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. 2021 Aug 3:12:707187.
doi: 10.3389/fmicb.2021.707187. eCollection 2021.

Legionella feeleii: Ubiquitous Pathogen in the Environment and Causative Agent of Pneumonia

Lucianna Vaccaro  1 , Thiago Santos Gomes  1   2 , Fernando Izquierdo  1 , Angela Magnet  1 , Sergio Llorens Berzosa  1 , Dolores Ollero  1 , Santiago Salso  3 , Almudena Alhambra  3 , Carmen Gómez  3 , María López Cano  3 , Carmen Pelaz  4 , Beatriz Bellido Samaniego  4 , Carmen Del Aguila  1 , Soledad Fenoy  1 , Carolina Hurtado-Marcos  1
Affiliations

Legionella feeleii: Ubiquitous Pathogen in the Environment and Causative Agent of Pneumonia

Lucianna Vaccaro et al. Front Microbiol. .

Abstract

L. feeleii is one of the most frequent Legionella species isolated from natural pools of the central region of Spain. This study aimed to evaluate its ecology and to identify this Legionella species as a respiratory pathogen. A PCR assay for detecting the L. feeleii mip gene was developed to identify it in clinical and environmental samples. Culture and PCR were performed in environmental samples from four drinking water treatment plants (DWTPs). Free L. feeleii was only detected in raw water samples (3.4%), while L. feeleii as an Acanthamoeba endosymbiont was found in 30.7% of raw water, 11.5% of decanter biofilm, and 32% of finished water samples. Therefore, Acanthamoeba spp. plays an essential role in the multiplication, persistence, and spread of Legionella species in the environment. The first case of Legionnaires' disease caused by L. feeleii in Spain is described in this study. The case was diagnosed in an older woman through PCR and sequencing from urine and sputum samples. A respiratory infection could be linked with health care procedures, and the patient presented several risk factors (age, insulin-dependent diabetes, and heart disease). The detection of non-L. pneumophila, such as L. feeleii, is a factor that must be considered when establishing or reviewing measures for the control and prevention of legionellosis.

Keywords: L. feeleii; Legionella; Legionnaires’ disease; drinking water treatment plants; molecular diagnosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Schematic representation of water treatment lines of drinking water treatment plants (DWTPs) sampled. (A) Lamellar decanting. (B) Lamellar decanting and sludge recycling. (C) Accelator decanting and sludge recycling. (D) Pulsed bed decanting.
FIGURE 2
FIGURE 2
Microbiological and molecular detection of L. feeleii in environmental samples from drinking water treatment plants (DWTPs). (A) Selective medium GVPC for the primary isolation of Legionella. (B) BCYE medium with and without L-cysteine to confirm Legionella isolated. (C) Genomic DNA extraction from the concentrated water sample and homogenized biofilms. (D) 2% Neff’s saline non-nutrient agar plates seeded with heat shock inactivated Escherichia coli. FLA, free-living amoebae.
FIGURE 3
FIGURE 3
Presence of L. feeleii in environmental samples from drinking water treatment plants (DWTPs).
FIGURE 4
FIGURE 4
Presence of L. feeleii in each sampling point from 4 drinking water treatment plants (DWTPs) of the central region of Spain using different detection methodologies.
FIGURE 5
FIGURE 5
Presence of L. feeleii in finished water from drinking water treatment plants (DWTPs) according to season.
FIGURE 6
FIGURE 6
Admission chest radiography and computed tomography of the patient with szpneumonia caused by L. feeleii. (A) Chest radiography: radiological signs showed condensation in the lower right lobe (arrow) and a bilateral interstitial pattern. (B) Computed tomography showed extensive areas of consolidation with air bronchogram. Predominant affectation was observed in posterior basal segments and pseudo-nodular opacities of acinar aspect (arrows).
See this image and copyright information in PMC

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