7 [28.6%], p = 0.034, Fisher’s exact test). In conclusion, the bronchial microbiome had significantly higher diversity than the microbial flora lodged in the oropharynx in early stage CF. Although the RA of the Staphylococcus genus was low in bronchial secretions and did not reach a dominance pattern, slight overrepresentations of this genus was associated with higher exacerbation frequencies in these patients.
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Affiliation(s)
- Marian Garcia-Nuñez
- Department of Respiratory Medicine, Institut d'Investigació i Innovació Parc Taulí (I3PT), Hospital Universitari Parc Taulí, Sabadell, Spain.,Centro de Investigación en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Miguel Garcia-Gonzalez
- Cystic Fibrosis Unit, Hospital Universitari Parc Taulí, Sabadell, Spain.,Department of Pediatrics, Institut d'Investigació i Innovació Parc Taulí (I3PT), Hospital Universitari Parc Taulí, Sabadell, Spain.,Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Xavier Pomares
- Department of Respiratory Medicine, Institut d'Investigació i Innovació Parc Taulí (I3PT), Hospital Universitari Parc Taulí, Sabadell, Spain.,Centro de Investigación en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.,Cystic Fibrosis Unit, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Concepción Montón
- Department of Respiratory Medicine, Institut d'Investigació i Innovació Parc Taulí (I3PT), Hospital Universitari Parc Taulí, Sabadell, Spain.,Cystic Fibrosis Unit, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Laura Millares
- Department of Respiratory Medicine, Institut d'Investigació i Innovació Parc Taulí (I3PT), Hospital Universitari Parc Taulí, Sabadell, Spain.,Centro de Investigación en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.,Infectious and Respiratory Disease Research Group, Fundació Institut d'Investigació Germans Trias i Pujol, Badalona, Spain
| | - Sara Quero
- Department of Respiratory Medicine, Institut d'Investigació i Innovació Parc Taulí (I3PT), Hospital Universitari Parc Taulí, Sabadell, Spain.,Centro de Investigación en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.,Infectious and Respiratory Disease Research Group, Fundació Institut d'Investigació Germans Trias i Pujol, Badalona, Spain
| | - Elena Prina
- Department of Respiratory Medicine, Institut d'Investigació i Innovació Parc Taulí (I3PT), Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Oscar Asensio
- Cystic Fibrosis Unit, Hospital Universitari Parc Taulí, Sabadell, Spain.,Department of Pediatrics, Institut d'Investigació i Innovació Parc Taulí (I3PT), Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Montserrat Bosque
- Cystic Fibrosis Unit, Hospital Universitari Parc Taulí, Sabadell, Spain.,Department of Pediatrics, Institut d'Investigació i Innovació Parc Taulí (I3PT), Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Silvia Capilla
- Department of Microbiology, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Oscar Cuevas
- Department of Pediatrics, Institut d'Investigació i Innovació Parc Taulí (I3PT), Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Eduard Monsó
- Department of Respiratory Medicine, Institut d'Investigació i Innovació Parc Taulí (I3PT), Hospital Universitari Parc Taulí, Sabadell, Spain.,Centro de Investigación en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.,Universitat Autonoma de Barcelona, Barcelona, Spain
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Gavaldà L, Garcia-Nuñez M, Quero S, Gutierrez-Milla C, Sabrià M. Role of hot water temperature and water system use on Legionella control in a tertiary hospital: An 8-year longitudinal study. Water Res 2019; 149:460-466. [PMID: 30472548 DOI: 10.1016/j.watres.2018.11.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/24/2018] [Accepted: 11/14/2018] [Indexed: 06/09/2023]
Abstract
Although measures to minimize Legionella colonization in sanitary hot water installations are well established, there is little evidence of their long-term effectiveness in hospital buildings. During an 8-year period, hot water in a large hospital building was sampled monthly in areas with suitable dimensioning and recirculation and in areas with dead legs and low-use taps. In the former areas, the percentage of Legionella-negative samples was 83.2% when the temperature was ≥55%, 64.9% when between 50.1 °C and 54.0 °C, and 51.6% when ≤50 °C (p for trend <0.001). In the highest temperature group, no samples with ≥103 cfu/L were observed. In poorly designed areas, only 44.7% of samples were negative, and 28.9% presented ≥103 cfu/L although reaching 55 °C. In these areas, multivariate analysis showed that if hot water supplies were not used daily, the risk of Legionella colonization was greater than two-fold (odds ratio: 2.84; 95% confidence interval: 1.26-6.41), and the risk of finding Legionella concentrations ≥103 cfu/L was more than three-fold (odds ratio: 3.18; 95% confidence interval: 1.36-7.46), regardless the temperature. These findings indicate that the effectiveness of maintaining sanitary hot water at a minimum temperature of 55 °C is significantly better than that at 50 °C for the environmental control of Legionella but only in installations with suitable dimensioning and recirculation. In installations that do not meet these conditions, high temperatures alone result in insufficient control.
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Affiliation(s)
- Laura Gavaldà
- Department of Preventive Medicine-Hospital Hygiene. Hospital Universitari de Bellvitge-IDIBELL, Feixa Llarga, s/n. 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Marian Garcia-Nuñez
- Infectious diseases Unit, Fundació Institut d'Investigació Germans Trias I Pujol, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet, s/n, 08916, Badalona, Barcelona, Spain; CIBER de Enfermedades Respiratorias, CIBERES, Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain; Department of Respiratory Medicine, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, I3PT, Parc Taulí, 1, 08208, Sabadell, Barcelona, Spain.
| | - Sara Quero
- Infectious diseases Unit, Fundació Institut d'Investigació Germans Trias I Pujol, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet, s/n, 08916, Badalona, Barcelona, Spain.
| | - Carmen Gutierrez-Milla
- Department of Preventive Medicine-Hospital Hygiene. Hospital Universitari de Bellvitge-IDIBELL, Feixa Llarga, s/n. 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Miquel Sabrià
- Infectious diseases Unit, Fundació Institut d'Investigació Germans Trias I Pujol, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet, s/n, 08916, Badalona, Barcelona, Spain; CIBER de Enfermedades Respiratorias, CIBERES, Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain; Department of Medicine, Universitat Autònoma de Barcelona (UAB), Av. de Can Domènech, 737, 08193, Cerdanyola del Vallès, Barcelona, Spain.
