Antimicrobial susceptibility and epidemiological types of Legionella pneumophila human isolates from Italy (1987–2020)
ABSTRACT: Objectives: Although antimicrobial resistance has not yet emerged as an overarching problem for Legionella pneumophila (L. pneumophila) infection, the description of clinical and environmental strains resistant to fluoroquinolones and macrolides is a cause of concern. This study aimed to...
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Elsevier
2025-03-01
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| Series: | Journal of Global Antimicrobial Resistance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716525000025 |
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| author | Maria Scaturro Alessio Lanni Fabiola Mancini Antonietta Girolamo Silvia Fillo Andrea Ciammaruconi Florigio Lista Clementina Elvezia Cocuzza Rosario Musumeci Christophe Ginevra Ghislaine Descours Sophie Jarraud Jessica Iera Paolo Visca Maria Luisa Ricci |
| author_facet | Maria Scaturro Alessio Lanni Fabiola Mancini Antonietta Girolamo Silvia Fillo Andrea Ciammaruconi Florigio Lista Clementina Elvezia Cocuzza Rosario Musumeci Christophe Ginevra Ghislaine Descours Sophie Jarraud Jessica Iera Paolo Visca Maria Luisa Ricci |
| author_sort | Maria Scaturro |
| collection | DOAJ |
| description | ABSTRACT: Objectives: Although antimicrobial resistance has not yet emerged as an overarching problem for Legionella pneumophila (L. pneumophila) infection, the description of clinical and environmental strains resistant to fluoroquinolones and macrolides is a cause of concern. This study aimed to investigate the antimicrobial susceptibility of L. pneumophila human isolates in Italy. Methods: A total of 204 L. pneumophila clinical isolates were tested for sensitivity to 9 antibiotics using the broth microdilution assay (BMD). All isolates were typed by sequence-based typing, and Legionella pneumophila serogroup 1 (Lp1) isolates by monoclonal antibody subgrouping. Minimum inhibitory concentration (MIC) data were correlated with the possible source of infection and geographical distribution. The presence of the lpeAB efflux pump genes was also investigated. The genome sequences of a subpopulation of isolates showing reduced susceptibility to azithromycin were also analysed. Results: The L. pneumophila isolates did not show significant resistance to the tested antibiotics, although a trend toward reduced sensitivity to azithromycin was observed in a subpopulation of 46 strains, most of which belonged to sequence type 1 (ST1), the second most widespread ST in Italy. An amplicon of the expected size overlapping the lpeAB genes was obtained only in the 46-subpopulation above mentioned. In 4 of the 46 isolates, sequencing analysis showed the occurrence of amino-acid substitutions already described in other strains. No further mutation was found. Conclusions: The presence of L. pneumophila strains with reduced susceptibility or resistance to azithromycin should be monitored to predict future trends and suggest to physicians a combined therapy with fluoroquinolones when a poor response to azithromycin is observed. © 2025 The Author(s). Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy. |
| format | Article |
| id | doaj-art-8792d17e26d84734a368f20f8c6f1521 |
| institution | Kabale University |
| issn | 2213-7165 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj-art-8792d17e26d84734a368f20f8c6f15212025-02-04T04:10:24ZengElsevierJournal of Global Antimicrobial Resistance2213-71652025-03-0141181188Antimicrobial susceptibility and epidemiological types of Legionella pneumophila human isolates from Italy (1987–2020)Maria Scaturro0Alessio Lanni1Fabiola Mancini2Antonietta Girolamo3Silvia Fillo4Andrea Ciammaruconi5Florigio Lista6Clementina Elvezia Cocuzza7Rosario Musumeci8Christophe Ginevra9Ghislaine Descours10Sophie Jarraud11Jessica Iera12Paolo Visca13Maria Luisa Ricci14Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy; ESCMID Study Group for Legionella Infections (ESGLI), Basel, SwitzerlandDepartment of Infectious Diseases, Istituto Superiore di Sanità, Rome, ItalyDepartment of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy; ESCMID Study Group for Legionella Infections (ESGLI), Basel, SwitzerlandDepartment of Infectious Diseases, Istituto Superiore di Sanità, Rome, ItalyScientific Department, Army Medical Center, Rome, ItalyScientific Department, Army Medical Center, Rome, ItalyScientific Department, Army Medical Center, Rome, ItalyDepartment of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy; MicroMiB Biorepository, University of Milano-Bicocca, Associated Member of the JRU MIRRI-IT, Monza, ItalyDepartment of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy; MicroMiB Biorepository, University of Milano-Bicocca, Associated Member of the JRU MIRRI-IT, Monza, ItalyESCMID Study Group for Legionella Infections (ESGLI), Basel, Switzerland; National Reference Centre of Legionella, Institute of Infectious