Abstract
We evaluated the in vitro activity of antimicrobial agents against Legionella obtained from hotel and hospital water systems in three different regions of Turkey. Sixty-five Legionella strains (Legionella pneumophila serogroup 6 [n = 32], L. pneumophila serogroup 1 [n = 27], L. pneumophila serogroup 3 [n = 2], and Legionella spp. [n = 4]) were tested against levofloxacin, ciprofloxacin, clarithromycin, azithromycin, and rifampicin. The minimum inhibitory concentration (MIC) values of each antimicrobial agent for these strains was determined by the microdilution method using buffered yeast extract medium supplemented with 0.1% ketoglutarate broth. L. pneumophila ATCC 33152, Staphylococcus aureus ATCC 29213, and Escherichia coli ATCC 25922 were used as controls. Minimum inhibitory concentration values were in the following ranges: clarithromycin 0.001–0.5 mg/L, azithromycin 0.001–0.5 mg/L, levofloxacin 0.001–0.5 mg/L, ciprofloxacin 0.001–0.125 mg/L, and rifampicin 0.001– 0.5 mg/L. The MIC90 for rifampicin, levofloxacin, ciprofloxacin, azithromycin, and clarithromycin were 0.015, 0.125, 0.06, 0.125, and 0.06 mg/L, respectively. To the best of our knowledge, this is the first study to determine in vitro activities of antimicrobial agents against Legionella species in Turkey. Rifampicin had the lowest MIC90 value. It would seem that azithromycin and clarithromycin exhibit good activity as well as levofloxacin and ciprofloxacin against Legionella isolated from environmental water systems in Turkey.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Barker, J. E., & Farrell, I. D. (1990). The effects of single and combined antibiotics on the growth of Legionella pneumophila using time-kill studies. Journal of Antimicrobial Chemotherapy, 26, 45–53.
Blázquez Garrido, R. M., Espinosa Parra, F. J., Alemany Francés, L., Ramos Guevara, R. M., Sánchez-Nieto, J. M., Segovia Hernández, M., et al. (2005). Antimicrobial chemotherapy for Legionnaires disease: Levofloxacin versus macrolides. Clinical Infectious Diseases, 40, 800–806.
Critchley, I. A., Jones, M. E., Heinze, P. D., Hubbard, D., Engler, H. D., Evangelista, A. T., et al. (2002). In vitro activity of levofloxacin against contemporary clinical isolates of Legionella pneumophila, Mycoplasma pneumoniae and Chlamydia pneumoniae from North America and Europe. Clinical Microbiology and Infection, 8, 214–221.
Dubois, J., & St-Pierre, C. (1999). In vitro activity of gatifloxacin, compared with ciprofloxacin, clarithromycin, erythromycin, and rifampin, against Legionella species. Diagnostic Microbiology and Infectious Disease, 33, 261–265.
Dunbar, L. M., & Farrell, D. J. (2007). Activity of telithromycin and comparators against isolates of Legionella pneumophila collected from patients with community-acquired respiratory tract infections: PROTEKT years 1–5. Clinical Microbiology and Infection, 13, 743–746.
Edelstein, P. H. (1991). Rifampin resistance of Legionella pneumophila is not increased during therapy for experimental Legionnaires disease: Study of rifampin resistance using a guinea pig model of Legionnaires disease. Antimicrobial Agents and Chemotherapy, 35, 5–9.
Erdogan, H., & Arslan, H. (2007). Colonization of Legionella species in hotel water systems in Turkey. Journal of Travel Medicine, 14, 369–373.
García, M. T., Pelaz, C., Giménez, M. J., & Aguilar, L. (2000). In vitro activities of gemifloxacin versus five quinolones and two macrolides against 271 Spanish isolates of Legionella pneumophila: Influence of charcoal on susceptibility test results. Antimicrobial Agents and Chemotherapy, 44, 2176–2178.
Gómez-Lus, R., Adrián, F., del Campo, R., Gómez-Lus, P., Sánchez, S., García, C., et al. (2001). Comparative in vitro bacteriostatic and bactericidal activity of trovafloxacin, levofloxacin and moxifloxacin against clinical and environmental isolates of Legionella spp. International Journal of Antimicrobial Agents, 18, 49–54.
Mandell, L. A., Wunderink, R. G., Anzueto, A., Bartlett, J. G., Campbell, G. D., & Dean, N. C. (2007). Infectious diseases society of America; American thoracic society. Infectious diseases society of America/American thoracic society consensus guidelines on the management of community-acquired pneumonia in adults. Clinical Infectious Diseases, 44, S27–S72.
Pedro-Botet, L., & Yu, V. L. (2006). Legionella: Macrolides or quinolones? Clinical Microbiology and Infection, 12, 25–30.
Reda, C., Quaresima, T., & Pastoris, M. C. (1994). In-vitro activity of six intracellular antibiotics against Legionella pneumophila strains of human and environmental origin. Journal of Antimicrobial Chemotherapy, 33, 757–764.
Roig, J., & Rello, J. (2003). Legionnaires’ disease: A rational approach to therapy. Journal of Antimicrobial Chemotherapy, 51, 1119–1129.
Stout, J. E., Sens, K., Mietzner, S., Obman, A., & Yu, V. L. (2005). Comparative activity of quinolones, macrolides and ketolides against Legionella species using in vitro broth dilution and intracellular susceptibility testing. International Journal of Antimicrobial Agents, 25, 302–307.
Stout, J. E., & Yu, V. L. (1997). Legionellosis. New England Journal of Medicine, 337, 682–687.
Tsakris, A., Alexiou-Daniel, S., Souliou, E., & Antoniadis, A. (1999). In-vitro activity of antibiotics against Legionella pneumophila isolates from water systems. Journal of Antimicrobial Chemotherapy, 44, 693–695.
Author information
Authors and Affiliations
Corresponding author
Additional information
An erratum to this article can be found at http://dx.doi.org/10.1007/s10661-010-1356-0
Rights and permissions
About this article
Cite this article
Erdogan, H., Can, F., Demirbilek, M. et al. In vitro activity of antimicrobial agents against Legionella isolated from environmental water systems: first results from Turkey. Environ Monit Assess 171, 487–491 (2010). https://doi.org/10.1007/s10661-009-1293-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10661-009-1293-y