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Quero S, Párraga-Niño N, Sabria M, Barrabeig I, Sala MR, Jané M, Mateu L, Sopena N, Pedro-Botet ML, Garcia-Nuñez M. Legionella SBT applied directly to respiratory samples as a rapid molecular epidemiological tool. Sci Rep 2019; 9:623. [PMID: 30679570 PMCID: PMC6346096 DOI: 10.1038/s41598-018-36924-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/29/2018] [Indexed: 11/09/2022] Open
Abstract
Legionnaires' disease (LD) is an atypical pneumonia caused by the inhalation of Legionella. The methods used for the diagnosis of LD are direct culture of respiratory samples and urinary antigen detection. However, the sensitivity of culture is low, and the urinary antigen test is specific only for L. pneumophila sg1. Moreover, as no isolates are obtained, epidemiological studies cannot be performed. The implementation of Nested-sequence-based typing (Nested-SBT) makes it possible to carry out epidemiological studies while also confirming LD, especially in cases caused by non-sg 1. Sixty-two respiratory samples from patients with Legionella clinically confirmed by positive urinary antigen tests were cultured and tested by Nested-SBT, following the European Study Group for Legionella Infections (ESGLI) protocol. Only 2/62 (3.2%) respiratory samples were culture-positive. Amplification and sequencing of Nested-SBT genes were successfully performed in 57/62 samples (91.9%). The seven target genes were characterised in 39/57 (68.4%) respiratory samples, and the complete sequence type (ST) was obtained. The mip gene was the most frequently amplified and sequenced. Nested-SBT is a useful method for epidemiological studies in culture-negative samples, achieving a 28.7-fold improvement over the results of culture studies and reducing the time needed to obtain molecular epidemiological results.
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Affiliation(s)
- Sara Quero
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
| | - Noemí Párraga-Niño
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Miquel Sabria
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. .,CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain. .,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
| | - Irene Barrabeig
- Vigilància Epidemiològica i Resposta a Emergències de Salut Pública, Agencia de Salut Pública de Catalunya, Barcelona, Spain
| | - Maria Rosa Sala
- Vigilància Epidemiològica i Resposta a Emergències de Salut Pública, Agencia de Salut Pública de Catalunya, Barcelona, Spain
| | - Mireia Jané
- Vigilància Epidemiològica i Resposta a Emergències de Salut Pública, Agencia de Salut Pública de Catalunya, Barcelona, Spain
| | - Lourdes Mateu
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain.,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Nieves Sopena
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain.,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Maria Luisa Pedro-Botet
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain.,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Marian Garcia-Nuñez
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. .,CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain. .,Hospital Universitari Parc Taulí, Sabadell, Spain.
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Garcia-Nuñez M, Gallego M, Monton C, Capilla S, Millares L, Pomares X, Espasa M, Ferrari R, Moya A, Monsó E, Perez-Brocal V. The respiratory virome in chronic obstructive pulmonary disease. Future Virol 2018. [DOI: 10.2217/fvl-2018-0027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Aim: To characterize the respiratory virome in moderate/severe chronic obstructive pulmonary disease (COPD) patients using metagenomics, with healthy subjects as the reference. Patients & Methods: Sputum COPD samples were collected during stability and exacerbations with negative usual-care microbiologic analysis. Results: Eukaryotic viruses from the Anelloviridae, Herpesviridae and Retroviridae families and phages from the Shiphoviridae family were commonly found in COPD, and the respiratory virome in stability and noninfectious exacerbations showed a substantial similarity. DNA viruses with the highest relative abundance in COPD are Anelloviridae. Conclusion: These results support a colonizing role for eukaryotic viruses in COPD and highlight the importance of analyzing both DNA and RNA viruses when focusing on the respiratory virome.
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Affiliation(s)
- Marian Garcia-Nuñez
- Department of Respiratory Medicine, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autonoma de Barcelona, Sabadell, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias, CIBERES, Bunyola, Spain
- Fundació Insitut d'Investigació GermansTrias i Pujol, Badalona, Spain
| | - Miguel Gallego
- Department of Respiratory Medicine, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autonoma de Barcelona, Sabadell, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias, CIBERES, Bunyola, Spain
| | - Concepción Monton
- Department of Respiratory Medicine, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autonoma de Barcelona, Sabadell, Spain
| | - Silvia Capilla
- Department of Microbiology, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autonoma de Barcelona, Sabadell, Spain
| | - Laura Millares
- Department of Respiratory Medicine, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autonoma de Barcelona, Sabadell, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias, CIBERES, Bunyola, Spain
- Fundació Insitut d'Investigació GermansTrias i Pujol, Badalona, Spain
| | - Xavier Pomares
- Department of Respiratory Medicine, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autonoma de Barcelona, Sabadell, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias, CIBERES, Bunyola, Spain
| | - Mateu Espasa
- Department of Microbiology, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autonoma de Barcelona, Sabadell, Spain
| | - Rafaella Ferrari
- Genomics & Health Area, Centro Superior de Investigación en Salud Pública – Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (CSISP-FISABIO), Valencia, Spain
| | - Andres Moya
- Genomics & Health Area, Centro Superior de Investigación en Salud Pública – Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (CSISP-FISABIO), Valencia, Spain
- Department of Genetics, Institut Cavanilles de Biodiversitat i Biologia Evolutiva, (ICBiBE) Universitat de València, València, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Eduard Monsó
- Department of Respiratory Medicine, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autonoma de Barcelona, Sabadell, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias, CIBERES, Bunyola, Spain
| | - Vicente Perez-Brocal
- Genomics & Health Area, Centro Superior de Investigación en Salud Pública – Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (CSISP-FISABIO), Valencia, Spain
- Department of Genetics, Institut Cavanilles de Biodiversitat i Biologia Evolutiva, (ICBiBE) Universitat de València, València, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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Noell G, Cosío BG, Faner R, Monsó E, Peces-Barba G, de Diego A, Esteban C, Gea J, Rodriguez-Roisin R, Garcia-Nuñez M, Pozo-Rodriguez F, Kalko SG, Agustí A. Multi-level differential network analysis of COPD exacerbations. Eur Respir J 2017; 50:50/3/1700075. [PMID: 28954781 DOI: 10.1183/13993003.00075-2017] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 06/26/2017] [Indexed: 11/05/2022]
Abstract
Patients with chronic obstructive pulmonary disease (COPD) often suffer episodes of exacerbation (ECOPD) that impact negatively the course of their disease. ECOPD are heterogeneous events of unclear pathobiology and non-specific diagnosis. Network analysis is a novel research approach that can help unravelling complex biological systems. We hypothesised that the comparison of multi-level (i.e., clinical, physiological, biological, imaging and microbiological) correlation networks determined during ECOPD and convalescence can yield novel patho-biologic information.In this proof-of-concept study we included 86 patients hospitalised because of ECOPD in a multicentre study in Spain. Patients were extensively characterised both during the first 72 h of hospitalisation and during clinical stability, at least 3 months after hospital discharge.We found that 1) episodes of ECOPD are characterised by disruption of the network correlation observed during convalescence; and 2) a panel of biomarkers that include increased levels of dyspnoea, circulating neutrophils and C-reactive protein (CRP) has a high predictive value for ECOPD diagnosis (AUC 0.97).We conclude that ECOPD 1) are characterised by disruption of network homeokinesis that exists during convalescence; and 2) can be identified objectively by using a panel of three biomarkers (dyspnoea, circulating neutrophils and CRP levels) frequently determined in clinical practice.
