Publications

antibiotic therapy of experimental airborne legionnaires' disease.	the efficacy of erythromycin, gentamicin and rifampicin has been compared in the treatment of experimental airborne legionnaires' disease in guinea-pigs. evaluation was based on survival of animals after 1ld50 or 10ld50 infection, on numbers of legionella pneumophila in the lungs and on the extent of histopathological lesions. all three drugs were effective in increasing survival in 1ld50 infections, but only rifampicin gave any protection against 10ld50 infection. rifampicin was the most effect ...	1983	6663081
[severe legionella pneumopathy in an immunologically normal infant].	a case of legionnaires' disease is described in a 9 months old boy. he had a rapidly extensive bilateral pneumoniae. there was no premorbidity. the diagnosis was made by demonstrating legionella pneumophila serogroup 1 in pulmonary biopsy and pleural liquid, by direct immunofluorescence assay and positive culture. there was no seroconversion. an adenovirus type 2 was also isolated in pulmonary biopsy, with an strong seroconversion. the course was favorable, with doxycycline therapy.	1983	6664746
[legionnaires' disease with late pulmonary sequelae. apropos of a case].	the authors report a case of legionnaires' disease with retractile late sequelae affecting the lingula and the dorsal segment of the culmen. they stress the need for appropriate and prolonged treatment because of the possible presence of intracellular legionella pneumophila. the existence of an associated staphylococcal infection is also one of the hypotheses raised in explaining such sequelae.	1983	6664945
[legionella infections].	the authors review the bacteriological features of legionella infections, their clinical symptoms and the methods of diagnosis. they stress the unusual ecological features of legionella which generally lives in natural water reservoirs or in artificial reservoirs (drinking water piping, air conditioning). in the clinical situation, current emphasis is on the extrapulmonary infections whose pathogenesis has not yet been fully explained. the incidence and prevalence of legionella in pneumonia stil ...	1983	6666882
[legionnaires' disease: legionella pneumophila, an agent in nosocomial infection].	legionella pneumophila recently identified in 1977 as responsible for legionnaires' disease, is present in the natural environment. the discovery of the bacteria, the development of suitable complex media ( bcye ) and of serological techniques improved the knowledge of epidemiologic features of l. pneumophila widely distributed geographically. legionella has been frequently isolated from the aquatic environment: the organism is able to colonize the condensed water of air-conditioning systems and ...	1983	6675736
[a case of opportunistic legionnaires' disease with primary lung cancer].		1983	6676537
[legionnaires' disease. ii. epidemiologic, microbiologic and anatomo-pathologic aspects].		1983	6679256
rapidly progressive pneumonia in a young man.		1983	6680608
neuropathologic evaluation of 40 confirmed cases of legionella pneumonia.	autopsy examination of the brain was performed in 40 cases of legionella pneumonia. thirty-nine of 40 patients had underlying chronic or acute medical problems. sixteen patients (40%) had neurologic signs or symptoms that were not explained by preexisting disease. csf was normal in six of seven patients examined; csf protein content was 66 mg/100 ml in one patient. neuropathologic examination in all 40 patients demonstrated no lesions attributable to disseminated legionella pneumophila. mechanis ...	1983	6684231
reactivity of serum from patients with suspected legionellosis against 29 antigens of legionellaceae and legionella-like organisms by indirect immunofluorescence assay.	sets of sera (444) submitted for diagnostic testing for legionellosis were tested against 29 indirect immunofluorescence assay (ifa) antigens prepared from the characterized legionella species and legionella-like organisms to determine the prevalence of antibodies to legionella organisms. reciprocal titers of 15% of the serum sets rose fourfold or more to greater than or equal to 128 (indicating seroconversion) against one or more legionella antigens. the specificity of the test was 96% when eva ...	1983	6185598
bacteriostatic and bactericidal modes of action of bis(tributyltin)oxide on legionella pneumophila.	the modes of action of bis(tributyltin)oxide (tbto) doses between 1 x 10(4) and 6 x 10(7) molecules per cell on a single environmental isolate of legionella pneumophila were studied by monitoring the following parameters: (i) growth, (ii) cell viability, (iii) 14c-amino acid incorporation, (iv) 14co2 production from 14c-amino acids, (v) [3h]uridine incorporation, (vi) [3h]thymidine incorporation, (vii) oxygen consumption, (viii) cellular atp levels, and (ix) adenylate energy charge. the amount o ...	1983	6186198
a new staining method for legionella pneumophila.	most of the methods that have been described for the staining of bacteria in tissue sections have been found unsatisfactory for legionella pneumophila. in this report, we describe a method that consistently stains l. pneumophila in tissue and has certain advantages over recommended methods currently in use.	1983	6187207
effects of alpha-amylase on in vitro growth of legionella pneumophila.	sterile parotid saliva inhibited growth of legionella pneumophila on solid media, and the salivary component involved in this inhibition has been shown to be amylase. disk diffusion and well plate assays were used to study possible mechanisms for this effect. the amylolytic activity of saliva copurified with inhibitory activity, and both activities were sensitive to proteinase k digestion and heat treatment. in addition, purified alpha-amylase from several sources (bacteria, fungi, porcine pancr ...	1983	6190756
