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P H Edelstein

Publications and source records attributed to P H Edelstein.

At least 73 records · Page 4Linked to original sources
PubMed1988

Legionella pneumophila serogroup Lansing 3 isolated from a patient with fatal pneumonia, and descriptions of L. pneumophila subsp. pneumophila subsp. nov., L. pneumophila subsp. fraseri subsp. nov., and L. pneumophila subsp. pascullei subsp. nov.

Previous DNA relatedness and enzyme electrophoretic mobility studies indicated heterogeneity among strains of Legionella pneumophila serogroups 1, 4, 5, and Lansing 3 (a new, as yet unnumbered serogroup). In this study 60 L. pneumophila strains were studied by DNA hybridization (hydroxyapatite method) to assess their genomic relatedness. These strains were also studied biochemically and serologically to determine whether they formed one or more phenotypic groups. DNA relatedness studies identified three groups. DNA group 1 contained the type strain Philadelphia 1 and strains from serogroups 1 through 14 of L. pneumophila. The average relatedness of DNA group 1 strains was 88% at 60 degrees C with 1.1% divergence in related sequences and 85% at 75 degrees C. DNA group 2 contained strain Los Angeles 1, the reference strain of serogroup 4, and strains of serogroups 1, 4, 5, and Lansing 3, an unnumbered serogroup. Average relatedness of DNA group 2 strains was 84% at 60 degrees C with 0.7% divergence and 87% at 75 degrees C. Reciprocal relatedness of DNA groups 1 and 2 was approximately 67% at 60 degrees C with 6.0% divergence and 48% at 75 degrees C. DNA group 3 strains were in serogroup 5. They were 98% related at 60 degrees C with 0.5% divergence and 97% related at 75 degrees C. Reciprocal relatedness of DNA group 3 and DNA group 1 was approximately 74% at 60 degrees C with 5.3% divergence and 43% at 75 degrees C, and reciprocal relatedness of DNA groups 3 and 2 was 66% at 60 degrees C with 5.7% divergence and 55% at 75 degrees C. The DNA groups could not be separated biochemically or serologically or by cell wall fatty acid and isoprenoid quinone composition. Three subspecies of L. pneumophila are proposed to accommodate the three DNA groups: L. pneumophila subsp. pneumophila subsp. nov. for DNA group 1, L. pneumophila subsp. fraseri subsp. nov. for DNA group 2, and pneumophila subsp. pascullei subsp. nov. for DNA group 3.

DNA, Bacterial↗
PubMed1988

Retrospective evaluation of the Du Pont radioimmunoassay kit for detection of Legionella pneumophila serogroup 1 antigenuria in humans.

We used the Du Pont radioimmunoassay kit for soluble Legionella pneumophila serogroup 1 antigenuria (Du Pont Co., Wilmington, Del.) to test 422 urine samples from patients with and without Legionnaires disease (LD). The urine specimens were collected from 23 patients with culture-proven LD and from 346 patients without LD. L. pneumophila serogroup 1 was isolated from 14 patients with culture-proven LD, and other L. pneumophila serogroups or other Legionella species were isolated from 9 patients; 58 urine specimens were tested from these 23 patients. The non-LD group was composed of 75 bacteremic patients (35 gram-negative and 40 gram-positive bacteremias), 7 patients with candidemia, 48 patients with non-LD pneumonia, 90 patients with gram-negative bacteriuria (greater than 10(5) CFU/ml), 23 patients with gram-positive bacteriuria (greater than 10(5) CFU/ml), 14 patients with candiduria (greater than 10(5) CFU/ml), and 89 outpatients with negative urine cultures. All tests were performed in duplicate, including positive and negative controls. Sample results with values greater than or equal to 3.0 times those of the negative controls were considered positive for L. pneumophila serogroup 1 antigenuria. The average sample-to-negative ratios were 19.1 for the L. pneumophila serogroup 1 specimens, and 1.0 for both the non-serogroup 1 legionella group and the non-LD specimens. All but one of the patients who were culture positive for L. pneumophila serogroup 1 had at least one specimen positive for serogroup 1 antigenuria; none of the non-L. pneumophila serogroup 1 patients had a positive urine test. The test was highly specific (100%) and sensitive (93%) for the detection of L. pneumophila serogroup 1 antigenuria. Concentrations of urine by vacuum evaporation increased test sensitivity without apparently affecting specificity.

Antigens, Bacterial↗
PubMed1987

Laboratory diagnosis of infections caused by legionellae.

