The Prokaryotes pp 3281-3303 | Cite as

The Genus Legionella

  • A. William Pasculle


Legionnaires’ disease is the commonly accepted name for an acute purulent bacterial pneumonia caused by Legionella pneumophila. The name resulted from the investigation of an explosive outbreak of pneumonia (189 cases with 29 deaths) among the approximately 3,000 delegates to the annual convention of the Pennsylvania Division of the American Legion in July 1976. Although the exact source of the infection was never determined, epidemiologic investigations demonstrated a strong association between disease acquisition and the amount of time spent in or near the headquarters hotel (Fraser et al., 1977). Initial attempts at isolation of the causative agent were unsuccessful, but subsequent attempts resulted in the isolation of a novel bacterium, L. pneumophila, from lung tissue removed at the autopsies of several of the patients (McDade et al., 1977). The new bacterium was not related to any recognized at that time and was placed into a new family, the Legionellaceae (Brenner et al., 1979).


Water Distribution System Cooling Tower Plumbing System Major Outer Membrane Protein Multilocus Enzyme Electrophoresis 


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Literature Cited

  1. Aguero-Rosenfield, M. E., and P. H. Edelstein 1988. Retrospective evaluation of the DuPont Radioimmunoassay kit for detection of Legionella pneumophila serogroup 1 antigenuria in humans. J. Clin. Microbiol. 26: 1775–1778.Google Scholar
  2. Ampel, N. M., F. L. Rubin, and C. W. Norden 1985. Cutaneous abscess caused by Legionella micdadei in an immunosuppressed patient. Ann. Int. Med. 102: 630–632.PubMedCrossRefGoogle Scholar
  3. Arnow, P. M., R. Chou, D. Weil, E. N. Shapiro, and C. Kretzmar 1982. Nosocomial Legionnaires’ disease caused by aerosolized tap water from respiratory devices. J. Infect. Dis. 146: 460–467.PubMedCrossRefGoogle Scholar
  4. Arnow, P. M., E. J. Boyko, and E. L. Friedman 1983. Perirectal abscess caused by Legionella pneumophila and mixed anaerobic bacteria. Ann. Int. Med. 98: 184–185.PubMedCrossRefGoogle Scholar
  5. Band, J. D., M. La Venture, J. P. Davis, G. F. Mallison, P. Skaliy, P. S. Hayes, W. L. Schell, H. Weiss, O. J. Greenbary, D. W. Fraser 1981. Epidemic Legionnaires disease; airborne transmission down a chimney. JAMA 245: 2404–2407.PubMedCrossRefGoogle Scholar
  6. Barbaree, J. M., B. S. Fields, J. C. Feeley, G. W. Gorman, and W. T. Martin 1986. Isolation of protozoa from water associated with a legionellosis outbreak and demonstration of intracellular multiplication of Legionella pneumophila. Appl. Environ. Microbiol. 51: 422–424PubMedPubMedCentralGoogle Scholar
  7. Bartlett, C. L. R., J. B. Kurtz, J. G. P. Hutchinson, G. C. Turner, and A. E. Wright 1983. Legionella in hospital and hotel water supplies. Lancet 2: 1315.Google Scholar
  8. Baskerville, A. R. B. Fitzgeorge, A. M. Broster, P. Hambleton, and P. J. Dennis 1981. Experimental transmission of Legionnaires disease by exposure to aerosols of Legionella pneumophila. Lancet 2: 1389–1390.PubMedCrossRefGoogle Scholar
  9. Baumgardner, D. J., D. K. Johnson, and D. E. Ross 1988. Prevalence of Legionella in pharyngeal secretions of patients with pharyngitis. J. Amer. Bd. Fam. Pract. 1: 24–28.Google Scholar
  10. Benson, R. E, W. L. Thacker, B. B. Plikaytis, and H. W. Wilkinson 1987. Cross-reactions in Legionella antisera with Bordetella pertussis strains. J. Clin. Microbiol. 25: 594–596.PubMedPubMedCentralGoogle Scholar
  11. Best, M., V. L. Yu, J. Stout, A. Goetz, R. R. Muder, and F. Taylor 1983. Legionellaceae in the hospital hot water supply. Epidemiological link with disease and evaluation of a method for control of nosocomial Legionnaires disease and Pittsburgh Pneumonia. Lancet 2: 307–310.PubMedCrossRefGoogle Scholar