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Affiliation(s)
- Guillaume Noell
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Barcelona, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Joint lead authors
| | - Borja G Cosío
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Barcelona, Spain.,Servei Pneumologia, Hospital Universitari Son Espases-IdISBa, Mallorca, Spain.,Joint lead authors
| | - Rosa Faner
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Barcelona, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Joint lead authors
| | - Eduard Monsó
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Barcelona, Spain.,Servei Pneumologia, Hospital Parc Taulí, Sabadell, Spain
| | | | - Alfredo de Diego
- Servicio Neumología, Hospital Universitario La Fe, Valencia, Spain
| | | | - Joaquim Gea
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Barcelona, Spain.,Servei de Pneumologia, Hospital del Mar - IMIM. DCEXS, Universitat Pompeu Fabra, Barcelona, Spain
| | - Robert Rodriguez-Roisin
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Barcelona, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Marian Garcia-Nuñez
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Barcelona, Spain.,Servei Pneumologia, Hospital Parc Taulí, Sabadell, Spain
| | - Francisco Pozo-Rodriguez
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Barcelona, Spain.,Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Susana G Kalko
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Alvar Agustí
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Barcelona, Spain .,Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.,Respiratory Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain
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Garcia-Nuñez M, Marti S, Puig C, Perez-Brocal V, Millares L, Santos S, Ardanuy C, Moya A, Liñares J, Monsó E. Bronchial microbiome, PA biofilm-forming capacity and exacerbation in severe COPD patients colonized by P. aeruginosa. Future Microbiol 2017; 12:379-392. [PMID: 28339291 DOI: 10.2217/fmb-2016-0127] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AIM The bronchial microbiome of severe chronic obstructive pulmonary disease patients colonized by Pseudomonas aeruginosa was analyzed using 16S rRNA gene sequencing to identify differences related to biofilm-forming capacity. PATIENTS & METHODS Patient sputum samples from 21 patients were studied. RESULTS Statistically significant differences related to biofilm-forming capacity were only found for genera with relative abundances <1%, and Fusobacterium was over-represented when biofilm-forming capacity was high. Genera with relative abundances >50% which increased from baseline were observed in 10/14 exacerbations, but corresponded to Pseudomonas only in three episodes, while other pathogenic genera were identified in seven. CONCLUSION The bronchial microbiome shows differences according with P. aeruginosa biofilm-forming capacity. Pathogenic microorganisms other than P. aeruginosa cause a significant part of the exacerbations in colonized chronic obstructive pulmonary disease patients.
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Affiliation(s)
- Marian Garcia-Nuñez
- CIBER de Enfermedades Respiratorias (CIBERes), Instituto de Salud Carlos III, Madrid, Spain E-28029
- Department of Respiratory Medicine, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain E-08208
- Fundació Institut d'Investigació Germans Trias i Pujol, Badalona, Spain E-08916
- Universitat Autonoma de Barcelona, Esfera UAB, Barcelona, Spain E-08193
| | - Sara Marti
- CIBER de Enfermedades Respiratorias (CIBERes), Instituto de Salud Carlos III, Madrid, Spain E-28029
- Microbiology Department, Hospital Universitari Bellvitge, Universitat de Barcelona-IDIBELL, Barcelona, Spain E-08908
| | - Carmen Puig
- CIBER de Enfermedades Respiratorias (CIBERes), Instituto de Salud Carlos III, Madrid, Spain E-28029
- Microbiology Department, Hospital Universitari Bellvitge, Universitat de Barcelona-IDIBELL, Barcelona, Spain E-08908
| | - Vicente Perez-Brocal
- Genomics & Health Area, Centro Superior de Investigación en Salud Pública - Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (CSISP-FISABIO), Valencia, Spain E-46020
- Department of Genetics, Institut Cavanilles de Biodiversitat i Biologia Evolutiva, (ICBiBE) Universitat de València, València, Spain E-46020
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain E-28029
| | - Laura Millares
- CIBER de Enfermedades Respiratorias (CIBERes), Instituto de Salud Carlos III, Madrid, Spain E-28029
- Department of Respiratory Medicine, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain E-08208
- Fundació Institut d'Investigació Germans Trias i Pujol, Badalona, Spain E-08916
- Universitat Autonoma de Barcelona, Esfera UAB, Barcelona, Spain E-08193
| | - Salud Santos
- CIBER de Enfermedades Respiratorias (CIBERes), Instituto de Salud Carlos III, Madrid, Spain E-28029
- Department of Pulmonary Medicine, Hospital Universitari de Bellvitge, Institut d'Investigacions Biomèdiques de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain E-08908
| | - Carmen Ardanuy
- CIBER de Enfermedades Respiratorias (CIBERes), Instituto de Salud Carlos III, Madrid, Spain E-28029
- Microbiology Department, Hospital Universitari Bellvitge, Universitat de Barcelona-IDIBELL, Barcelona, Spain E-08908
| | - Andres Moya
- Genomics & Health Area, Centro Superior de Investigación en Salud Pública - Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (CSISP-FISABIO), Valencia, Spain E-46020
- Department of Genetics, Institut Cavanilles de Biodiversitat i Biologia Evolutiva, (ICBiBE) Universitat de València, València, Spain E-46020
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain E-28029
| | - Josefina Liñares
- CIBER de Enfermedades Respiratorias (CIBERes), Instituto de Salud Carlos III, Madrid, Spain E-28029
- Microbiology Department, Hospital Universitari Bellvitge, Universitat de Barcelona-IDIBELL, Barcelona, Spain E-08908
| | - Eduard Monsó
- CIBER de Enfermedades Respiratorias (CIBERes), Instituto de Salud Carlos III, Madrid, Spain E-28029
- Department of Respiratory Medicine, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain E-08208
- Fundació Institut d'Investigació Germans Trias i Pujol, Badalona, Spain E-08916
- Universitat Autonoma de Barcelona, Esfera UAB, Barcelona, Spain E-08193
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7
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Reynaga E, Torres C, Garcia-Nuñez M, Navarro M, Vilamala A, Puigoriol E, Lucchetti GE, Sabrià M. Clinical impact and prevalence of MRSA CC398 and differences between MRSA-Tet R and MRSA-Tet S in an area of Spain with a high density of pig farming: a prospective cohort study. Clin Microbiol Infect 2017; 23:678.e1-678.e4. [PMID: 28365311 DOI: 10.1016/j.cmi.2017.03.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/28/2017] [Accepted: 03/23/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Tetracycline resistance (TetR) is a phenotypic marker of the livestock-associated methicillin-resistant Staphylococcus aureus (MRSA) CC398 clone. The aim of this study was to analyse the prevalence of MRSA CC398 in patients in contact with healthcare facilities and differences between patients with MRSA-TetR and MRSA tetracycline-susceptible (TetS) strains. METHODS Patients diagnosed with MRSA from January 2012 to December 2015 were divided into two groups, MRSA-TetR and MRSA-TetS. Epidemiologic and clinical data were evaluated. Molecular analysis was performed (multilocus sequence typing, spa typing) on MRSA-TetR strains. RESULTS Data from 288 MRSA patients were obtained, and 106 (36.8%) carried MRSA-TetR (93 typed as CC398 (87.7%); the remaining 13 isolates were ascribed to CC9, CC1, CC121, CC30, CC97, CC146 and CC152). The most frequent spa type was t011 (56.6%, 61/106). Detection of MRSA-TetR increased over the years (21.9%, 16/73, in 2012; 50.7%, 36/71, in 2015; p <0.001). Hospital acquisition was found in 16.7% (19/114) of MRSA-TetR patients vs. 83.3% (95/114) in MRSA-TetS patients (p <0.001). Frequency of MRSA-TetR patients in nursing homes was lower than in MRSA-TetS patients (4.7%, 5/106, vs. 27.5%, 50/182, p <0.001). MRSA-TetR as distinct from MRSA-TetS was associated with workers on pig farms (49.0%, 52/106, vs. 1.0%, 2/182; p <0.001), fewer admissions to hospital (46.2%, 49/106, vs. 68.1%, 124/182; p <0.001) and fewer comorbidities (81.1%, 86/106, vs. 59.9%, 109/182; p <0.001). Sixty cases of MRSA-CC398 infection were diagnosed, including, among others, endocarditis, septic arthritis, prosthetic joint infection, pneumonia and bacteraemia. CONCLUSIONS Prevalence of MRSA-TetR (especially CC398) at the hospital level in a Spanish region with intensive pig farming activity is high and is responsible for severe infections. Significant differences were detected in clinical and epidemiologic characteristics among MRSA-TetR and MRSA-TetS patients.