Legionnaires' disease can be diagnosed by detection of antibody to the organism or by direct detection of the bacterium and/or its products using immunological means, culture or a DNA probe. Culture isolation, still the most specific and sensitive test, can be done with sputum samples if proper selective techniques are used. Antibody detection is more suited for epidemiological purposes than individual cases. It has been overused to the exclusion of more specific and rapid methods, such as culture and other means of bacterial detection. Immunofluorescent microscopy remains an important tool in diagnosis, although urinary antigen detection and DNA probes are promising alternative tests. For optimal sensitivity, culture must be performed, regardless of which test is used.

Antibodies, Bacterial↗
PubMed1987

Nosocomial outbreak of Legionnaires' disease: molecular epidemiology and disease control measures.

Molecular laboratory techniques were used to study the epidemiology of an outbreak of nosocomial Legionnaires' disease. All patient isolates were Legionella pneumophila serogroup 1 and showed identical plasmid profiles and reactions with serogroup-specific monoclonal antibodies. L pneumophila was also cultured from four of five cooling tower water samples; however, the isolate from only one tower was serogroup 1 of the same subtype as patient isolates. Since the cases were temporally clustered and epidemiologically associated with exposure to cooling tower aerosols, the single cooling tower implicated by molecular analysis was the most likely source of the outbreak. Chlorination of cooling tower ponds has eradicated the epidemic strain. Since potable water also harbored the infecting organism and was the probable source for cooling tower contamination, decontamination of the hospital water system was also undertaken. Superchlorination of hot water holding tanks to 17 ppm on a weekly basis has effectively eradicated L pneumophila from the potable water system and appears to be a reasonable, simple, and relatively inexpensive alternative to previously described methods of control.

Cross Infection↗
PubMed1987

Influence of growth temperature on virulence of Legionella pneumophila.

The effect of growth temperature on the virulence of a strain of broth-grown serogroup 1 Legionella pneumophila (Wadsworth F889) was examined by growing the bacterium at different temperatures and then infecting guinea pigs (by intratracheal injection) and guinea pig alveolar macrophages. The 50% lethal dose for guinea pigs infected with 25 degrees C-grown F889 was log10 5.0 CFU and that for 41 degrees C-grown F889 was log10 5.7 CFU, or a fivefold difference. Guinea pig alveolar macrophages were infected in quadruplicate with log10 3.8 CFU of F889 cells grown at either 25 or 41 degrees C. Counts of F889 in the alveolar macrophages infected with 25 degrees C-grown bacteria were 40% greater after 1 day of incubation (P = 2 X 10(-4)) than were counts in the alveolar macrophage suspensions inoculated with 41 degrees C-grown bacteria. However, the counts were not significantly different after 3 days of incubation. Examination of cover slip cultures of guinea pig alveolar macrophages infected with 25 degrees C-grown or 41 degrees C-grown bacteria showed that the bacteria grown at the lower temperature were twice as likely to be macrophage-associated after 1 h of incubation than were the bacteria grown at the higher temperature. Growth at the lower temperature was also associated with a change in reactivity with monoclonal antibodies, but not with a change in plasmid content. Thus, environmental temperature may play an important role in modulating the virulence of L. pneumophila, possibly by affecting bacterial adherence to host cells.

Animals↗
PubMed1987

Legionella micdadei and Legionella dumoffii monoclonal antibodies for laboratory diagnosis of Legionella infections.

Two different monoclonal antibodies directed against Legionella micdadei and L. dumoffii (Genetic Systems Corp., Seattle, Wash.) were evaluated for their specificity and ability to detect L. micdadei and L. dumoffii in human and animal clinical samples and bacterial isolates in an indirect immunofluorescence assay. All three frozen sputum samples and all three Formalin-fixed sputum and liver samples from patients with culture-documented L. micdadei pneumonia were positive when tested with the L. micdadei monoclonal antibody. A Formalin-preserved lung sample from a patient with culture-documented L. dumoffii pneumonia was positive with its homologous monoclonal antibody. No cross-staining reactions were found with either monoclonal antibody on any of 25 human sputum samples tested from patients without Legionella infections. A total of 66 Legionella strains and 56 non-Legionella strains including 22 Pseudomonas strains and 34 other bacterial strains were studied. No cross-staining reactions were found except in Staphylococcus aureus Cowan 1 ATCC 12598. The lower limit of detection in seeded sputum samples was about 7 X 10(4) cells per ml for both monoclonal antibodies. Lung and tracheal lavage specimens from L. micdadei- or L. dumoffii-infected guinea pigs showed specific staining only with their respective monoclonal antibodies. The monoclonal antibodies stained homologous bacteria slightly less intensely than did the polyclonal antisera, but the signal-to-noise ratio was considerably higher for the monoclonal antibodies. No differences in sensitivity of staining of clinical specimens or bacterial isolates were noted between the monoclonal antibodies and the polyclonal reagents for L. micdadei and L. dumoffii (Centers for Disease Control, Atlanta, Ga., and BioDx, Denville, N.J. These monoclonal antibodies ae sensitive and specific, making them good candidates for laboratory diagnostic purposes.