  12. Blander, S. J., and M. A. Horwitz 1989. Vaccination with the major secretory protein of Legionella pneumophila induces cell-mediated and protective immunity in a guinea pig model of Legionnaires’ disease. J. Exp. Med. 169: 691–705.PubMedCrossRefGoogle Scholar
  13. Blackmon, J. A., E. W. Chandler, W. B. Cherry, A. C. England, J. C. Feeley, M. D. Hicklin, and H. W. Wilkinson 1981. Legionellosis. Amer. J. Pathol. 103: 429–465.Google Scholar
  14. Bolin, G. E., J. F. Plouffe, M. F. Para, and R. B. Prior 1985. Difference in virulence of environmental isolates of Legionella pneumophila. J. Clin. Microbiol. 21: 674–677.Google Scholar
  15. Bopp, C. A., J. W. Sumner, G. K. Morris, and J. G. Wells 1981. Isolation of Legionella spp. from environmental samples by low pH treatment and use of selective medium. J. Clin. Microbiol. 13: 714–719.PubMedPubMedCentralGoogle Scholar
  16. Bozeman, E. M., J. W. Humphries, and J. M. Campbell 1968. A new group of rickettsia-like agents recovered from guinea pigs. Acta Virologica (Praha). 12: 87–93.Google Scholar
  17. Brabender, W, Hinthorn, D. R., Asher, M. J. Lindsey, and C. Liu 1983. Legionella pneumophila wound infection. JAMA 250: 3091–3092.Google Scholar
  18. Brenner, D. J. 1987. Classification of the Legionellae. Semin. Resp. Infections. 2: 190–205.Google Scholar
  19. Brenner, D. J., A. G. Steigerwalt, P. Epple, W. E Bibb, R. M. McKinney, R. W. Starnes, J. M. Colzille, R. K. Selander, P. H. Edelstein, and C. W. Moss 1988. Legionella pneumophila serogroup Lansing 3 isolated from a patient with fatal pneumonia, and the description of L. pneumophila subsp. pneumophila, subsp. nov., L. pneumophila subsp. fraseri subsp. nov. and Legionella pneumophila subsp. pascullei subsp. nov. J. Clin. Microbiol. 26: 1695–1703.Google Scholar
  20. Brenner, D. J, A. G. Steigerwalt, and G. W. Gorman 1980. Legionella bozemanü sp nov and Legionella dumofjli sp nov: classification of two additional species of Legionella associated with human pneumonia. Curr. Microbiol. 3: 255–257.Google Scholar
  21. Brenner, D. J., A. G. Steigerwalt, G. W. Gorman, H. W. Wilkinson, W. E Bibb, M. Hackel, R. L. Tyndall, J. Campbell, J. C. Feeley, W. L. Thacker, P. Skaliy, W. T. Martin, B. J. Brake, B. S. Fields, H. V. McEachern, and L. K. Corcoran 1985. Ten new species of Legionella. Int. J. Syst. Bacteriol. 35: 50–59.CrossRefGoogle Scholar
  22. Brenner, D. J., A. G. Steigerwalt, and J. E. McDade 1979. Classification of the legionnaires disease bacterium: Legionella pneumophila genus novum, species nova, of the family Legionellaceae, familia nova. Ann. Int. Med. 90: 656–658.PubMedCrossRefGoogle Scholar
  23. Bridge, J. A., and P. H. Edelstein 1983. Oropharyngeal colonization with Legionella pneumophila. J. Clin. Microbiol. 18: 1108–1112.PubMedPubMedCentralGoogle Scholar
  24. Brindle, R. J., P. J. Stanner, and R. N. Cunliffe 1987. Legionella pneumophila: comparison of isolation from water specimens by centrifugation and filtration. Epidemiol. Infect. 99: 241–247.PubMedPubMedCentralCrossRefGoogle Scholar
  25. Broome, C. V., W. B. Cherry, W. C. Winn, and B. R. MacPherson 1979. Rapid diagnosis of Legionnaires’ disease by direct immunofluorescent staining. Ann. Int. Med. 90: 1–4.PubMedCrossRefGoogle Scholar
  26. Brown, A., G. M. Garrity, and R. M. Vickers 1981. Fluoribacter dumoffii (Brenner et al) comb. nov. and Fluoribactergormanii (Brenner et al) comb. nov. Int. J. Syst. Bacteriol. 31: 111–115.Google Scholar
  27. Brown, A., R. M. Vickers, E. M. Elder, M. Lema, and G. M. Garrity 1982. Plasmid and surface antigen Markers of endemic and epidemic Legionella pneumophila strains. J. Clin. Microbiol. 16: 230–235.PubMedPubMedCentralGoogle Scholar
  28. Buesching, W. J., R. A. Brust, and L. W. Ayers 1983. Enhanced primary isolation of Legionella pneumophila from clinical specimens by low pH treatment. J. Clin. Microbiol. 17: 153–1155.Google Scholar