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Affiliation(s)
- E Reynaga
- Department of Internal Medicine, Hospital Universitari de Vic, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Spain.
| | - C Torres
- Area de Bioquímica y Biología Molecular, Universidad de La Rioja, Logroño, Spain
| | - M Garcia-Nuñez
- Infectious Diseases Unit, Health Sciences Research Institute of the Germans Trias i Pujol Foundation, Badalona, Barcelona, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - M Navarro
- Microbiology Department, Hospital Universitari de Vic, Spain
| | - A Vilamala
- Microbiology Department, Hospital Universitari de Vic, Spain
| | - E Puigoriol
- Epidemiology Department, Hospital Universitari de Vic, Spain
| | - G E Lucchetti
- Department of Internal Medicine, Hospital Universitari de Vic, Spain
| | - M Sabrià
- Department of Medicine, Universitat Autònoma de Barcelona, Spain; Infectious Diseases Unit, Health Sciences Research Institute of the Germans Trias i Pujol Foundation, Badalona, Barcelona, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain
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8
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Millares L, Bermudo G, Pérez-Brocal V, Domingo C, Garcia-Nuñez M, Pomares X, Moya A, Monsó E. The respiratory microbiome in bronchial mucosa and secretions from severe IgE-mediated asthma patients. BMC Microbiol 2017; 17:20. [PMID: 28103814 PMCID: PMC5248442 DOI: 10.1186/s12866-017-0933-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 01/13/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The bronchial microbiome in chronic lung diseases presents an abnormal pattern, but its microbial composition and regional differences in severe asthma have not been sufficiently addressed. The aim of the study was to describe the bacterial community in bronchial mucosa and secretions of patients with severe chronic asthma chronically treated with corticosteroids in addition to usual care according to Global Initiative for Asthma. Bacterial community composition was obtained by 16S rRNA gene amplification and sequencing, and functional capabilities through PICRUSt. RESULTS Thirteen patients with severe asthma were included and provided 11 bronchial biopsies (BB) and 12 bronchial aspirates (BA) suitable for sequence analyses. Bacteroidetes, Firmicutes, Proteobacteria and Actinobacteria showed relative abundances (RAs) over 5% in BB, a cutoff that was reached by Streptococcus and Prevotella at genus level. Legionella genus attained a median RA of 2.7 (interquartile range 1.1-4.7) in BB samples. In BA a higher RA of Fusobacteria was found, when compared with BB [8.7 (5.9-11.4) vs 4.2 (0.8-7.5), p = 0.037], while the RA of Proteobacteria was lower in BA [4.3 (3.7-6.5) vs 17.1 (11.2-33.4), p = 0.005]. RA of the Legionella genus was also significantly lower in BA [0.004 (0.001-0.02) vs. 2.7 (1.1-4.7), p = 0.005]. Beta-diversity analysis confirmed the differences between the microbial communities in BA and BB (R2 = 0.20, p = 0.001, Adonis test), and functional analysis revealed also statistically significant differences between both types of sample on Metabolism, Cellular processes, Human diseases, Organismal systems and Genetic information processing pathways. CONCLUSIONS The microbiota in the bronchial mucosa of severe asthma has a specific pattern that is not accurately represented in bronchial secretions, which must be considered a different niche of bacteria growth.
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Affiliation(s)
- Laura Millares
- Fundació Parc Taulí, Parc Taulí 1, Edificio Santa Fe, planta baja, 08208, Sabadell, Barcelona, Spain.
- CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain.
- Universitat Autònoma de Barcelona, Esfera UAB, Barcelona, Spain.
- Fundació Insitut d'Investigació Germans Trias i Pujol, Badalona, Spain.
| | - Guadalupe Bermudo
- Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Vicente Pérez-Brocal
- Genomics and Health Area, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO-Public Health), Valencia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Evolutionary Genetics Unit, Institut Cavanilles de Biodiversitat i Biologia Evolutiva (ICBiBE), Universitat de València, Valencia, Spain
| | - Christian Domingo
- Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Marian Garcia-Nuñez
- Fundació Parc Taulí, Parc Taulí 1, Edificio Santa Fe, planta baja, 08208, Sabadell, Barcelona, Spain
- CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain
- Universitat Autònoma de Barcelona, Esfera UAB, Barcelona, Spain
- Fundació Insitut d'Investigació Germans Trias i Pujol, Badalona, Spain
| | - Xavier Pomares
- Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Andrés Moya
- Genomics and Health Area, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO-Public Health), Valencia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Evolutionary Genetics Unit, Institut Cavanilles de Biodiversitat i Biologia Evolutiva (ICBiBE), Universitat de València, Valencia, Spain
| | - Eduard Monsó
- CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain
- Universitat Autònoma de Barcelona, Esfera UAB, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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9
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Reynaga E, Navarro M, Vilamala A, Roure P, Quintana M, Garcia-Nuñez M, Figueras R, Torres C, Lucchetti G, Sabrià M. Prevalence of colonization by methicillin-resistant Staphylococcus aureus ST398 in pigs and pig farm workers in an area of Catalonia, Spain. BMC Infect Dis 2016; 16:716. [PMID: 27894267 PMCID: PMC5127002 DOI: 10.1186/s12879-016-2050-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 11/21/2016] [Indexed: 11/30/2022] Open
Abstract
Background A livestock-associated clonal lineage (ST398) of methicillin-resistant Staphylococcus aureus (MRSA) has been identified causing colonization or infection in farm workers. The aim of the study was to analyze the prevalence of MRSA-ST398 colonization in pigs and in pig farmers in an area with a high pig population (Osona, Barcelona province, Catalonia, Spain). Methods We performed a cross-sectional prevalence study in Osona (Catalonia, Spain), from June 2014 to June 2015. All pig farm workers from 83 farms were studied. Twenty of these farms were randomly selected for the study of both pigs and farmers: 9 fattening and 11 farrow-to-finish farms. All workers over the age of 18 who agreed to participate were included. Samples were analyzed to identify MRSA-ST398 and their spa type. Results Eighty-one of the 140 pig farm workers analyzed (57.9% (95% IC: 50.0–66.4%)) were MRSA-positive, all of them ST398. The mean number of years worked on farms was 17.5 ± 12.6 (range:1–50), without significant differences between positive and negative MRSA results (p = 0.763). Over 75% of MRSA-ST398 carriers worked on farms with more than 1250 pigs (p < 0.001). At least one worker tested positive for MRSA-ST398 on all 20 selected pig farms. Ninety-two (46.0% (95% IC: 39.0–53.0%)) of the nasal swabs from 200 pigs from these 20 farms were MRSA-positive, with 50.5% of sows and 41.4% of fattening pigs (p = 0.198) giving MRSA-positive results. All the isolates were tetracycline-resistant, and were identified as MRSA-ST398. The spa type identified most frequently was t011 (62%). Similar spa types and phenotypes of antibiotic resistance were identified in pigs and farmers of 19/20 tested farms. Conclusions The prevalence of MRSA-ST398 among pig farm workers and pigs on farms in the studied region is very high, and the size of the farm seems to correlate with the frequency of colonization of farmers. The similar spa-types and phenotypes of resistance detected in pigs and workers in most of the farms studied suggest animal-to-human transmission.