Animals↗
PubMed1987

Comparison of blood culture methods for recovery of Legionella pneumophila from the blood of guinea pigs with experimental infection.

Blood was cultured from guinea pigs with experimental Legionella pneumophila serogroup 1 pneumonia, using four different methods. A 0.03-ml amount was spread onto each of several plates of buffered charcoal-yeast extract supplemented with alpha-ketoglutarate (BCYE) (direct plate); 1.5 ml each was inoculated into a BCYE agar-yeast extract broth bottle (biphasic), a pediatric Isolator tube (E. I. du Pont de Nemours & Co., Inc., Wilmington, Del.), and a glass tube containing 0.025% sodium polyanethanolsulfonate. Blood processed in the Isolator tube was plated on BCYE, as was the buffy coat blood fraction, which was obtained by centrifugation of the tube containing sodium polyanethanolsulfonate and blood. Observations were made of the number of positive cultures, the time to detection of positive cultures, and the absolute bacterial concentrations. Each system was equally sensitive in detecting bacteremia. The biphasic method required 5 days for cultures to become positive, whereas the other systems required 2 to 3 days to detect all positive cultures (P = 1.3 X 10(-5) by Friedman group statistic, and P less than 10(-5) for comparison of the biphasic and other methods). The direct plating method demonstrated the best quantitative recovery of L. pneumophila in comparison to the other methods tested (P = 2.0 X 10(-5) by analysis of variance group statistic and P less than 0.05 for comparison between each of the methods). Quantitative recovery by the Isolator method was intermediate between the direct plating and buffy coat methods. The biphasic and Isolator blood culture methods performed poorly in comparison to the other methods, indicating the need for caution in choosing blood culture methods for Legionella isolation.

Animals↗
PubMed1987

Retrospective study of Gen-Probe rapid diagnostic system for detection of legionellae in frozen clinical respiratory tract samples.

The Gen-Probe Rapid Diagnostic System for legionellae, which uses 125I-labeled cDNA directed against the rRNAs of legionellae, was evaluated for its ability to detect members of the genus by using clinical specimens which had been frozen at -70 degrees C for 2 to 8 years. Culture and direct immunofluorescence (DFA) results obtained at the time of specimen collection were used to categorize samples. The specimens tested were 112 samples culture positive for legionellae and 230 samples negative on culture and DFA tests. They were tested in a blinded and randomized fashion. Results were expressed in terms of the ratio of counts per minute of the sample to the counts per minute of the provided negative control. A ratio of greater than or equal to 4.0 was picked for optimal specificity. Of the 112 previously positive specimens, 63 (57%) were positive by the probe assay, and of the 230 previously negative samples, 228 (99.1%) were negative. The 51 discrepant specimens were reexamined by culture and DFA testing if adequate amounts remained; this was possible for 34 specimens. On repeat culture, 22 of 33 previously culture-positive samples yielded legionellae and 11 were negative. Ten of the positive repeat cultures yielded two or fewer colonies per plate. One probe-positive but previously culture-negative sample was overgrown by contaminants on repeat culture. Reanalysis of data after exclusion of the 17 unavailable, 11 repeat culture-negative, and 1 unevaluable specimen gave a probe sensitivity of 74% and specificity of 100%. The Gen-Probe test is therefore specific and is of useful sensitivity.

DNA↗
PubMed1987

The laboratory diagnosis of Legionnaires' disease.

Legionnaires' disease can be diagnosed by culture, by direct detection of the bacterium or its products by using immunologic means, with a DNA probe, and by serologic means. Culture diagnosis is the most specific and sensitive test. Legionellae can be isolated from sputum samples by using selective techniques. Antibody detection is more suited for epidemiologic purposes than for use in individual cases. Immunofluorescent microscopy is a useful and rapid means of diagnosis. Alternative rapid and specific tests are urinary antigen detection and the use of a DNA probe. Culture must always be performed for optimal sensitivity and for epidemiologic purposes.