rapid diagnosis of legionnaires' disease by bronchoalveolar lavage.	legionella pneumophila has, in recent years, emerged as a common pulmonary pathogen in the normal and immuno-compromised patient (icp). making a specific etiologic diagnosis of pneumonia in the latter group is a common clinical dilemma often complicated by poor specimen availability and risks of invasive procedures. improved staining and isolation techniques for l pneumophila would suggest that early diagnosis could be possible if adequate specimens were available. this report summarizes our exp ...	1983	6191927
legionella pneumophila seen in gram stains of respiratory secretions and recovered from conventional blood cultures.	we report a fatal case of legionnaires' disease in which legionella pneumophila was easily visible in large numbers in gram stains of clinical material and was recovered from conventional blood cultures after seven days incubation. the presence of many readily seen gram-negative, pleomorphic bacilli in direct gram stains of respiratory secretions should support a possible diagnosis of legionnaires' disease.	1983	6192178
warthin-starry for legionella.		1983	6192704
a phylogenetic analysis of legionella.	four species of legionella, l. pneumophila nctc 11192, l. bozemanii nctc 11368, l. micdadei nctc 11371 and l. jordanis atcc 33623 have been characterized by oligonucleotide cataloguing of their 16s ribosomal rna. all four species are phylogenetically closely related, while no specific relationship could be detected with any other group of organisms investigated so far with respect to this method. at a low level of relationship legionellae are members of the broad group of purple photosynthetic b ...	1983	6194769
visualization of legionella pneumophila in paraffin sections using hexamine silver.	a modification of gomori's hexamine silver technique is given as a simple, reliable method for the nonspecific demonstration of legionella pneumophila in paraffin sections. when tested against serogroups i to vi it was found that pretreatment with potassium dichromate rendered l. pneumophila demonstrable by the gomori-burtner hexamine silver solution when buffered to ph 7.8. tissue was fixed in 10% buffered formalin and sections were cut at 3-5 microns. after treatment with 10% potassium dichrom ...	1983	6197774
induction of proteinases in legionella by growth on agar containing serum.	non-proliferating cells of legionella show a rather small proteolytic action on human serum proteins. however, if the strains grow on agar plates containing serum the proteolysis is very strong. this effect may be due to an induction of the appropriate enzymes by their substrates. the alterations of 24 investigated proteins demonstrated by immunoelectrophoresis show anodic shifts of bands and their disappearance (table 1, fig. 1-15). the shifted proteins are not degraded significantly. their alt ...	1983	6201025
effect of oxygen-dependent antimicrobial systems on legionella pneumophila.	legionella pneumophila was susceptible to the antimicrobial action of oxygen metabolites generated by both the myeloperoxidase-h(2)o(2)-halide and the xanthine oxidase systems.	1983	6295960
production of superoxide and hydrogen peroxide in medium used to culture legionella pneumophila: catalytic decomposition by charcoal.	the difficulties associated with the growth of legionella species in common laboratory media may be due to the sensitivity of these organisms to low levels of hydrogen peroxide and superoxide radicals. exposure of yeast extract (ye) broth to fluorescent light generated superoxide radicals (3 microm/h) and hydrogen peroxide (16 microm/h). autoclaved ye medium was more prone to photochemical oxidation than ye medium sterilized by filtration. activated charcoals and, to a lesser extent, graphite, b ...	1983	6303219
status of serologic tests for legionella antigen and antibody at the centers for disease control.	nine species and 16 serogroups have been defined for the genus legionella. direct immunofluorescence assay (dfa) results with 12 conjugates in 3 polyvalent pools showed that l. pneumophila serogroup 1 comprised 63% of the legionellae identified in specimens from patients with legionellosis. indirect immunofluorescence assay (ifa) titers of paired sera from patients with suspected legionellosis against multiple legionella antigens showed preferential reactivity for the l. pneumophila antigens. th ...	1983	6314700
new beta-lactamase-resistant cephem treatment of guinea pigs infected with legionella pneumophila.	the in vivo antimicrobial effect of seven new beta-lactamase-resistant cephems (cefotaxime, latamoxef, ceftazidime, ceftriaxone, cefotiam, cefbuperazone, and mt-141) on legionella pneumophila (strain 81-066, serogroup iv) in guinea pigs was compared with that of erythromycin. as the minimal ld100 within one week was about 4.0 x 10(9) cfu/ml by intraperitoneal injection of the strain, the animals were inoculated with 2.0 ml of twofold dilutions of a suspension of this bacterium. the animals devel ...	1983	6316115
nosocomial legionnaires' disease. occurrence in recipients of bone marrow transplants.	nosocomial pneumonia caused by legionella pneumophila serogroup 1 occurred in five patients after bone marrow transplantation for hematologic malignancies. two patients died as a result of the infection despite treatment with erythromycin. serologic screening revealed no other cases of legionnaires' disease in 40 consecutive recipients of bone marrow transplants, giving a frequency of infection of 13 percent. these five cases represent 23 percent of the pneumonia occurring in this group of patie ...	1983	6337488