  29. Byrd, T. E, and M. A. Horwitz 1989. Interferon gamma-activated human monocytes downregulate transferrin receptors and inhibit the intracellular multiplication of Legionella pneumophila by limiting the availability of iron. J. Clin. Invest. 83: 1457–1465.PubMedPubMedCentralCrossRefGoogle Scholar
  30. Cercenado, E, R H. Edelstein, L. H. Gosting, and J. C. Sturge 1987. Legionella micdadei and Legionella dumoffzi monoclonal antibodies for laboratory diagnosis of Legionella infections. J. Clin. Microbiol. 25: 2163–2167.Google Scholar
  31. Chandler, E W., M. D. Hicklin, and J. A. Blackmon 1977. Demonstration of the agent of Legionnaires’ disease in tissue. N. Engl. J. Med. 297: 1218–1220.PubMedCrossRefGoogle Scholar
  32. Cherry, W. B., B. Pittman, R R Harris, G. A. Hebert, B. M. Thomason, L. Thacker, and R. E. Weaver 1978. Detection of Legionnaires’ disease bacteria by direct immunofluorescent staining. J. Clin. Microbiol. 8: 329–338.PubMedPubMedCentralGoogle Scholar
  33. Cho, S. N., M. T. Collins, and J. S. Reif 1984. Serologic evidence of Legionella infection in horses. Am. J. Vet. Res. 45: 2600–2602.PubMedGoogle Scholar
  34. Cho, S. N., M. T. Collins, J. S. Reif, and A. E. McChesney 1983. Experimental infections of horses with Legionella pneumophila Am. J. Vet. Res. 44: 662–663.PubMedGoogle Scholar
  35. Cianciotto, N. R, B. I. Eisenstein, C. H. Mody, G. B. Toews, and N. C. Engleberg 1989. A Legionella pneumophila gene encoding a species-specific surface protein potentiates initiation of intracellular infection. Infect. Immun. 57: 1255–62.PubMedPubMedCentralGoogle Scholar
  36. Ciesielski, C. A., M. J. Blaser, and W.-L. L. Wang 1986. Serogroup specificity of Legionella pneumophila is related to lipopolysaccharide characteristics. Infect. Immun. 51: 397–404.PubMedPubMedCentralGoogle Scholar
  37. Colbourne, J. S., D. J. Pratt, M. G. Smith, and S. R Fisher-Hoch 1984. Water fittings as a source of Legionella pneumophila in a hospital plumbing system. Lancet 1: 210–213.PubMedCrossRefGoogle Scholar
  38. Collins, M. T., J. McDonald, N. Hiby, and O. Aalund 1984. Agglutinating antibody titers to members of the family Legionellaceae in cystic fibrosis patients as a result of cross-reacting antibodies to Pseudomonas aeruginosa. J. Clin. Microbiol. 19: 757–762.PubMedPubMedCentralGoogle Scholar
  39. Conlan, J. W., A. Baskerville, and L. A. Ashworth 1986. Separation of Legionella pneumophila proteases and purification of a protease which produces lesions like those of Legionnaires’ disease in guinea pig lung. J. Gen. Microbiol. 132: 1565–1564.PubMedGoogle Scholar
  40. Cordes, L. G., A. M. Wiesenthal, G. W. Gorman, J. R Phair, H. M. Sommers, A. Brown, V. L. Yu, M. H. Magnussen, R. D. Meyer, J. S. Wolf, K. N. Shands, and D. W. Fraser 1981. Isolation of Legionella pneumophila from hospital shower heads. Ann. Int. Med. 94: 195–197.PubMedCrossRefGoogle Scholar
  41. Davis, G. S., W. C. Winn, D. W. Gump, and H. W. Beaty 1983. The kinetics of early inflammatory events during experimental pneumonia due to Legionella pneumophila in guinea pigs. J. Infect. Dis. 148: 823–835.PubMedCrossRefGoogle Scholar
  42. Freitas, J. L., J. Borst, and P. L. Meenhorst 1979. Easy visualization of Legionella pneumophila by “half-agram” stain procedure. Lancet 1: 270–271.PubMedCrossRefGoogle Scholar
  43. Doebbeling, B. N., M. J. Bale, E P. Koonz, C. M. Helms, R. P. Wenzel, and M. A. Pfaller 1988. Prospective evaluation of the Gen-Probe assay for detection of Legionellae in respiratory secretions. Eur. J. Clin. Microbiol. Infect. Dis. 7: 748–752.PubMedCrossRefGoogle Scholar
  44. Dondero, T. J., Jr., R. C. Rentdorf, G. F Mallison, R. M. Weeks, J. S. Levy, E. W. Wong, and W. Schaffner 1980. An outbreak of Legionnaires’ disease associated with a contaminated air-conditioning cooling tower. N. Engl. J. Med. 302: 365–370.PubMedCrossRefGoogle Scholar