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Affiliation(s)
- Esteban Reynaga
- Department of Internal Medicine, Hospital Universitari de Vic, Barcelona, Spain. .,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Marian Navarro
- Microbiology Department, Hospital Universitari de Vic, Barcelona, Spain
| | - Anna Vilamala
- Microbiology Department, Hospital Universitari de Vic, Barcelona, Spain
| | - Pere Roure
- Epidemiology Department, Hospital Universitari de Vic, Barcelona, Spain
| | - Manuel Quintana
- Epidemiology Department Hospital Vall d'Hebron, Barcelona, Spain
| | - Marian Garcia-Nuñez
- Infectious Diseases Unit, Health Sciences Research Institute of the Germans Trias i Pujol Foundation, Badalona, Barcelona, Spain.,CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Raül Figueras
- Veterinary, Associació Tecnicosanitària del Porcí (ASSAPORC), Vic, Barcelona, Spain
| | - Carmen Torres
- Area de Bioquímica y Biología Molecular, Universidad de La Rioja, Logroño, Spain
| | - Gianni Lucchetti
- Department of Internal Medicine, Hospital Universitari de Vic, Barcelona, Spain
| | - Miquel Sabrià
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Infectious Diseases Unit, Health Sciences Research Institute of the Germans Trias i Pujol Foundation, Badalona, Barcelona, Spain.,CIBER de Enfermedades Respiratorias, Madrid, Spain.,Infectious Diseases Department, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
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10
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Garcia-Nuñez M, Quero S, Pedro-Botet ML, Barrabeig I, Avarez J, Campoy I, Sala MR, Parraga-Niño N, Minguell S, Caylà J, Mateu L, Sabria M. Characterization of unrelated clinical Legionella pneumophila isolates in Catalonia by monoclonal subgrouping and sequence-based typing. Future Microbiol 2016; 11:865-75. [PMID: 27357520 DOI: 10.2217/fmb-2016-0013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM To characterize the genetic diversity of unrelated Legionella pneumophila clinical isolates in Catalonia and compare with other European regions. METHODS 95 unrelated isolates were analyzed using monoclonal antibodies and sequence-based typing, 1989-2013. RESULTS The isolates showed a high diversity (IOD 0.964) with a predominance of some profiles (ST37-Phialdelphia, ST23-Philadelphia and ST1-OLDA). All regions had predominant sequence types (STs) that differed between regions, and only 3% of STs were shared between the three regions. CONCLUSION L. pneumophila clinical isolates from Catalonia presented a high diversity and can be used in epidemiological surveillance studies. The heterogeneous predominance of STs between European regions suggested a relationship between geographical distribution and virulence of some STs.
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Affiliation(s)
- Marian Garcia-Nuñez
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Germans Trias i Pujol, Badalona, Spain E-08916.,Grupo de estudio de la Legionelosis, Autonomous University of Barcelona, Cerdanyola, Spain E-08913.,Ciber de Enfermedades Respiratorias, Madrid, Spain E-28029
| | - Sara Quero
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Germans Trias i Pujol, Badalona, Spain E-08916.,Grupo de estudio de la Legionelosis, Autonomous University of Barcelona, Cerdanyola, Spain E-08913.,Ciber de Enfermedades Respiratorias, Madrid, Spain E-28029
| | - Maria Lluisa Pedro-Botet
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Germans Trias i Pujol, Badalona, Spain E-08916.,Grupo de estudio de la Legionelosis, Autonomous University of Barcelona, Cerdanyola, Spain E-08913.,Ciber de Enfermedades Respiratorias, Madrid, Spain E-28029
| | - Irene Barrabeig
- Epidemiological Surveillance, Publich Health Agency of Catalonia, Barcelona, Spain E-08005
| | - Josep Avarez
- Epidemiological Surveillance, Publich Health Agency of Catalonia, Barcelona, Spain E-08005
| | - Irene Campoy
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Germans Trias i Pujol, Badalona, Spain E-08916
| | - Maria Rosa Sala
- Epidemiological Surveillance, Publich Health Agency of Catalonia, Barcelona, Spain E-08005
| | - Noemí Parraga-Niño
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Germans Trias i Pujol, Badalona, Spain E-08916.,Grupo de estudio de la Legionelosis, Autonomous University of Barcelona, Cerdanyola, Spain E-08913.,Ciber de Enfermedades Respiratorias, Madrid, Spain E-28029
| | - Sofia Minguell
- Epidemiological Surveillance, Publich Health Agency of Catalonia, Barcelona, Spain E-08005
| | - Joan Caylà
- Epidemiological Surveillance, Publich Health Agency of Catalonia, Barcelona, Spain E-08005.,Ciber de Salud Publica, Madrid, Spain, E-28029
| | - Lourdes Mateu
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Germans Trias i Pujol, Badalona, Spain E-08916.,Grupo de estudio de la Legionelosis, Autonomous University of Barcelona, Cerdanyola, Spain E-08913.,Ciber de Enfermedades Respiratorias, Madrid, Spain E-28029
| | - Miquel Sabria
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Germans Trias i Pujol, Badalona, Spain E-08916.,Grupo de estudio de la Legionelosis, Autonomous University of Barcelona, Cerdanyola, Spain E-08913.,Ciber de Enfermedades Respiratorias, Madrid, Spain E-28029
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11
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Garcia-Nuñez M, Millares L, Pomares X, Ferrari R, Pérez-Brocal V, Gallego M, Espasa M, Moya A, Monsó E. Reply to "chronic obstructive pulmonary disease lung microbiota diversity may be mediated by age or inhaled corticosteroid use". J Clin Microbiol 2015; 53:1051. [PMID: 25700527 PMCID: PMC4390632 DOI: 10.1128/jcm.03358-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Marian Garcia-Nuñez
- Fundació Parc Taulí, Sabadell/Badalona, Spain CIBER de Enfermedades Respiratorias, CIBERES, Bunyola, Spain Universitat Autònoma de Barcelona, Esfera UAB, Barcelona, Spain Fundació Institut d'Investigació Germans Trias i Pujol, Badalona, Spain
| | - Laura Millares
- Fundació Parc Taulí, Sabadell/Badalona, Spain CIBER de Enfermedades Respiratorias, CIBERES, Bunyola, Spain Universitat Autònoma de Barcelona, Esfera UAB, Barcelona, Spain Fundació Institut d'Investigació Germans Trias i Pujol, Badalona, Spain