legionella incidence and density in potable drinking water supplies.	the incidence and density of legionella spp. in raw water, water at various stages of treatment, and in potable distribution water were determined by direct immunofluorescence. the number of cells reacting with legionella-specific fluorescent antibody conjugates in raw waters ranged from about 10(4) to 10(5) cells/liter, whereas the concentrations of fluorescent antibody-positive cells in the distribution waters were generally 10- to 100-fold lower than in the raw source waters. no viable or vir ...	1983	6337552
microenzyme-linked immunosorbent assay for detection of immunoglobulin g and immunoglobulin m antibodies to legionella pneumophila.	the microenzyme-linked immunosorbent assay (elisa) for the detection of immunoglobulin m and g (igm, igg) antibodies to legionella pneumophila serogroup 1 antigens was evaluated. igm antibodies were measured by both double-sandwich and single-sandwich techniques. these assays were compared with the previously standardized indirect immunofluorescence test in four groups of subjects: (i) pneumonia patients with culture-proven legionnaires disease with serogroup 1 isolates, (ii) pneumonia patients ...	1983	6338032
variability in eia plates used in elisa tests for the detection of antibodies to legionella pneumophila.		1983	6338052
legionella micdadei (pittsburgh pneumonia agent). two infections with unusual clinical features.	we describe herein the clinical features, diagnosis, and successful treatment of two patients with legionella micdadei pneumonia, the pittsburgh pneumonia agent. the rapid pulmonary cavitation and relapse of symptoms after a course of therapy in a renal transplant recipient, and the prolonged illness with hemorrhagic pleural fluid, splenomegaly, and multiple-organ dysfunction in a nonimmunocompromised host, illustrate the clinical spectrum of infections with this organism.	1983	6338266
pneumonia due to the pittsburgh pneumonia agent: new clinical perspective with a review of the literature.	we review the current knowledge concerning this newly recognized pathogen, pittsburgh pneumonia agent (ppa), and present a new, comprehensive perspective of ppa based on our extensive clinical experience: 1) ppa pneumonia is more common and affects a broader range of patients than previously appreciated. 2) in the general population, the disease is not distinguishable from acute pneumonia due to other causes. because specialized diagnostic tests are required for detection, it is likely that many ...	1983	6338342
isolation of legionella pneumophila serogroup 1 from blood with nonsupplemented blood culture bottles.	legionella pneumophila serogroup 1 was isolated from antemortem aerobic blood culture bottles not supplemented with l-cysteine or ferric pyrophosphate and from the postmortem lung tissue of a 72-year-old man. we recommend that aerobic blood culture bottles (johnston laboratories, cockeysville, md.) of bactec be subcultured to an agar that supports the growth of l. pneumophila when growth indexes range from 30 to 60 but fail to increase further.	1983	6339543
counterimmunoelectrophoresis in the serodiagnosis of legionnaires' disease.	counterimmunoelectrophoresis (cie) was found to be a rapid, specific method for detecting circulating antibodies to legionella pneumophila, using a simple ultrasonically disrupted antigen. the diagnostic specificity of the technique was 93% and the diagnostic sensitivity was 86.3%. both igm and igg classes of antibody can be detected. there is some cross-reactivity between serogroup 1 and serogroup 6 but none between serogroup 1 and serogroups 3, 4, and 5. it is suggested that cie may provide a ...	1983	6339567
[the significance of tap water contaminated with legionella pneumophila for the occurrence of legionella pneumonia as hospital infection].		1983	6339957
symbiotic interactions between legionella pneumophila and human leukocytes.		1983	6341276
legionella infections: a review of five years of research.	in an attempt to place in perspective the role of legionella pneumophila in human disease, the literature concerning this organism was reviewed. in the five years since the etiology of legionnaires' disease was elucidated, an impressive body of information has been gathered from retrospective investigations of illnesses of previously unidentified etiology and from studies of new cases of nosocomial or community-acquired infection caused by l. pneumophila. topics on which considerable knowledge h ...	1983	6342093
improved facility and sensitivity in the use of guinea pigs for the isolation of legionella pneumophila from cooling tower water.	the established criteria for the determination of the optimum time for the sacrifice of guinea pigs inoculated with samples of cooling tower water were found to be inadequate for the detection of low levels of legionella pneumophila. by ignoring the requirement for fever and by sequentially sacrificing the infected guinea pigs on days 3 through 5 postinoculation, we simplified the procedure, and the sensitivity of detection was improved a great deal.	1983	6342532
legionella pneumophila pneumonia in a renal transplant patient.		1983	6343293
[legionnaires' disease].		1983	6343671
acute-phase, indirect fluorescent antibody procedure for diagnosis of mycoplasma pneumoniae infection.	an indirect fluorescent antibody (ifa) technique was developed to detect igg and igm-specific antibodies to mycoplasma pneumoniae. the presence of igm-specific mycoplasma antibody was interpreted as reflecting active infection in patients with atypical pneumonia or other clinically compatible illness. the procedure is suitable for use in routine clinical laboratories, correlated well with complement fixation test results and did not show cross reaction with legionella pneumophila antibody. the r ...	1983	6344745
prevalence of pneumonias caused by legionella species among patients on whom autopsies were performed.	we wanted to determine the prevalence of pneumonias caused by legionella species among patients on whom autopsies were performed in two medical centers in st louis from january 1976 to june 1981. we screened formaldehyde-fixed deparaffinized lung tissue sections with microscopic evidence of pneumonia from 97 patients with use of the direct immunofluorescence antibody technique with a multivalent antilegionella conjugate containing antibodies to legionella pneumophila serogroups 1 through 4 plus ...	1983	6344838