Antibodies, Bacterial↗
PubMed1986

Control of Legionella in hospitals.

Legionellas are present in water distribution systems and cooling towers of many hospitals. No firm data are available regarding the need for prophylactic disinfection of these contaminated systems. Disinfection of water systems and cooling towers is an accepted and effective means of ending nosocomial Legionnaires' disease, but it should be performed in conjunction with good epidemiological and microbiological studies to pinpoint environmental reservoirs and disseminators. Chlorination, pasteurization, or both, are the only means of disinfection found to be effective in disease outbreaks. Prospective surveillance of immuno compromised patients with pneumonia is probably the most effective means to determine if a hospital is a source of Legionnaires' disease and, therefore, requires further investigations and disinfection.

Cross Infection↗
PubMed1986

Evaluation of the Gen-Probe DNA probe for the detection of legionellae in culture.

A commercial DNA probe kit designed to detect rRNA from legionellae was evaluated for its ability to correctly discriminate between legionellae and non-legionellae taken from culture plates. The probe kit, made by the Gen-Probe Corp. (San Diego, Calif.), was radiolabeled with 125I, and probe bacterial RNA hybridization, detected in a simple one-tube system hybridization assay, was quantitated with a gamma counter. A total of 156 Legionella sp. strains were tested, of which 125 were Legionella pneumophila and the remainder were strains from 21 other Legionella spp. A total of 106 gram-negative non-legionellae, isolated from human respiratory tract (81%) and other body site (19%) specimens, were also tested; 14 genera and 28 species were represented. The probe easily distinguished all of the legionellae from the non-legionellae. The average legionellae/non-legionellae hybridization ratio was 42:1, and the lowest ratio was 2:1; a minor modification in the procedure increased the lowest ratio to 5:1. In addition to correctly identifying all Legionella species, the probe was able to separate some of the various species of Legionella. L. pneumophila strains hybridized more completely to the probe than did the other Legionella spp.; L. wadsworthii and L. oakridgensis hybridized only about 25% of the probe relative to L. pneumophila. Some strains of phenotypically identified L. pneumophila had much lower hybridization to the probe than other members of the species and may represent a new Legionella species. The simplicity of the technique and specificity of the probe make it a good candidate for confirming the identity of legionellae in culture.

DNA↗
PubMed1986

Comparison of cross-staining reactions by Pseudomonas spp. and fluorescein-labeled polyclonal and monoclonal antibodies directed against Legionella pneumophila.

Commercially prepared polyclonal antisera to Legionella pneumophila are known to cross-react with organisms of the genus Pseudomonas. To determine whether a commercially available monoclonal antibody reagent specific for L. pneumophila would also cross-react with pseudomonads, a two-laboratory study was undertaken to test both monoclonal and polyclonal reagents against 33 isolates of Pseudomonas spp., including 25 Pseudomonas aeruginosa, 4 P. putida, 2 P. maltophilia, 1 P. fluorescens, and 1 P. alcaligenes. Four antisera were tested; polyclonal anti-legionella antisera pools A and B (Centers for Disease Control [CDC], Atlanta, (Ga.), polyclonal 1-6 antisera (BioDx, Inc., Denville, N.J.), and a monoclonal antibody reagent produced by Genetic Systems Corp., Seattle, Wash. All reagents were labeled with fluorescein. Cross-staining reactions were found with the BioDx L. pneumophila antisera and 10 isolates of Pseudomonas. Four of these isolates demonstrated cross-staining with CDC pool A. When tested with individual serotype-specific reagents (CDC), three of four cross-reacted with L. pneumophila serotype 1 antisera; the fourth cross-reacted with serotype 3. No cross-staining reactions were noted with the monoclonal reagent and any of the pseudomonads tested, demonstrating that the Genetic Systems Corp. monoclonal reagent is the most specific of the four reagents tested.

Antibodies, Bacterial↗
PubMed1986

Paleoepidemiologic investigation of Legionnaires disease at Wadsworth Veterans Administration Hospital by using three typing methods for comparison of legionellae from clinical and environmental sources.