| | - Xavier Pomares
- Universitat Autònoma de Barcelona, Esfera UAB, Barcelona, Spain Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Rafaela Ferrari
- Genomics and Health Area, Centro Superior de Investigación en Salud Pública, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (CSISP-FISABIO), Valencia, Spain Department of Genetics, Institut Cavanilles de Biodiversitat i Biologia Evolutiva (ICBiBE), Universitat de València, València, Spain
| | - Vicente Pérez-Brocal
- Genomics and Health Area, Centro Superior de Investigación en Salud Pública, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (CSISP-FISABIO), Valencia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Department of Genetics, Institut Cavanilles de Biodiversitat i Biologia Evolutiva (ICBiBE), Universitat de València, València, Spain
| | - Miguel Gallego
- Universitat Autònoma de Barcelona, Esfera UAB, Barcelona, Spain Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Mateu Espasa
- Department of Microbiology, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Andrés Moya
- Genomics and Health Area, Centro Superior de Investigación en Salud Pública, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (CSISP-FISABIO), Valencia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Department of Genetics, Institut Cavanilles de Biodiversitat i Biologia Evolutiva (ICBiBE), Universitat de València, València, Spain
| | - Eduard Monsó
- Fundació Parc Taulí, Sabadell/Badalona, Spain CIBER de Enfermedades Respiratorias, CIBERES, Bunyola, Spain Universitat Autònoma de Barcelona, Esfera UAB, Barcelona, Spain Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain
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12
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Sabrià M, Mòdol JM, Garcia-Nuñez M, Reynaga E, Pedro-Botet ML, Sopena N, Rey-Joly C. Environmental Cultures and Hospital-Acquired Legionnaires' Disease: A 5-Year Prospective Study in 20 Hospitals in Catalonia, Spain. Infect Control Hosp Epidemiol 2015; 25:1072-6. [PMID: 15636295 DOI: 10.1086/502346] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AbstractObjective:To determine whether environmental cultures forLegionellaincrease the index of suspicion for legionnaires' disease (LD).Design:Five-year prospective study.Setting:Twenty hospitals in Catalonia, Spain.Methods:From 1994 to 1996, the potable water systems of 20 hospitals in Catalonia were tested forLegionella, Cases of hospital-acquired LD and availability of an “in-house”Legionellatest in the previous 4 years were assessed. After the hospitals were informed of the results of their water cultures, a prospective 5-year-study was conducted focusing on the detection of new cases of nosocomial legionellosis and the availability and use of Legionella testing.Results:Before environmental cultures were started, only one hospital had conducted active surveillance of hospital-acquired pneumonia and usedLegionellatests includingLegionellaurinary antigen in all pneumonia cases. Only one other hospital had used the latter test at all. In six hospitals,Legionellatests had been completely unavailable. Cases of nosocomial LD had been diagnosed in the previous 4 years in only two hospitals. During prospective surveillance, 12 hospitals (60%) usedLegionellaurinary antigen testing in house and 11 (55%) found cases of nosocomial legionellosis, representing 64.7% (11 of 17) of those with positive water cultures. Hospitals with negative water cultures did not find nosocomial LD.Conclusions:The environmental study increased the index of suspicion for nosocomial LD. The number of cases of nosocomial LD increased significantly during the prospective follow-up period, and most hospitals began using theLegionellaurinary antigen test in their laboratories.
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Affiliation(s)
- Miquel Sabrià
- Infectious Diseases Section, Hospital Universitari Germans Trias i Pujol, Universitat Autonoma de Barcelona, Badalona, Spain
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13
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Garcia-Nuñez M, Millares L, Pomares X, Ferrari R, Pérez-Brocal V, Gallego M, Espasa M, Moya A, Monsó E. Severity-related changes of bronchial microbiome in chronic obstructive pulmonary disease. J Clin Microbiol 2014; 52:4217-23. [PMID: 25253795 PMCID: PMC4313290 DOI: 10.1128/jcm.01967-14] [Citation(s) in RCA: 143] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Bronchial colonization by potentially pathogenic microorganisms (PPMs) is often demonstrated in chronic obstructive pulmonary disease (COPD), but culture-based techniques identify only a portion of the bacteria in mucosal surfaces. The aim of the study was to determine changes in the bronchial microbiome of COPD associated with the severity of the disease. The bronchial microbiome of COPD patients was analyzed by 16S rRNA gene amplification and pyrosequencing in sputum samples obtained during stable disease. Seventeen COPD patients were studied (forced expiratory volume in the first second expressed as a percentage of the forced vital capacity [FEV1%] median, 35.0%; interquartile range [IQR], 31.5 to 52.0), providing a mean of 4,493 (standard deviation [SD], 2,598) sequences corresponding to 47 operational taxonomic units (OTUs) (SD, 17) at a 97% identity level. Patients were dichotomized according to their lung function as moderate to severe when their FEV1% values were over the median and as advanced when FEV1% values were lower. The most prevalent phyla in sputum were Proteobacteria (44%) and Firmicutes (16%), followed by Actinobacteria (13%). A greater microbial diversity was found in patients with moderate-to-severe disease, and alpha diversity showed a statistically significant decrease in patients with advanced disease when assessed by Shannon (ρ = 0.528; P = 0.029, Spearman correlation coefficient) and Chao1 (ρ = 0.53; P = 0.028, Spearman correlation coefficient) alpha-diversity indexes. The higher severity that characterizes advanced COPD is paralleled by a decrease in the diversity of the bronchial microbiome, with a loss of part of the resident flora that is replaced by a more restricted microbiota that includes PPMs.