new developments in infectious diseases for the critical care physician.	there have been numerous recent developments in the field of infectious diseases which are relevant to critical care medicine. these include a number of new syndromes, pathogens, and chemotherapeutic modalities. the purpose of this review is to summarize the most significant developments during the past 5 yr which are applicable to the practice of intensivists.	1983	6345089
legionnaires' disease.		1983	6345418
new serogroup of legionella pneumophila, serogroup 8.	a strain of legionella pneumophila (designated concord 3) was isolated from a postmortem lung specimen of a patient with pneumonia. direct fluorescent-antibody and immunoelectrophoresis tests, using absorbed and unabsorbed reagents prepared to this and other strains of legionellae, indicated that the concord 3 strain represents a new serogroup of l. pneumophila, serogroup 8.	1983	6345579
factors influencing the reactivity of legionella antigens in immunofluorescence tests.	we examined several factors for their effects on the serological reactivity of legionella antigens used for direct or indirect fluorescent-antibody tests. these factors included media, methods of killing, strain differences, and the nature of the reactivity with diverse human sera. the maximum serological reactivities were obtained with charcoal-yeast extract agar; the relative antigenicity of cells grown on a chemically defined medium could be fourfold less than those grown on the charcoal-yeas ...	1983	6345580
cell-mediated immunity in legionnaires' disease.	previous studies from this laboratory have suggested a role for cell-mediated immunity in host defense against legionella pneumophila. in this paper, cell-mediated immunity to l. pneumophila in patients recovered from legionnaires' disease was studied by examining patient mononuclear cell responses to l. pneumophila antigens. patient mononuclear cells were assayed both for their capacity to respond to l. pneumophila antigens with the production of cytokines that activate monocytes, as measured b ...	1983	6345589
legionella extracellular protease activity on chromogenic peptides: a simplified procedure for biochemical enzyme identification.	legionella strains produce extracellular proteases. one method to demonstrate these is through the activity of broth culture filtrates on para-nitroanilide (pna)-derivatized peptides. previously, this method has comprised a 100-times concentration of the filtrates, in order to bring the protease activity, as measured by the liberation of free pna from hydrolysed peptides, up to easily recordable values. by introducing a diazotation step, the sensitivity of the test has been increased sufficientl ...	1983	6346796
enhanced primary isolation of legionella pneumophila from clinical specimens by low-ph treatment.	during the 12-month study period, 919 clinical specimens were submitted to the laboratory for culture of legionella pneumophila. all specimens were plated onto nonselective and semiselective media both directly and after treatment with a kcl-hcl solution, ph 2.2. of the 51 specimens (5.5%) positive for l. pneumophila and legionella-like organisms, 20 were recovered by acid pretreatment only, 5 were recovered by direct plating only, and 26 were recovered by both acid pretreatment and direct inocu ...	1983	6348079
patterns of extracellular proline-specific endopeptidases in legionella and flavobacterium spp. demonstrated by use of chromogenic peptides.	some legionella strains possess a strong extracellular proline-specific endopeptidase (pse) activity. using an enlarged selection of chromogenic peptides representing a variety of n-terminal amino-acids binding to a -prolyl-proline, paranitroanilide chain, pse activity of legionella and flavobacterium strains was examined. differences in pse activity emphasized the importance of the chemical structure at the nonchromogenic end of the peptide substrates. there seem to be distinct patterns of n-te ...	1983	6348081
erythromycin--three decades later.	this article reviews some of the more recent developments relating to the clinical usage of erythromycin. the bactericidal and tissue-penetrating properties of this antibiotic are described and the suggestion that erythromycin has a very useful spectrum of activity in respiratory tract infections is supported by a variety of studies. we examine the increasing application of erythromycin in an extending number of problems such as sexually acquired disorders, a variety of diseases produced by infe ...	1983	6348968
community-acquired bacterial pneumonia requiring admission to hospital.	patients who develop bacterial pneumonia in the community often require admission to acute-care hospitals. knowledge of the incidence of pneumonia due to different pathogens that are brought into an institution from the community may play a role in determining the patterns of infecting organisms responsible for hospital-acquired pneumonia. for 1 year, we prospectively reviewed the records of patients admitted to our 1000-bed community hospital with community-acquired bacterial pneumonia (cabp). ...	1983	6349427
diagnosis of pneumonitis in immunocompromised patients by open lung biopsy.	the records of 59 immunocompromised patients with fever and pulmonary infiltrates who underwent open lung biopsy, were reviewed. a specific diagnosis was made by lung biopsy in 49 (83%) patients, and in 32 instances (54%) the diagnosis was a treatable infection. only two (3.4%) false-negative biopsies occurred. transplant recipients were more likely to have a specific, treatable pneumonia (74%) than patients with a reticuloendothelial malignancy (42%, p less than 0.05). this was due to a greater ...	1983	6349779
