RESEARCH PAPER
Assessment of antibiotic susceptibility of Legionella pneumophila isolated from water systems in Poland
1
Department of Medical Microbiology, Medical University of Lublin, Poland
2
Pope John Paul II State School of Higher Education of Biała Podlaska, Poland
3
National Institute of Public Health - National Institute of Hygiene, Department of Environmental Hygiene, Warsaw, Poland
Corresponding author
Ann Agric Environ Med. 2017;24(1):66-69
KEYWORDS
ABSTRACT
Introduction and objective:
Several studies have reported therapy failures in patients with legionnaires’disease; however, antimicrobial resistance of clinical and environmental isolates of Legionella spp. has not yet been documented. Routine susceptibility testing of Legionella spp. is not recommended because of difficulties in determining standard minimal inhibitory concentration values. The purpose of this study was to analyze the antimicrobial susceptibility of Legionella pneumophila. strains isolated from a water supply system.
Material and Methods:
Twenty-eight isolates of L. pneumophila (16 – L. pneumophila SG 1, 12 – L. pneumophila SG 2–14) obtained from water systems in public buildings in Poland were tested. Susceptibility testing was performed using the E-test method. The tested antibiotic were azithromycin, ciprofloxacin, and rifampicin. The medium used for the susceptibility testing was BCYE-, a special medium for Legionella cultivation.
Results:
Among the tested strains, L. pneumophila was the only one resistant to azithromycin. It was a strain of L. pneumophila SG 2–14 isolated from the water system in a sanitorium. All isolates were found to be sensitive to ciprofloxacin and rifampicin. However, the azithromycin-resistant strain exhibited higher ciprofloxacin and rifampicin MIC (1.5 μg/ml, and 0.19 μg/ml, respectively). The MIC50 for azithromycin, ciprofloxacin, and rifampicin were 0,032, 0,125, and 0,003 μg/ml, respectively. The MIC90 for azithromycin, ciprofloxacin, and rifampicin were 0,032, 0,125, and 0,003 μg/ml, respectively.
Conclusions:
Azithromycin resistance was found in one strain of L. pneumophila SG 2–14, but the resistance mechanism is unknown and needs further study. It is possible that therapeutic failures in Legionnaires’ disease may be associated with bacterial resistance which should be taken into account. The antibiotic sensitivity testing described in this study could be helpful in detecting the resistance of clinical L. pneumophila isolates. Ciprofloxacin and rifampicin have good in vitro activity against environmental L. pneumophila SG 1 and SG 2–14 in Poland.
Several studies have reported therapy failures in patients with legionnaires’disease; however, antimicrobial resistance of clinical and environmental isolates of Legionella spp. has not yet been documented. Routine susceptibility testing of Legionella spp. is not recommended because of difficulties in determining standard minimal inhibitory concentration values. The purpose of this study was to analyze the antimicrobial susceptibility of Legionella pneumophila. strains isolated from a water supply system.
Material and Methods:
Twenty-eight isolates of L. pneumophila (16 – L. pneumophila SG 1, 12 – L. pneumophila SG 2–14) obtained from water systems in public buildings in Poland were tested. Susceptibility testing was performed using the E-test method. The tested antibiotic were azithromycin, ciprofloxacin, and rifampicin. The medium used for the susceptibility testing was BCYE-, a special medium for Legionella cultivation.
Results:
Among the tested strains, L. pneumophila was the only one resistant to azithromycin. It was a strain of L. pneumophila SG 2–14 isolated from the water system in a sanitorium. All isolates were found to be sensitive to ciprofloxacin and rifampicin. However, the azithromycin-resistant strain exhibited higher ciprofloxacin and rifampicin MIC (1.5 μg/ml, and 0.19 μg/ml, respectively). The MIC50 for azithromycin, ciprofloxacin, and rifampicin were 0,032, 0,125, and 0,003 μg/ml, respectively. The MIC90 for azithromycin, ciprofloxacin, and rifampicin were 0,032, 0,125, and 0,003 μg/ml, respectively.
Conclusions:
Azithromycin resistance was found in one strain of L. pneumophila SG 2–14, but the resistance mechanism is unknown and needs further study. It is possible that therapeutic failures in Legionnaires’ disease may be associated with bacterial resistance which should be taken into account. The antibiotic sensitivity testing described in this study could be helpful in detecting the resistance of clinical L. pneumophila isolates. Ciprofloxacin and rifampicin have good in vitro activity against environmental L. pneumophila SG 1 and SG 2–14 in Poland.
REFERENCES (25)
1.
Phin N, Parry-Ford F, Harrison T, Stagg HR, Zhang N, Kumar K, et al. Epidemiology and clinical management of Legionnaires’ disease. Lancet Infect Dis. 2014; 14(10): 1011–1021.
2.
Kozioł-Montewka M, Pańczuk A, Tokarska-Rodak M, Paluch-Oleś J, Gładysz I, Sikora A, et al Current infectious threats associated with the development of civilization and progress in medicine – methods of prevention and education. Health Probl Civiliz. 2014; 8(1): 6–14.
3.