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Affiliation(s)
- Marian Garcia-Nuñez
- Fundació Parc Taulí, Sabadell/Badalona, Spain CIBER de Enfermedades Respiratorias (CIBERES), Bunyola, Spain Universitat Autonoma de Barcelona, Esfera (UAB), Barcelona, Spain Fundació Institut d'Investigació Germans Trias i Pujol, Badalona, Spain
| | - Laura Millares
- Fundació Parc Taulí, Sabadell/Badalona, Spain CIBER de Enfermedades Respiratorias (CIBERES), Bunyola, Spain Universitat Autonoma de Barcelona, Esfera (UAB), Barcelona, Spain Fundació Institut d'Investigació Germans Trias i Pujol, Badalona, Spain
| | - Xavier Pomares
- Universitat Autonoma de Barcelona, Esfera (UAB), Barcelona, Spain Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Rafaela Ferrari
- Genomics and Health Area, Centro Superior de Investigación en Salud Pública- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (CSISP-FISABIO), Valencia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Department of Genetics, Institut Cavanilles de Biodiversitat i Biologia Evolutiva (ICBiBE), Universitat de València, Valencia, Spain
| | - Vicente Pérez-Brocal
- Genomics and Health Area, Centro Superior de Investigación en Salud Pública- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (CSISP-FISABIO), Valencia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Department of Genetics, Institut Cavanilles de Biodiversitat i Biologia Evolutiva (ICBiBE), Universitat de València, Valencia, Spain
| | - Miguel Gallego
- Universitat Autonoma de Barcelona, Esfera (UAB), Barcelona, Spain Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Mateu Espasa
- Department of Microbiology, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Andrés Moya
- Genomics and Health Area, Centro Superior de Investigación en Salud Pública- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (CSISP-FISABIO), Valencia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Department of Genetics, Institut Cavanilles de Biodiversitat i Biologia Evolutiva (ICBiBE), Universitat de València, Valencia, Spain
| | - Eduard Monsó
- Fundació Parc Taulí, Sabadell/Badalona, Spain CIBER de Enfermedades Respiratorias (CIBERES), Bunyola, Spain Universitat Autonoma de Barcelona, Esfera (UAB), Barcelona, Spain Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain
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Millares L, Ferrari R, Gallego M, Garcia-Nuñez M, Pérez-Brocal V, Espasa M, Pomares X, Monton C, Moya A, Monsó E. Bronchial microbiome of severe COPD patients colonised by Pseudomonas aeruginosa. Eur J Clin Microbiol Infect Dis 2014; 33:1101-11. [PMID: 24449346 PMCID: PMC4042013 DOI: 10.1007/s10096-013-2044-0] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 12/20/2013] [Indexed: 02/07/2023]
Abstract
The bronchial microbiome in severe COPD during stability and exacerbation in patients chronically colonised by Pseudomonas aeruginosa (PA), has not been defined. Our objective was to determine the characteristics of the bronchial microbiome of severe COPD patients colonised and not colonised by P. aeruginosa and its changes during exacerbation. COPD patients with severe disease and frequent exacerbations were categorised according to chronic colonisation by P. aeruginosa. Sputum samples were obtained in stability and exacerbation, cultured, and analysed by 16S rRNA gene amplification and pyrosequencing. Sixteen patients were included, 5 of them showing chronic colonisation by P. aeruginosa. Pseudomonas genus had significantly higher relative abundance in stable colonised patients (p = 0.019), but no significant differences in biodiversity parameters were found between the two groups (Shannon, 3 (2-4) vs 3 (2-3), p = 0.699; Chao1, 124 (77-159) vs 140 (115-163), p = 0.364). In PA-colonised patients bronchial microbiome changed to a microbiome similar to non-PA-colonised patients during exacerbations. An increase in the relative abundance over 20 % during exacerbation was found for Streptococcus, Pseudomonas, Moraxella, Haemophilus, Neisseria, Achromobacter and Corynebacterium genera, which include recognised potentially pathogenic microorganisms, in 13 patients colonised and not colonised by P. aeruginosa with paired samples. These increases were not identified by culture in 5 out of 13 participants (38.5 %). Stable COPD patients with severe disease and PA-colonised showed a similar biodiversity to non-PA-colonised patients, with a higher relative abundance of Pseudomonas genus in bronchial secretions. Exacerbation in severe COPD patients showed the same microbial pattern, independently of previous colonisation by P. aeruginosa.
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Affiliation(s)
- L. Millares
- Fundació Parc Taulí, Sabadell, Spain
- CIBER de Enfermedades Respiratorias, CIBERES, Bunyola, Spain
- Universitat Autònoma de Barcelona, Esfera UAB, Barcelona, Spain
- Fundació Institut d’Investigació Germans Trias i Pujol, Badalona, Spain
| | - R. Ferrari
- Genomics and Health Area, Centro Superior de Investigación en Salud Pública—Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (CSISP-FISABIO), Valencia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Genetics, Institut Cavanilles de Biodiversitat i Biologia Evolutiva, (ICBiBE) Universitat de València, Valencia, Spain
| | - M. Gallego
- CIBER de Enfermedades Respiratorias, CIBERES, Bunyola, Spain
- Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - M. Garcia-Nuñez
- Fundació Parc Taulí, Sabadell, Spain
- CIBER de Enfermedades Respiratorias, CIBERES, Bunyola, Spain
- Fundació Institut d’Investigació Germans Trias i Pujol, Badalona, Spain
| | - V. Pérez-Brocal
- Genomics and Health Area, Centro Superior de Investigación en Salud Pública—Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (CSISP-FISABIO), Valencia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Genetics, Institut Cavanilles de Biodiversitat i Biologia Evolutiva, (ICBiBE) Universitat de València, Valencia, Spain
| | - M. Espasa
- Department of Microbiology, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - X. Pomares
- Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - C. Monton
- Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - A. Moya
- Genomics and Health Area, Centro Superior de Investigación en Salud Pública—Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (CSISP-FISABIO), Valencia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Genetics, Institut Cavanilles de Biodiversitat i Biologia Evolutiva, (ICBiBE) Universitat de València, Valencia, Spain
| | - E. Monsó
- CIBER de Enfermedades Respiratorias, CIBERES, Bunyola, Spain
- Universitat Autònoma de Barcelona, Esfera UAB, Barcelona, Spain
- Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain
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15
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Marin A, Monsó E, Garcia-Nuñez M, Sauleda J, Noguera A, Pons J, Agustí A, Morera J. Variability and effects of bronchial colonisation in patients with moderate COPD. Eur Respir J 2009; 35:295-302. [PMID: 19643939 DOI: 10.1183/09031936.00126808] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Sputum and lung function were periodically assessed in stable moderate chronic obstructive pulmonary disease (COPD) outpatients to determine relationships between bronchial colonisation and inflammation. Relationships between potentially pathogenic microorganism (PPM) typology, bronchial inflammation (neutrophilia, tumour necrosis factor-alpha, interleukin (IL)-1beta, IL-6, IL-8, IL-10 and IL-12) and post-bronchodilator decline in forced expiratory volume in 1 s (FEV(1)) were analysed. PPMs periodically showing the same molecular profile using pulse field gel electrophoresis were considered long-term persistent. Bronchial colonisation was observed in 56 out of 79 follow-up examinations (70.9%) and was mainly due to Haemophilus influenzae, Pseudomonas aeruginosa and enterobacteria (n = 47). These PPMs were all related to sputum neutrophilia (p< or =0.05, Chi-squared test), and H. influenzae was related to higher levels of IL-1beta (p = 0.005) and IL-12 (p = 0.01), with a dose-response relationship (Spearman's correlation coefficient of 0.38 for IL-1beta (p = 0.001), and of 0.32 for IL-12 (p = 0.006)). Haemophilus parainfluenzae was not associated with an identifiable inflammatory response. Long-term persistence of the same strain was observed in 12 examinations (21.4%), mainly due to P. aeruginosa or enterobacteria. A neutrophilic bronchial inflammatory response was associated with a statistically significant decline in FEV(1) during follow-up (OR 2.67, 95% CI 1.07-6.62). A load-related relationship to bronchial inflammation in moderate COPD was observed for colonisation by H. influenzae, but not for colonisation by H. parainfluenzae.