cellular immunity to legionella pneumophila in guinea pigs assessed by direct and indirect migration inhibition reactions in vitro.	spleen cell cultures from guinea pigs given legionella pneumophila vaccine in complete freund adjuvant or as a sublethal infection were inhibited in their migration activity in vitro when incubated with specific antigen. both direct and indirect migration inhibition assays revealed sensitization of the guinea pigs to the bacterium, with demonstrable reactivity 25 to 40 days or more after sensitization. no consistent reactions occurred when the guinea pigs were given the killed legionella vaccine ...	1983	6350180
isolation of legionella pneumophila from clinical specimens via amoebae, and the interaction of those and other isolates with amoebae.	the development of an amoebal enrichment method, for the recovery of viable legionella pneumophila from clinical materials is described. the method has been used successfully in five of six cases of legionnaires' disease in which l pneumophila was isolated. studies on those l pneumophila isolates led to the discovery that virulent legionellae are attracted to, and attack suitable host amoebae, rather than infection following chance ingestion.	1983	6350372
blastogenic responsiveness of spleen cells from guinea pigs sensitized to legionella pneumophila antigens.	an in vitro leukocyte blastogenic assay was utilized to establish an in vitro correlate of cell-mediated immunity to legionella pneumophila antigen with spleen cells from sensitized guinea pigs. incubation of spleen cells from sensitized but not normal guinea pigs with graded amounts of killed whole cell legionella bacteria or sonicate derived from the bacteria resulted in an antigen-induced blast cell proliferation as evidenced by an increased uptake of [3h]-thymidine into spleen cell cultures. ...	1983	6351091
ceftazidime: a new approach in the treatment of moderate and severe infections.	ninety patients with serious infections, including 61 with septicaemia, pneumonia, peritonitis or meningitis, were treated with ceftazidime. of these patients, 85.6% were clinically cured (73.3%) or improved (12.2%) by the antibiotic. in this study, 57.7% had infections due to escherichia coli (24.7%), klebsiella sp. (14.5%) and pseudomonas sp. (18.5%). two children with cystic fibrosis and pseudomonas pneumonia and an adult with legionella pneumonia responded well to ceftazidime treatment. seve ...	1983	6352615
diagnosis of legionnaires' disease. an update of laboratory methods with new emphasis on isolation by culture.	a prospective clinical study of 40 cases of legionnaires' disease combined with serial laboratory examinations enabled us to present an update as well as new recommendations concerning the use of diagnostic tests for legionnaires' disease. transtracheal aspirate specimens are the optimal specimen for recovery of legionella pneumophila by culture as well as the most sensitive method for early diagnosis. in addition, with recent improvements in culture media and methodology, l pneumophila can now ...	1983	6352966
serological investigations of legionella infections in denmark.	during the period 1 july 1978 to 1 january 1982, sera from 728 patients suspected of suffering from legionella infection were tested for legionella antibodies by an indirect fluorescent antibody test. the antigens used were prepared from heat-killed strains of l.pneumophila serogroups 1-4. in 1981 we further incorporated antigens from serogroups 5 and 6 of l.pneumophila together with l.micdadei, l.bozemanii, l.dumoffii and l.gormanii. according to the criteria put forward by cdc, atlanta, usa le ...	1983	6353855
epidemiology of infection by nontuberculous mycobacteria. iv. preferential aerosolization of mycobacterium intracellulare from natural waters.	we report here the first laboratory studies simulating the conditions for natural aerosolization of mycobacterium intracellulare and m. scrofulaceum and estimate the yields for this pathway of transfer of pathogenic mycobacteria from water to air; m. intracellulare and m. scrofulaceum were both concentrated in droplets ejected from cell suspensions of densities comparable to those found in natural freshwaters (100 to 2,000 colony-forming units per ml). the enrichment factor (defined as the conce ...	1983	6354024
comparison of microagglutination with the indirect immunofluorescence assay for the diagnosis of infection with legionella pneumophila serogroup 1.	a comparison was made of the indirect immunofluorescence assay and microagglutination in the diagnosis of infections caused by legionella pneumophila serogroup 1. control sera consisted of 709 sera from patients without pneumonia and 99 sera from patients with mycoplasma or chlamydia infection. the 468 test sera were from 51 patients with serologically confirmed or suspected legionella pneumophila serogroup 1 infection, and from 230 patients with pneumonia of unknown aetiology. there was good ag ...	1983	6354714
the chest x-ray in legionella pneumonia (legionnaires' disease).	the authors compared the radiological evolution and patterns of legionella pneumophila pneumonia in 13 immunocompromised and 13 non-immunocompromised patients. apart from the occurrence of cavitation and the longer time it took before consolidations cleared in immunocompromised patients no differences were found between the two groups of patients.	1983	6354717
detection of antibodies against legionella pneumophila serogroups 1 to 6 and the leiden-1 strain by micro elisa and immunofluorescence assay.	one hundred and seventy-five human sera were tested for the presence of type-specific antibodies against l pneumophila serogroups 1 to 6 and the leiden-1 strain by means of an enzyme linked immunosorbent assay (elisa) and compared with the results obtained by the indirect immunofluorescence assay (ifa). a high correlation (correlation coefficient 0.92) between both methods was found. no consistent pattern of igg, iga and igm classes of antibody titres against l pneumophila were found. in the ser ...	1983	6355195
