Legionella Book

	Preface	xv
1.	Legionnaires' Disease 25 Years Later: Lessons Learned	1
I.	I. Pathogenesis	11
2.	Role of the Type II Protein Secretion Pathway in Pathogenesis of Legionella pneumophila	13
3.	Analysis of Acid Phosphatase and Esterase/Lipase Mutants of Legionella pneumophila	18
4.	Legionella pneumophila Secretes Different Phospholipases A	22
5.	In Vitro Secretion Kinetics of Legionella pneumophila Compared with Those of Non- L. pneumophila Species	27
6.	Iron Requirements of and Acquisition of Iron by Legionella pneumophila	31
7.	Resistance of Legionella pneumophila to Cationic Antimicrobial Peptides	38
8.	Function and Expression of Legionella pneumophila Surface Factors	43
9.	Localization of Legionella pneumophila Mip Protein Inside Phagosomes of Acanthamoeba castellanii	49
10.	Changes in the lag-1 Locus of Legionella pneumophila Serogroup 1 Strains Result in Different Lipopolysaccharides Recognized by Monoclonal Antibodies but Do Not Influence Virulence	52
11.	Phase Variation of Lipopolysaccharide and Other Virulence Determinants in Legionella pneumophila	56
12.	Mechanism of Serum Resistance in Legionella pneumophila: Comparison of Wild-Type and Mutant Strains after Phase Variation of Bacterial Surface Structures	60
13.	Characterization of the Legionella pneumophila DnaJ-Like Protein DjlA: Virulence Attenuation of djlA Mutants	64
14.	Phase Variation in Legionella pneumophila Serogroup 1, Subgroup OLDA, Strain RC1 Influences Lipid A Structure	68
15.	The Legionella pneumophila Life Cycle: Connections between Growth Phase, Virulence Expression, and Replication Vacuole Biogenesis	74
16.	Morphological and Physiological Evidence for a Developmental Cycle in Legionella pneumophila	82
17.	Legionella pneumophila Proliferation Is Not Dependent on Intracellular Replication	86
18.	Genetic Analysis of Legionella pneumophila Intracellular Multiplication in Human and Protozoan Hosts	90
19.	The Legionella pneumophila Sequencing Project
20.	Conjugal Transfer of Chromosomal DNA in Legionella pneumophila	105
21.	Innate and Adaptive Immunity to Legionella pneumophila	109
22.	Legionella pneumophila and Interleukin-12 Production: In Vitro Infection Model	120
23.	Differential Cytokine Response Following Challenge of A/J Mice with Virulent and Avirulent Legionella pneumophila	124
24.	Protection against Lethal Challenge by Legionella pneumophila in A/J Mice Following Immunization with Flagella	129
II.	Legionella and Protozoa	133
25.	The Social Life of Legionellae	135
26.	Pore Formation-Mediated Egress from Mammalian and Protozoan Cells by Legionella pneumophila	143
27.	Selection of Signature-Tagged Legionella pneumophila Mutants in Acanthamoeba castellanii	152
28.	Interaction of Legionella pneumophila with Dictyostelium discoideum	161
29.	Characterization of a 16-Kilodalton Species-Specific Protein of Legionella pneumophila Promoting Uptake in Amoebae	165
30.	Impact of Amoebae, Bacteria, and Tetrahymena on Legionella pneumophila Multiplication and Distribution in an Aquatic Environment	170
31.	Biofilm Formation and Multiplication of Legionella on Synthetic Pipe Materials in Contact with Treated Water under Static and Dynamic Conditions	176
III.	Clinical Presentation, Laboratory Diagnosis, and Therapy	181
32.	Chemotherapy of Legionnaires' Disease with Macrolide or Quinolone Antimicrobial Agents	183
33.	Clinical Validation of Diagnosis of Legionella Infections	189
34.	Legionella Pneumonia: Three Cases in an Oncological Hospital	193
35.	Human Leukocyte Antigen Typing in Legionella-Positive Transplant Patients	196
36.	Legionella Serogroup and Subgroup Distribution among Patients with Legionnaires' Disease in Denmark	200
37.	Detection of Legionella pneumophila Antigen in Urine Samples: Recognition of Serogroups and Monoclonal Subgroups	204
38.	Comparison of Non-Serogroup 1 Detection by Biotest and Binax Legionella Urinary Antigen Enzyme Immunoassays	207
39.	Evaluation of a Rapid Immunochromatographic Assay for Detection of Legionella pneumophila in Urine	211
40.	PCR as a Routine Method for Diagnosis of Legionnaires' Disease	213
41.	Detection of Legionella-Specific DNA in Serum	216
42.	Direct Detection of Legionellae in Respiratory Tract Specimens by Using Fluorescence In Situ Hybridization	221
IV.	Detection and Typing	225
43.	Molecular Tools for Epidemiological Investigations into Legionella pneumophila Infections	227