Wullings BA, van der Kooij D. Occurrence and genetic diversity of uncultured Legionella spp. in drinking water treated at temperatures below 15 o C. Appl Environ Microbiol. 2006; 72(1): 157–166.
4.
Hilbi H, Hoffmann C, Harrison CF. Legionella spp. outdoors: colonization, communication and persistence. Environ Microbiol Rep. 2011; 3(3): 286–296.
5.
Bruin JP, Diederen BMW, Ijzerman EP, den Boer JW, Mouton JW. Correlation of MIC value and disk inhibition zone diameters in clinical Legionella pneumophila serogroup 1 isolates. Diagn Microbiol Infect Dis. 2013; 76(3): 339–342.
6.
Onody C, Bernard-Matsiota P, Naściel C. Lack of resistance to erythromycin, rifampicin and ciprofloxacin in 98 clinical isolates of Legionella pneumophila. J Antimicrob Chemother. 1997; 39(6): 815–816.
7.
Pedro-Botet ML, Yu VL. Treatment strategies for Legionella infection. Expert Opin Pharmacother. 2009; 10(7): 1109–1121.
8.
Dedicoat M, Venkatesan P. The treatment of Legionnaires’ disease. J Antimicrob Chemother 1999; 43(6): 747–752.
9.
Erdogan H, Can F, Demirbilek M, Timurkaynak F, Arslan H. In vitro of antimicrobial agents against Legionella isolated from environmental water systems: first results from Turkey. Environ Monit Assess. 2010; 171(1–4): 487–491.
10.
Varner TR, Bookstaver PB, Rudisill CN, Albrecht H. Role of rifampin-based combination therapy for severe community-acquired Legionella pneumophila pneumonia. Ann Pharmacother. 2011; 45(7–8): 967–976.
11.
Roig J, Rello J. Legionnaires’ disease: an approach to therapy. J Antimicrob Chemother. 2003; 51(5): 1119–1129.
12.
Tsakris A, Alexiou-Daniel S, Souliou E, Antoniadis A. In vitro activity of antibiotics against Legionella pneumophila isolates from water systems. J Antimicrob Chemother. 1999; 44(5): 693–695.
13.
Nielsen K, Bangsborg JM, Hoiby N. Susceptibility of Legionella species to five antibiotics and development to resistance by exposure to erythromycin, ciprofloxacin, and rifampicin. Diagn Microbiol Infect Dis. 2000; 36(1): 43–48.
14.
Rhomberg PR, Bale MJ, Jones RN. Application of the Etest to antimicrobial susceptibility testing of Legionella spp. Diagn Microbiol Infect Dis. 1994; 19(3): 175–178.
15.
Rhomberg P, Jones RN. Evaluation of the E-test for antimicrobial susceptibility testing of Legionella pneumophila, including validation of the imipenem and sparfloxacin strips. Diagn Microbiol Infect Dis. 1994; 20(3): 159–162.
16.
Pendland SL, Martin SJ, Chen C, Schreckenberger PC, Danziger LH. Comparison of charcoal- and starch-based media for testing susceptibilities of Legionella species to macrolides, azalides, and fluoroquinolones. J Clin Microbiol. 1997; 35(11): 3004–3006.
17.
Marques T, Piedade J. Susceptibility testing by E-test and agar dilution of 30 strains of Legionella spp. isolated in Portugal. Clin Microbiol Infect. 1997; 3(3): 365–368.
18.
Segreti J, Meyer P, Kapell K. In vitro activity of macrolides against intracellular Legionella pneumophila. Diag Microbiol Infect Dis. 1996; 25(3): 123–126.
19.
Pedro-Botet L, Yu VL. Legionella: macrolides or quinolones? Clin Microbiol Infect. 2006; 12: (Suppl 3): 25–30.
20.
Schrock J, Hackman BA, Plouffe JF. Susceptibility of ninety-eight clinical isolates of Legionella to macrolides and quinolones using the Etest. Diagn Microbiol Infect Dis. 1997; 28(4): 221–223.
21.
Aras Z, Sayin Z. Detection of Legionella pneumophila from domestic water their antibiotic resistance profiles. J Coast Life Med. 2015; 3: 273–275.
22.
Stout JE, Sens K, Mitzner S, Obman A, Yu VL. Comparative activity of quinolones, macrolides and ketolides against Legionella species using in vitro broth dilution and intracellular susceptibility testing. Int J Antimicrob Agents. 2005; 25(4): 302–307.
23.
Chen SC, Paul ML, Gilbert GL. Susceptibility of Legionella species to antimicrobial agents. Pathology 1993; 25(2): 180–183.
24.
Leclercq R. Mechanisms of resistance to macrolides and lincosamides: nature of the resistance elements and their clinical implications. Clin Infect Dis. 2002; 34(4): 482–492.
25.
Alexandropoulou IG, Parasidis TA, Konstantinidis TG, Constantinidis TC, Panopoulou M. Antibiotic susceptibility surveillance of environmental Legionella strains: application of the E-test to bacteria isolated from hospitals in Greece. J Infect Dis Ther. 2013; 2: e103.
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