[the detection of the agent of legionnaires' disease--a confirmation of koch's postulates].	the genus legionella, belonging to the family of legionellaceae, comprises nowadays seven species, among which legionella pneumophila might be the most important. the identification of the agent is difficult because l. pneumophila is very pretentious requiring peculiar conditions concerning culture medium, temperature, and time. the initial cultivation will succeed the best in an atmosphere enriched with co2. the demonstration of serum antibodies will succeed by means of indirect immunofluoresce ...	1983	6356647
indirect immunofluorescence assay (ifa), microagglutination test (ma) and enzyme-linked-immunosorbent assay (elisa) in diagnosis of legionellosis.	lipopolysaccharide was extracted with cold phenol water from legionella pneumophila and used as antigen for elisa. igg and igm antibodies were measured with the elisa and the immunofluorescence assay (ifa). agglutinating antibodies were measured by the microagglutination (ma) test. in tests on sera from 27 patients with confirmed legionella infections predominantly due to l. pneumophila serogroup 1 the results with the elisa, the ifa and the ma were compared to each other. antibody titers obtain ...	1983	6356706
legionella microagglutination test. a serological study of danish patients.	a microagglutination (ma) test for antibodies to 10 different legionella antigens was evaluated by comparison with an indirect fluorescent antibody (ifa) test. sera from 227 patients were investigated. there was good agreement between the two tests, especially when testing sera from patients with a rise in titre. the ma is promising as an easy, quick, cheap and reproducible test for antibodies to legionella.	1983	6356707
extracellular proteases from legionella.	bacterial endopeptidase (proteinase) activity can be specifically registered using synthetic chromogenic peptides. this method does not replace, but adds to the previously existing methods for measuring proteolytic activity. the use of concentrated broth filtrates from legionella bacteria on a number of different peptides has permitted the establishment of peptide hydrolysis patterns. to some extent these patterns appear species specific. thus, a close similarity is demonstrated between strains ...	1983	6356708
sero-epidemiology of legionellosis in austria.	out of 1961 patients with the clinical diagnosis of atypical pneumonia 11 cases (0.65%) of recent legionella infections were diagnosed by indirect immunofluorescence test (ifa). a higher incidence (1.37%) has been found in 364 patients in whom clinicians suspected a legionella infection and therefore asked for serological testing. prevalence of antibodies (greater than or equal to 1:32) reacting with antigens of l. pneumophila serogroup 1 to 6 was highest to serogroup 6 (37%), and lowest to ser ...	1983	6356709
serological tests for legionella pneumophila serogroup 1 infections.	the indirect fluorescent antibody test (ifat) using a formolised yolk sac antigen (fysa) has been shown to be a sensitive, specific test for legionellosis and results obtained on the same serum specimens in different laboratories agree closely. the rapid micro-agglutination test (rmat) has the advantage of being semi-automatable and also sensitive and specific. both tests gave negative results with sera from patients with infections due to mycoplasma pneumoniae, chlamydia psittaci, coxiella burn ...	1983	6356710
autecology of legionella pneumophila.	species of legionella are readily isolated from freshwater aquatic habitats throughout the united states, which are diverse in their physical and chemical parameters. temperature studies indicate that legionella is not present in habitats with temperatures above 63 degrees c, and isolates have been obtained from frozen rivers. the presence of the organism in natural hot springs and man-made thermal habitats suggest that legionella may have been present for a long period of time, but has only rec ...	1983	6356711
experience with heat-killed antigens of l. longbeachae serogroups 1 and 2, and l. jordanis in the indirect fluorescence antibody test.	sera from 1384 individuals were examined with a trivalent antigen composed of legionella longbeachae serogroups 1 and 2 and l. jordanis. one hundred and twenty nine (9.3%) showed a reaction on screening. thirty-six (2.6%) had a titre of greater than or equal to 64 with monovalent antigens. ten (0.7%) had a high (greater than or equal to 256) or greater than or equal to fourfold rising titre of antibody to one or more antigens and six of these patients had a severe chest infection. no correlation ...	1983	6356712
antibodies against legionellaceae in the population of west germany and their methodical determination.	the preparation of antigen (l. pneumophila serogroups 1--4 and l. micdadei) was performed by heat killing at 70 degrees c for 5 min as the most conservative method. the serological investigations used the indirect immunofluorescence assay (if) and the microagglutination test (ma). no clear differences were observed between sera of normal and suspicious human beings and between sera of males and females. young people has the highest percentage of low titers. l. pneumophila serogroup 1 produced th ...	1983	6356713