44.	Sequence-Based Genotyping Scheme for Legionella	237
45.	Application of Amplified Fragment Length Polymorphism Analysis to Subtyping of Legionella pneumophila Serogroup 6	243
46.	Molecular Typing of Legionella Strains with Pulsed-Field Gel Electrophoresis and Random Primer-Amplified Polymorphic DNA in Nosocomial Legionnaires' Disease	248
47.	Multilocus Sequence Typing for Characterization of Legionella pneumophila Serogroup 1 Isolates	251
48.	Evaluation of PCR and Random Amplification of Polymorphic DNA for Detection and Typing of Legionella in Environmental Water Samples	254
49.	Rapid Quantification of Legionella by PCR	257
50.	Molecular Typing of Legionella pneumophila by Pulsed-Field Gel Electrophoresis and Amplified Fragment Length Polymorphism Analysis	260
51.	The Fluorescent In Situ Hybridization Test in Comparison with Culture for Detection of Legionella pneumophila in Water Samples	263
52.	Typing of Legionella Strains Isolated from Patients and Environmental Sources in Germany, 1999-2000	267
53.	Development of an International External Quality Assurance Scheme for Isolation of Legionella Species from Environmental Specimens	271
54.	Prevalence of Legionella in Whirlpool Spas: Correlation with Total Bacterial Numbers	275
55.	Proposed Method for Optimum Recovery of Legionella from Cooling Water in South Africa	280
56.	Legionella Detection from South African Cooling Water Systems	284
57.	Cooling Towers and Legionellosis: a Large Urban Area Experience	291
58.	Occurrence of Legionella in Water from Dental Units and Estimation of Antibiotic Resistance of Isolated Strains	295
59.	Occurrence of Legionella in Danish Hot Water Systems	298
60.	Analysis of Legionella pneumophila Serogroup 1 Isolates in Japan by Using Pulsed-Field Gel Electrophoresis and Monoclonal Antibodies	302
61.	Relationship between Colonization of Building Water Systems by Legionella pneumophila and Environmental Factors	305
V.	Epidemiology	309
62.	Surveillance of Legionnaires' Disease in Europe	311
63.	Using Geographical Information Systems for Risk Assessment and Control of Legionnaires' Disease Associated with Cooling Towers	318
64.	Routine Sampling and Temporal Variation of Legionella Concentrations in Cooling Tower Water Systems	321
65.	Prevalence of Positive Antibody Titers against Legionellae in Two Residential Populations with Different Legionella Contaminations in Their Hot Water Systems	325
66.	Legionellosis in Sweden	330
67.	Risk of Exposure in Hospitals Colonized with Legionellae	334
68.	Development of Surveillance of Legionella Infections in Poland by Serological Investigations	338
69.	Legionellosis Outbreak at a Commercial Fair in Kapellen, Belgium, 1999: a Case-Control Study	342
70.	Outbreak of Legionnaires' Disease Linked to a Humidifier in a Hotel in Wales, United Kingdom	346
71.	Hot Water Systems with Low Concentrations of Legionellae May Be a Risk on Cruise Ships	349
72.	Epidemiology of Legionella Infection in Western Australia	353
73.	Isolation of Legionella longbeachae and Legionella spp. from Japanese Potting Soils	356
74.	Sporadic Community-Acquired Legionnaires' Disease and Contaminated Domestic Hot Water Supplies	360
75.	Epidemiological Typing of Legionella pneumophila Serogroup 5 Strains	364
VI.	Prevention and Control	369
76.	Australian Risk Management Approaches to Control of Legionella in Cooling Water Systems	371
77.	American Society of Heating, Refrigerating and Air-Conditioning Engineers Guideline 12-2000: Minimizing the Risk of Legionellosis Associated with Building Water Systems	376
78.	Strategies for Prevention and Control of Legionnaires' Disease in Germany	385
79.	Legionnaires' Disease in the United States: Opportunities for Prevention	391
80.	Eleven Years of Experience with Novel Strategies for Legionella Control in a Large Teaching Hospital	398
81.	UV Light for Elimination of Legionellae	402
82.	Monochloramine Disinfection of Biofilm-Associated Legionella pneumophila in a Potable Water Model System	406
83.	Control of Legionella in Drinking Water Systems: Impact of Monochloramine	411
84.	Efficacy of Copper-Silver Ionization in Controlling Legionella in a Hospital Hot Water Distribution System: a German Experience	419
85.	Educational Program for Prevention of Legionellosis in the Tourism Sector	425
	Author Index	429
	Subject Index	433