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Affiliation(s)
- A Marin
- Servei de Pneumologia, Hospital Germans Trias i Pujol, Carretera de Canyet s/n, 08916 Badalona, Catalonia, Spain.
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16
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Sanchez I, Garcia-Nuñez M, Ragull S, Sopena N, Pedro-Botet ML, Esteve M, Rey-Joly C, Sabria M. Genotypic variability and persistence of Legionella pneumophila PFGE patterns in 34 cooling towers from two different areas. Environ Microbiol 2008. [DOI: 10.1111/j.1462-2920.2008.01591.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sanchez I, Garcia-Nuñez M, Ragull S, Sopena N, Pedro-Botet ML, Estere M, Rey-Joly C, Sabria M, Esteve M. Genotypic variability and persistence of Legionella pneumophila PFGE patterns in 34 cooling towers from two different areas. Environ Microbiol 2008; 10:395-9. [PMID: 18199124 DOI: 10.1111/j.1462-2920.2007.01460.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Genotypic variability and clonal persistence are important concepts in molecular epidemiology as they facilitate the search for the source of sporadic cases or outbreaks of legionellosis. We studied the genotypic variability and persistence of Legionella pulsed-field gel electrophoresis (PFGE) patterns over time (period > 6 months) in 34 positive cooling towers from two different areas. In area A, radius of 70 km, 52 indistinguishable PFGE patterns were differentiated among the 27 cooling towers. In 13 cooling towers we observed >or= 2 PFGE patterns. Each cooling tower had its own indistinguishable Legionella PFGE pattern which was not shared with any other cooling tower. In area B, radius of 1 km, 10 indistinguishable PFGE patterns were obtained from the seven cooling towers. In four, we observed >or= 2 PFGE patterns. Three of these 10 indistinguishable PFGE patterns were shared by more than one cooling tower. In 27 of 34 cooling towers the same PFGE pattern was recovered after 6 months to up to 5 years of follow-up. The large genotypic diversity of Legionella observed in the cooling towers aids in the investigation of community outbreaks of Legionnaires' disease. However, shared patterns in small areas may confound the epidemiological investigation. The persistence of some PFGE patterns in cooling towers makes the recovery of the Legionella isolate causing the outbreak possible over time.
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Affiliation(s)
- Inma Sanchez
- Infectious Diseases Unit, Hospital Universitari Germans Trias i Pujol, Autonomous University of Barcelona, Badalona, Spain
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Garcia-Nuñez M, Sopena N, Ragull S, Pedro-Botet ML, Morera J, Sabria M. Persistence of Legionella in hospital water supplies and nosocomial Legionnaires' disease. ACTA ACUST UNITED AC 2007; 52:202-6. [PMID: 18093139 DOI: 10.1111/j.1574-695x.2007.00362.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The molecular epidemiology of clinical and environmental Legionella species isolates was studied in seven hospitals from 1989 to 2006. The number of environmental pulsed field gel electrophoresis (PFGE) patterns ranged from one to nine according to the hospital. Genomic PFGE pattern persistence was observed in 71% of the hospitals, even after 17 years in some hospitals, and the relationship between environmental and clinical isolates was established. The isolates associated with hospital-acquired Legionnaires' disease corresponded to the persistent environmental PFGE patterns of Legionella pneumophila in potable water supplies.
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Affiliation(s)
- Marian Garcia-Nuñez
- Infectious Diseases Unit, Fundació Institut d'Investigació Germans Trias i Pujol, Autonomous University of Barcelona, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
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19
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Ragull S, Garcia-Nuñez M, Pedro-Botet ML, Sopena N, Esteve M, Montenegro R, Sabrià M. Legionella pneumophila in cooling towers: fluctuations in counts, determination of genetic variability by pulsed-field gel electrophoresis (PFGE), and persistence of PFGE patterns. Appl Environ Microbiol 2007; 73:5382-4. [PMID: 17601811 PMCID: PMC1950996 DOI: 10.1128/aem.00066-07] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The concentrations of Legionella pneumophila in cooling towers may vary considerably over short periods of time, producing significant fluctuations throughout the year. Despite genetic variability, in small geographical areas the same indistinguishable pulsed-field gel electrophoresis patterns may be shared among different cooling towers and persist over time.
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Affiliation(s)
- Sonia Ragull
- Infectious Diseases Unit, Germans Trias i Pujol University Hospital, Cta Canyet s/n, 08916 Badalona (Barcelona), Spain
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Ragull S, Garcia-Nuñez M, Sopena N, Pedro-Botet M, Esteve M, Montenegro R, Sabria M. P1871 Fluctuation in Legionella pneumophila counts and persistence of DNA subtypes in 15 cooling towers over a one-year period. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71710-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sopena N, Garcia-Nuñez M, Prats R, Pedro-Botet ML, Elia S, Nieto J, Sabrià M. Appearance of methicillin-resistant Staphylococcus aureus (MRSA) sensitive to gentamicin in a hospital with a previous endemic distinct MRSA. Eur J Epidemiol 2002; 17:317-21. [PMID: 11767956 DOI: 10.1023/a:1012779617702] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Since 1990 a clone of gentamicin and methicillin-resistant Staphylococcus aureus (MRSA) has remained endemic in our hospital, but since January 1996 a gentamicin-sensitive strain has progressively replaced the previous clone. We characterized the phenotypic and molecular pattern of the MRSA strains isolated in our hospital in 1996 and compared prospectively the epidemiological, clinical and evolutionary characteristics of ninety patients infected or colonized by gentamicin-sensitive MRSA (GS-MRSA) (49) and by gentamicin-resistant MRSA (GR-MRSA) (41). Finally we studied the variation of aminoglycoside consumption in our hospital from 1989 to 1996. We observed two antibiotypes (GS-MRSA and GR-MRSA) corresponding to two major chromosomal patterns. Patients with GS-MRSA usually acquired the infection 72 hours after hospital admission. No significant differences were observed in epidemiological characteristics, clinical presentation and evolution between patients with GS-MRSA and GR-MRSA. Since 1989 aminoglycoside intake in our hospital has decreased by 46%.
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Affiliation(s)
- N Sopena
- Unitat de Malalties Infeccioses, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
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