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Volume 20, Number 11—November 2014
Dispatch

Nosocomial Neonatal Legionellosis Associated with Water in Infant Formula, Taiwan

Sung-Hsi Wei1, Pesus Chou1, Lei-Ron Tseng1, Hung-Chih Lin1, Jen-Hsien Wang, Ji-Nan Sheu, Ming-Tsan Liu, Fang-Ching Liu, Hoa-Hsin Wu, Min-Cheng Lin, Ching-Fen Ko, Hsiang-Yu Lin, Pei-Hsiu Kao, Kao-Pin Hwang, Yu-Lung Hsu, Tsung-Lin Kuo, and Chuen-Sheue ChiangComments to Author 
Author affiliations: Centers for Disease Control, Taipei, Taiwan (S.-H. Wei, L.-R. Tseng, M.-T. Liu, H.-H. Wu, M.-C. Lin, C.-F. Ko, P.-H. Kao, T.-L. Kuo, C.-S. Chiang); Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan (S.-H. Wei, P. Chou); China Medical University Hospital, Taichung, Taiwan (H.-C. Lin, J.-H. Wang, H.-Y. Lin, K.-P. Hwang, Y.-L. Hsu); School of Medicine, Chung Shan Medical University and Hospital, Taichung (J.-N. Sheu); Jen-Ai Hospital, Taichung (F.-C. Liu); National Taipei University of Nursing and Health Sciences, Taipei (C.-S. Chiang)

Main Article

Table

Results of Legionella culture in environmental water specimens associated with nosocomial infection of neonates, Taiwan*

Site of sampling 1st Sampling,†
strain (sequence type), concentration (CFU/L)‡ 2nd Sampling,†
strain (sequence type), concentration (CFU/L)
Case 1
  Tap water source 1 for bathing infants in nursery L. pneumophila serogroup 4 (ST1712), 2.5x103 L. pneumophila serogroup 4 (ST1712), TMTC
  Tap water source 2 in nursery L. pneumophila serogroup 4 (ST1712), 2x103 L. pneumophila serogroup 4 (ST1712), TMTC
  Drainage from air conditioner in nursery ND Negative
  Tap water source in room adjacent to nursery ND L. pneumophila serogroup 4 (ST1764), TMTC
  Cold water source of the hot/cold water dispenser§ L. pneumophila serogroup 5 (ST1032)¶, 2.2x104 ND
  Tap water source in maternity ward
 ND
 Negative
Case 2
  Tap water source for rinsing infants in nursery Negative Negative
  Tap water source for reverse osmosis water in nursery Negative Negative
  Cold water source of the hot/cold water dispenser§ L. pneumophila serogroup 1 (ST1)¶, 2x102 L. pneumophila serogroup 1 (ST1)¶, TMTC
  Hot water source of the hot/cold water dispenser ND Negative
  Tap water source 1 in maternity ward Negative Negative
  Tap water source 2 in maternity ward ND Negative
  Tap water source 3 in maternity ward Negative Negative
  Tap water source 4 in maternity ward ND Negative
  Tap water source for bathing in infant’s house ND Negative
  Tap water source for drinking water in infant’s home ND Negative

*Both case-patients were delivered by cesarean section and were not breast fed or placed in incubators. All potential infection sources were tested and listed. No humidifier was used in either nursery. ST, sequence type; TMTC, too many to count; ND, testing not done.
†The first samples from the environments of case-patients 1 and 2 were collected 33 d and 23 d after birth, respectively. The second samples were collected 34 d and 26 d after birth, respectively.
‡Concentration of Legionella spp. detected in water specimens, attributed to the presence of sampling swabs.
§Used in formula for neonates.
¶The pulsed-field gel electrophoresis profile of the strain was indistinguishable from that of the strain isolated from the patient’s sputum. The ST of the strain was the same as that of the strain isolated from the patient’s sputum.

Main Article

1These authors contributed equally to this manuscript.

Page created: October 06, 2014
Page updated: October 06, 2014
Page reviewed: October 06, 2014
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