Multilocus enzyme electrophoresis, monoclonal antibody typing for Legionella pneumophila serogroup 1, and plasmid analysis were used to type 89 L. pneumophila strains isolated from nosocomial cases of Legionnaires disease at the Veterans Administration Wadsworth Medical Center (VAWMC) and from the hospital environment. Twelve L. pneumophila clinical isolates, obtained from patients at non-VAWMC hospitals, were also typed by the same methods to determine typing specificity. Seventy-nine percent of 33 VAWMC L. pneumophila serogroup 1 clinical isolates and 70% of 23 environmental isolates were found in only one of the five monoclonal subgroups. Similar clustering was found for the other two typing methods, with excellent correlation between all methods. Enzyme electrophoretic typing divided the isolates into the greatest number of distinct groups, resulting in the identification of 10 different L. pneumophila types and 5 types not belonging to L. pneumophila, which probably constitute an undescribed Legionella species; 7 clinical and 34 environmental VAWMC isolates and 2 non-VAWMC clinical isolates were found to be members of the new species. Twelve different plasmid patterns were found; 95% of VAWMC clinical isolates contained plasmids. Major VAWMC epidemic-bacterial types were common in the hospital potable-water distribution system and cooling towers. Strains of L. pneumophila which persisted after disinfection of contaminated environmental sites were of a different type from the prechlorination strains. All three typing methods were useful in the epidemiologic analysis of the VAWMC outbreak.

Antibodies, Monoclonal↗
PubMed1985

Potable water as a source of Legionnaires' disease.

A three-year epidemic of legionnaires' disease in a hospital was dramatically curtailed following hyperchlorination of the potable water supply. The hypothesis that potable water was the source for the outbreak was further supported by isolation of Legionella pneumophila (the agent of legionnaires' disease) from the hospital water supply, observation that a sudden upsurge had occurred in the number of cases following a peculiar manipulation of the hospital water system, and documentation of a 30-fold increase in concentration of organisms in the water when this manipulation was artificially recreated. Thus, potable water may be an important source of epidemic legionnaires' disease and continuous hyperchlorination a method of control.

Adult↗
PubMed1985

Cross-reactive urinary antigens among patients infected with Legionella pneumophila serogroups 1 and 4 and the Leiden 1 strain.

A solid-phase radioimmunoassay was developed to detect antigens of Legionella pneumophila serogroup 4. The assay detected antigen in urine from four of seven patients with pneumonia caused by L. pneumophila serogroup 4, two of two patients with L. pneumophila Leiden 1 strain (proposed new serogroup), and 26 of 55 patients with L. pneumophila serogroup 1 (proven by culture or direct fluorescent-antibody assay). The antigen of two patients with serogroup 4, one with Leiden 1 strain, and 49 with serogroup 1 infections could be detected in a previously described assay for antigens of L. pneumophila serogroup 1. Serogroup specificity of the assays could be demonstrated if serial dilutions of urine were tested. None of 347 urine specimens used as controls were positive in the radioimmunoassay. We conclude that antigens are excreted in the urine of at least some patients with Legionnaires' disease caused by serogroup 4 and Leiden 1 strain. The urinary antigens in patients with serogroup 4 and Leiden 1 strain infections, although different from those in patients with serogroup 1 infections, serologically contain cross-reactive components.

Antigens, Bacterial↗
PubMed1985

Legionella anisa: a new species of Legionella isolated from potable waters and a cooling tower.

Between March 1980 and June 1981, five strains of Legionella-like organisms were isolated from water. Four were recovered from potable water collected from hospitals in Chicago, Ill., and Los Angeles, Calif., during outbreaks of nosocomial legionellosis. The fifth strain was isolated from water collected from an industrial cooling tower in Jamestown, N.Y. The strains exhibited biochemical reactions typical of Legionella species and were gram-negative motile rods which grew on buffered charcoal-yeast extract agar but not on blood agar, required cysteine, and were catalase positive, urease negative, nitrate negative, hippurate negative, and nonfermentative. All strains were positive for oxidase and beta-lactamase and produced a brown, diffusible pigment. Of the five strains, four exhibited blue-white autofluorescence under long-wavelength UV light. The fatty-acid composition and ubiquinone content of these strains were consistent with those of other Legionella species. Direct fluorescent-antibody examination of the five strains with conjugates to previously described Legionella species demonstrated no cross-reactions except with the conjugates to L. longbeachae serogroup 2 and L. bozemanii serogroup 2. Four strains gave a 4+ reaction to the L. longbeachae serogroup 2 conjugate and the fifth strain gave a 1+ reaction. Each of the five strains gave a 4+ reaction with the conjugate to L. bozemanii serogroup 2. DNAs from the five strains were highly related (84 to 99%) and showed 5 to 57% relatedness to other Legionella species. These strains constitute a new species in the genus Legionella, and the name Legionella anisa sp. nov. is proposed. The type strain of L. anisa is WA-316-C3 (ATCC 35292).

Air Conditioning↗