monoclonal antibodies to legionella pneumophila serogroup 1: possible applications in diagnostic tests and epidemiologic studies.	monoclonal antibodies were produced against two strains of legionella pneumophila serogroup 1. a panel of nine monoclonal antibodies were selected for their unique specificities observed in indirect fluorescent antibody tests with 130 strains of l. pneumophila serogroup 1. one monoclonal antibody was reactive with an antigen possessed by 128 of 130 strains. two major subgroups were identified and 13 different antigen patterns were observed among the 130 serogroup 1 strains.	1983	6356714
culture diagnosis of legionella infections.	culture diagnosis of legionella infections is feasible in most instances. using selective culture techniques, sputum can be used to diagnose these infections specifically, and with a degree of sensitivity equal to or greater than currently used immunological means of diagnosis. every laboratory performing diagnostic testing for this group of infections should perform cultures to achieve optimal yield.	1983	6356715
a survey of domestic animals to detect serological responses against legionella spp. by indirect fluorescent antibody.	one hundred ninety-six (196) animal sera were examined for antibodies against heat-killed antigens of legionella pneumophila serogroups 1 to 5, l. bozemanii, l. dumoffii, l. gormanii and l. micdadei by the indirect fluorescent antibody technique. only two animals (1%), both sheep, reacted against l. pneumophila serogroups at a titer of 256. however, 29% of the horses and 24% of the sheep tested were reactive to at least one non-l. pneumophila legionella spp. antigen at a titer of 256. at a titer ...	1983	6357411
serogrouping and subtyping of legionella pneumophila with monoclonal antibodies.	monoclonal antibodies directed against legionella pneumophila serogroups 1 to 6 were produced by fusing splenocytes of balb/c mice with the sp 2/0-ag14 or the nso mouse myeloma cell lines. specificity of these antibodies was determined by indirect fluorescent-antibody staining: 8 reacted with l. pneumophila serogroup 1 and, respectively, 13, 6, 6, 5, and 10 reacted with serogroups 2, 3, 4, 5, and 6; all except 5 were serogroup specific, and none presented cross-reactions with six other species o ...	1983	6358248
oropharyngeal colonization with legionella pneumophila.	a total of 186 volunteers, including 40 hospital patients, participated in a cross-sectional survey of oropharyngeal colonization with legionella pneumophila. colonization was defined as the appearance of any l. pneumophila organisms on culture or a positive direct fluorescent-antibody (fa) test or both in the absence of signs or symptoms of pneumonia. the direct fa tests were performed on throat swabs, using a polyvalent conjugate directed against l. pneumophila serogroups i through iv. throat ...	1983	6358250
comparison of slide agglutination test and direct immunofluorescence assay for identification of legionella isolates.	it is technically impractical for many clinical laboratories to use the direct immunofluorescence assay for identifying and serogrouping clinical isolates of legionella. we compared the results obtained with the direct immunofluorescence assay with the results of a simple and less-demanding slide agglutination test for identifying 15 serogroups representing seven legionella species. the slide agglutination test was in complete agreement with the direct immunofluorescence assay, and the serogroup ...	1983	6358251
interaction of l. pneumophilia and a free living amoeba (acanthamoeba palestinensis).	co-cultivation of legionella pneumophila serogroup i and acanthamoeba palestinensis in neff's medium at 35 degrees c resulted in the intracellular multiplication of the bacteria as demonstrated by electron microscopy and immunofluorescence. in the closed experimental system used, the number of legionellae rose from 10(7) colony forming units (c.f.u.)/ml initially to a maximum of 10(10) c.f.u./ml on day 5. legionellae were seen in expelled phagosomes, in some amoebae filling the cytoplasm and in ...	1983	6358342
isolation of legionella pneumophila from water supplies: comparison of methods based on the guinea-pig and culture media.	the detection of legionella pneumophila in water via guinea-pig intraperitoneal injection has been compared with direct isolation of these organisms on semiselective bcye alpha media. both techniques were of similar sensitivity, detecting as few as 10(2) l. pneumophila in 10 ml of water. however, at this concentration, detection using guinea-pig intraperitoneal injection was via the indirect parameters of antibody production and immunofluorescent microscopy. isolation of l. pneumophila from guin ...	1983	6358343
susceptibility of legionella pneumophila to chlorine in tap water.	a study was conducted to compare the susceptibility of legionellae and coliforms to disinfection by chlorine. the chlorine residuals used were similar to concentrations that might be found in the distribution systems of large public potable water supplies. the effects of various chlorine concentrations, temperatures, and ph levels were considered. a number of different legionella strains, both environmental and clinical, were tested. the results indicate that legionellae are much more resistant ...	1983	6360045
pittsburgh pneumonia agent in a cadaveric renal transplant recipient.	pittsburgh pneumonia agent, legionella micdadei, is a recently recognized source of pulmonary infection in immunocompromised hosts. a literature review suggests a typical pattern of clinical and radiologic presentation, of which the following case is representative. eighteen of twenty-one infections have occurred in recipients of cadaveric renal transplants, defining a population at risk. the onset often occurred within days to weeks of bolus doses of corticosteroids. fever, often accompanied by ...	1983	6360453
