PRESENCE OF LEGIONELLA PNEUMOPHILA IN TAP WATER AND ITS IMPORTANCE FOR PUBLIC HEALTH

Year 2024, Volume: 15 Issue: 2, 64 - 76, 31.08.2024

Ömer Çakmak , Tuba Aldemir , Erdi Ergene , Ulaş Acaröz , Damla Arslan-acaroz , Nuri Taş

https://doi.org/10.38137/vftd.1432171

Abstract

Legionella pneumophila is one of the Legionella species that has been implicated in outbreaks of Legionnaires' disease in many countries, particularly in the United States of America (USA), which is caused by tap water, resulting in severe pneumonia and a mortality rate of 7 to 10%. The majority of outbreaks were linked to buildings with plumbing systems (healthcare facilities, hospitals, large buildings, etc.) and specially designed water systems (cooling towers, fountains, showers, etc.), which are optimal sources for the growth of Legionella spp. Infections caused by L. pneumophila are more likely to be caused by hot water in showers, while L. anisa appears to be more likely to cause infections from cold water in taps. Aging municipal water infrastructure, main line outages and leaks in the system are cited as reasons for the transmission of microorganisms, which are difficult to remove from plumbing systems. In addition, climatic changes such as temperature and precipitation are other factors that contribute to the spread of Legionella spp. in water systems and expose more people to the pathogen. In 2023, the outbreak of L. pneumophila in Poland, which resulted in the death of 14 people, brought the importance of Legionnaires' disease back to the agenda. In this review; the epidemiology, transmission routes and detection methods of L. pneumophila, the most important agent of the disease, were revealed in order to prevent and control Legionnaires' disease outbreaks by searching the current literature. Also included is the treatment of Legionnaires' disease.

Keywords

Legionella pneumophila, Legionnaires disease, tap water, water pollution

ŞEBEKE SULARINDA LEGIONELLA PNEUMOPHILA VARLIĞI VE HALK SAĞLIĞI AÇISINDAN ÖNEMİ

Abstract

Legionella pneumophila; başta Amerika Birleşik Devletleri (ABD) olmak üzere bir çok ülkede şebeke suyu kaynaklı olarak ortaya çıkan, ciddi zatürre ile seyreden ve %7 ila 10 ölüm oranına sahip Lejyoner hastalığı salgınlarına neden olan Legionella türlerinden biridir. Görülen salgınlarının çoğunluğu, Legionella spp.’nin gelişimi için en uygun kaynaklar olan sıhhi tesisat sistemleri (sağlık tesisleri, hastaneler, büyük binalar vb.) ve özel tasarlanmış su sistemlerine (soğutma kuleleri, çeşmeler, duşlar vb.) sahip binalarla ilişkilendirilmiştir. L. pneumophila’nın neden olduğu enfeksiyonlar daha çok duşlardaki sıcak su kaynaklı iken, L. anisa'nın musluklardaki soğuk sudan kaynaklanan enfeksiyon yapabilme riskinin daha yüksek olduğu görülmektedir. Eskiyen şebeke suyu altyapısı, ana hat kesintileri ve sistemdeki sızıntılar mikroorganizmaların bulaşmasına neden olarak gösterilmekte ve bulaşının tesisat sistemlerinden uzaklaştırılması oldukça zor olmaktadır. Bununla birlikte sıcaklık ve yağış gibi iklimsel değişiklikler de Legionella spp.’nin su sistemlerinde yayılmasına ve daha fazla kişinin etkene maruz kalmasına zemin hazırlayan diğer etkenlerdir. 2023 yılında Polonya’da yaşanan ve 14 kişinin ölümüyle sonuçlanan L. pneumophila kaynaklı salgının ortaya çıkması Lejyoner hastalığının önemini yeniden gündeme getirmiştir. Bu derlemede; güncel literatür taraması yapılarak Lejyoner hastalığı salgınlarının önlenmesi ve kontrol altına alınması amacıyla hastalığın en önemli etkeni L. pneumophila’nın epidemiyolojisi, bulaşma yolları ve tespit yöntemleri ortaya konulmuştur. Ayrıca Lejyoner hastalığının tedavisine de yer verilmiştir.

Keywords

Legionella pneumophila, Lejyoner hastalığı, şebeke suyu, su kirliliği

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