Agents, Hospices Civils de Lyon, Lyon, France; CIRI, Centre International de Recherche en Infectiologie, Legionella Pathogenesis Team, University of Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, FranceESCMID Study Group for Legionella Infections (ESGLI), Basel, Switzerland; National Reference Centre of Legionella, Institute of Infectious Agents, Hospices Civils de Lyon, Lyon, France; CIRI, Centre International de Recherche en Infectiologie, Legionella Pathogenesis Team, University of Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, FranceESCMID Study Group for Legionella Infections (ESGLI), Basel, Switzerland; National Reference Centre of Legionella, Institute of Infectious Agents, Hospices Civils de Lyon, Lyon, France; CIRI, Centre International de Recherche en Infectiologie, Legionella Pathogenesis Team, University of Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, FranceDepartment of Infectious Diseases, Istituto Superiore di Sanità, Rome, ItalyDepartment of Science, University of Roma Tre, Rome, ItalyDepartment of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy; ESCMID Study Group for Legionella Infections (ESGLI), Basel, Switzerland; Corresponding author. Mailing address: Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome 00161, Italy.ABSTRACT: Objectives: Although antimicrobial resistance has not yet emerged as an overarching problem for Legionella pneumophila (L. pneumophila) infection, the description of clinical and environmental strains resistant to fluoroquinolones and macrolides is a cause of concern. This study aimed to investigate the antimicrobial susceptibility of L. pneumophila human isolates in Italy. Methods: A total of 204 L. pneumophila clinical isolates were tested for sensitivity to 9 antibiotics using the broth microdilution assay (BMD). All isolates were typed by sequence-based typing, and Legionella pneumophila serogroup 1 (Lp1) isolates by monoclonal antibody subgrouping. Minimum inhibitory concentration (MIC) data were correlated with the possible source of infection and geographical distribution. The presence of the lpeAB efflux pump genes was also investigated. The genome sequences of a subpopulation of isolates showing reduced susceptibility to azithromycin were also analysed. Results: The L. pneumophila isolates did not show significant resistance to the tested antibiotics, although a trend toward reduced sensitivity to azithromycin was observed in a subpopulation of 46 strains, most of which belonged to sequence type 1 (ST1), the second most widespread ST in Italy. An amplicon of the expected size overlapping the lpeAB genes was obtained only in the 46-subpopulation above mentioned. In 4 of the 46 isolates, sequencing analysis showed the occurrence of amino-acid substitutions already described in other strains. No further mutation was found. Conclusions: The presence of L. pneumophila strains with reduced susceptibility or resistance to azithromycin should be monitored to predict future trends and suggest to physicians a combined therapy with fluoroquinolones when a poor response to azithromycin is observed. © 2025 The Author(s). Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy.http://www.sciencedirect.com/science/article/pii/S2213716525000025Legionella pneumophilaLegionnaires’ diseaseAntimicrobial susceptibilityAzithromycinLpe A and BgenesSequence type |
| spellingShingle | Maria Scaturro Alessio Lanni Fabiola Mancini Antonietta Girolamo Silvia Fillo Andrea Ciammaruconi Florigio Lista Clementina Elvezia Cocuzza Rosario Musumeci Christophe Ginevra Ghislaine Descours Sophie Jarraud Jessica Iera Paolo Visca Maria Luisa Ricci Antimicrobial susceptibility and epidemiological types of Legionella pneumophila human isolates from Italy (1987–2020) Journal of Global Antimicrobial Resistance Legionella pneumophila Legionnaires’ disease Antimicrobial susceptibility Azithromycin Lpe A and Bgenes Sequence type |
| title | Antimicrobial susceptibility and epidemiological types of Legionella pneumophila human isolates from Italy (1987–2020) |
| title_full | Antimicrobial susceptibility and epidemiological types of Legionella pneumophila human isolates from Italy (1987–2020) |
| title_fullStr | Antimicrobial susceptibility and epidemiological types of Legionella pneumophila human isolates from Italy (1987–2020) |
| title_full_unstemmed | Antimicrobial susceptibility and epidemiological types of Legionella pneumophila human isolates from Italy (1987–2020) |
| title_short | Antimicrobial susceptibility and epidemiological types of Legionella pneumophila human isolates from Italy (1987–2020) |
| title_sort | antimicrobial susceptibility and epidemiological types of legionella pneumophila human isolates from italy 1987 2020 |
| topic | Legionella pneumophila Legionnaires’ disease Antimicrobial susceptibility Azithromycin Lpe A and Bgenes Sequence type |
| url | http://www.sciencedirect.com/science/article/pii/S2213716525000025 |
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