absence of siderophore activity in legionella species grown in iron-deficient media.	growth of legionella species in a defined medium deficient in iron did not result in the production of phenolic or hydroxamate siderophores which could be detected by chemical or biological assay methods. growth of a variety of other gram-negative organisms under the same conditions resulted in the production of both hydroxamate and phenolate siderophores. the iron-deficient medium limited growth of the legionella species more severely than it did the growth of the other gram-negative organisms. ...	1983	6219988
[bilateral abscessed lung caused by legionella pneumophila serogroup 3. lethal relapse after initially efficacious antibiotherapy].		1983	6223311
kinetic-dependent enzyme-linked immunosorbent assay for detection of antibodies to legionella pneumophila.	a semiautomated, kinetic-dependent, enzyme-linked immunosorbent assay (k-elisa) was adapted to detect serum antibodies to legionella pneumophila. in a comparative study, 158 human serum samples (79 pairs) were tested by k-elisa and the standard indirect immunofluorescence assay for determination of antibody levels to l. pneumophila serogroup 1. k-elisa determinations were made by using a serogroup-specific antigen or a preparation (unfractionated antigen) which contained both common antigen and ...	1983	6361052
direct demonstration and isolation of legionella pneumophila (serogroup 1) from bathroom water specimens in a hotel.	legionella pneumophila serogroup 1 organisms were isolated from one sample of water originating from a shower head in a bathroom of a hotel. seven of the 16 swab specimens collected from 2 different sites of the hotel bathrooms revealed fluorescing bacteria in direct fluorescent antibody test. the significance of present observations in relation to the cluster of l. pneumophila infections diagnosed recently in berlin among a group of visitors who stayed in this hotel has been discussed.	1983	6367308
[thermoresistance of legionella].	cells of legionella suspended in water were heated for 15 to 60 min, at temperatures between 40 and 70 degrees c, and their survival determined over 9 log-cycles. the survival curves were identical for the 6 strains, and were non-logarithmic. implications of the resistance plateau observed are discussed.	1983	6372576
how common is legionnaires' disease?		1983	6130363
legionella micdadei (pittsburgh pneumonia agent) may cause non-pneumonic legionellosis.		1983	6132064
intermediary metabolism in legionella pneumophila: utilization of amino acids and other compounds as energy sources.	the utilization of amino acids and other compounds as carbon and energy sources by legionella pneumophila was examined. based on the stimulation of oxygen consumption in washed-cell suspensions, glutamate, serine, threonine, and tyrosine were the only amino acids which were utilized as energy sources. other stimulators of oxygen uptake were lactate, pyruvate, acetate, fumarate, and succinate. citrate was a good stimulator only when the bacteria were grown in the presence of the substrate. radiol ...	1983	6133845
activities of newer quinolones against legionella group organisms.		1983	6135099
acanthamoebae and environmental spread of legionella pneumophila.		1983	6135118
legionellaceae in the hospital water-supply. epidemiological link with disease and evaluation of a method for control of nosocomial legionnaires' disease and pittsburgh pneumonia.	an epidemiological link was found between contamination of a hospital water-supply by legionella pneumophila and by pittsburgh pneumonia agent (ppa) and subsequent cases of nosocomial legionnaires' disease and pittsburgh pneumonia. the extent of l pneumophila isolation from the water-supply paralleled the occurrence of disease. whenever l pneumophila was isolated from more than 30% of ten selected water sites, nosocomial legionellosis occurred. the temperature of the hot water tanks was raised t ...	1983	6135832
waterborne legionella.		1983	6135877
activities of newer quinolones against legionella group organisms.		1983	6136688
subtypes of legionella pneumophila serogroup 1 associated with different attack rates.	from january, 1982, through february, 1983, 20 cases of nosocomial legionnaires' disease caused by legionella pneumophila serogroup 1 were identified in two adjoining hospital buildings, uh and rh. although the buildings housed similar patient populations and the hot water systems in each were colonised with similar numbers of l pneumophila serogroup 1, 19 cases (1.03/1000 discharges) occurred in uh and only 1 case (0.08/1000 discharges) occurred in rh. three subtypes of l pneumophila serogroup ...	1983	6136797
legionella by the legion.		1983	6136845
precautions with legionella.		1983	6137706
legionella by the legion.		1983	6138586
legionellosis and sudden infant death syndrome.		1983	6139658
legionella in hospital and hotel water supplies.		1983	6139664
peptidoglycan of legionella pneumophila: apparent resistance to lysozyme hydrolysis correlates with a high degree of peptide cross-linking.	peptidoglycan (pg) from legionella pneumophila was composed of muramic acid, glucosamine, glutamic acid, alanine, and meso-diaminopimelic acid in a molar ratio of 0.8:0.8:1.1:1.7:1. partially purified pg contained trypsin-insensitive proteins which were extracted by 1 n naoh hydrolysis without apparent dissolution of the pg. lysozyme hydrolysis of purified pg or cell walls caused an increase in reducing groups which correlated with roughly 70 to 100% digestion of disaccharides. however, there wa ...	1983	6129241
water fittings as sources of legionella pneumophila in a hospital plumbing system.	an extensive study of the plumbing systems in kingston hospital was made over the three years following the 1980 outbreak of legionnaires' disease. the introduction of chlorination and raising the water temperature controlled the outbreak but failed to decontaminate water outlets in the wards. legionella pneumophila was isolated from rubber washers in shower fittings, and laboratory experiments demonstrated the ability of l pneumophila to grow in water in contact with these rubber components. al ...	1984	6141347