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. 2020 Jul;26(7):1526-1528.
doi: 10.3201/eid2607.190941.

Transmission of Legionnaires' Disease through Toilet Flushing

Jeanne Couturier, Christophe Ginevra, Didier Nesa, Marine Adam, Cyril Gouot, Ghislaine Descours, Christine Campèse, Giorgia Battipaglia, Eolia Brissot, Laetitia Beraud, Anne-Gaëlle Ranc, Sophie Jarraud, Frédéric Barbut

Transmission of Legionnaires' Disease through Toilet Flushing

Jeanne Couturier et al. Emerg Infect Dis. 2020 Jul.

Abstract

We describe 2 cases of healthcare-associated Legionnaires' disease in patients in France hospitalized 5 months apart in the same room. Whole-genome sequencing analyses showed that clinical isolates from the patients and isolates from the room's toilet clustered together. Toilet contamination by Legionella pneumophila could lead to a risk for exposure through flushing.

Keywords: Bacteria; Legionella pneumophila; Legionnaires’ disease; healthcare-associated infections; nosocomial infections; phylogeny; pneumophilia; respiratory infections; toilet; transmission.

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Figures

Figure
Figure
Maximum-likelihood tree of 39 Legionella pneumophila ST1 isolates, including isolates from investigation of 2 cases of healthcare-associated Legionnaires’ disease in patients in France hospitalized 5 months apart in the same room (red bar). The tree was constructed using 258 single-nucleotide polymorphisms (SNPs) identified after the removal of recombination events. Bootstrap values were calculated from 500 replicates; only values >90 were indicated on the tree. Values at the right side of the tree represent the number of SNPs between the genome compared with the genome of patient 2 after recombination removal.
See this image and copyright information in PMC

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