  45. Dorn, G. L., and W. R. Barnes 1979. Rapid isolation of Legionella from seeded donor blood. J. Clin. Microbiol. 10: 114–115.PubMedPubMedCentralGoogle Scholar
  46. Dowling, J. N., A. W. Pasculle, F. N. Frola, K. Zaphyr, and R. B. Yee 1984. Infections caused by Legionella pneumophila and Legionella micdadei among renal transplant recipients. J. Infect. Dis. 149: 703–713.PubMedCrossRefGoogle Scholar
  47. Dowling, J. N., R. S. Weyant, and A. W. Pasculle 1982. Bactericidal activity of antibiotics against Legionella micdadei (Pittsburgh pneumonia agent). Antimicrob. Agents Chemo 22: 272–276.CrossRefGoogle Scholar
  48. Edelstein, P. H. 1987. The laboratory diagnosis of Legionnaires’ disease. Sem. Respir. Infect. 2: 235–241.Google Scholar
  49. Edelstein, P. H. 1986. Evaluation of the Gen-Probe DNA probe for the detection of Legionella in culture. J. Clin. Microbiol. 24: 556–558.Google Scholar
  50. Edelstein, P. H. 1982. Improved semiselective medium for isolation of L. pneumophila from contaminated clinical and environmental specimens. J. Clin. Microbiol. 10: 141–146.Google Scholar
  51. Edelstein, P. H., K. B. Beer, J. C. Sturge, A. J. Watson, and L. C. Goldstein 1985. Clinical utility of a monoclonal direct fluorescent reagent specific for Legionella pneumophila: Comparative study with other reagents. J. Clin. Microbiol. 22: 419–421.PubMedPubMedCentralGoogle Scholar
  52. Edelstein, P. H., K. Calarco, and V. K. Yasui 1984. Antimicrobial therapy of experimentally induced Legionnaires’ disease in guinea pigs. Am. Rev. Respir. Dis. 130: 849–856.PubMedGoogle Scholar
  53. Edelstein, P. H., R. W. McKinney, R. D. Meÿer, M. A. Edelstein, C. J. Krause, and S. M. Finegold SM. 1980. Immunologic diagnosis of Legionnaires’ disease: cross-reactions with anaerobic and microaerophilic organisms and infections caused by them. J. Infect. Dis. 141: 652–655.Google Scholar
  54. Edelstein, P. H., and R. D. Meyer 1984. Legionnaires’ disease. Chest 85: 114–120.PubMedCrossRefGoogle Scholar
  55. Edelstein, P. H., R. D. Meyer, and S. M. Finegold 1979. Isolation of Legionella pneumophila from blood. Lancet 1: 750–751.PubMedCrossRefGoogle Scholar
  56. Edelstein, P. H., R. D. Meyer, and S. M. Finegold 1980. Laboratory diagnosis of Legionnaires’ disease. Amer. Rev. Respir. Dis. 121: 317–317.Google Scholar
  57. Edelstein, R H., C. Nakahama, J. O. Tobin, K. Calarco, K. B. Beer, J. R. Joly, and R. K. Selander 1986. Paleoepidemic investigation of Legionnaires’ disease at Wadsworth Veterans Administration Hospital using three typing methods from clinical and environmental sources. J. Clin. Microbiol. 23: 1121–1126.PubMedPubMedCentralGoogle Scholar
  58. Edelstein, R. H., J. B. Snitzer, and S. M. Finegold 1982. Isolation of Legionella pneumophila from hospital potable water specimens; comparison of direct plating with guinea pig inoculation. J. Clin. Microbiol. 15: 1092–1096.PubMedPubMedCentralGoogle Scholar
  59. Edelstein, R. H., R. E. Whitaker, R. L. Kreiling, and C. L. Howell 1982. Efficacy of ozone in eradication of Legionella pneumophila from hospital plumbing fixtures. Appl. Environ. Microbiol. 44: 1330–1334.PubMedPubMedCentralGoogle Scholar
  60. Elliott, J. A., and W. C. Winn 1986. Treatment of alveolar macrophages with cytocholasin D inhibits uptake and subsequent growth of Legionella pneumophila. Infect. Immun. 51: 31–36.PubMedPubMedCentralGoogle Scholar
  61. England, A. C. III, D. W. Fraser, B. D. Plikaytis, T. F Tsai, and C. Y. Storch 1981. Sporadic legionellosis in the United States, the first thousand cases. Ann. Int. Med. 94: 164–170.PubMedCrossRefGoogle Scholar
  62. England, A. C., III, D. W. Fraser, G. F. Mallison, D. C. Mackel, R. Skaliy, and G. W. Gorman 1982. Failure of Legionella pneumophila sensitivities to predict culture results from disinfectant-treated air-conditioning cooling towers. Appl. Environ. Microbiol. 43: 240–244.PubMedPubMedCentralGoogle Scholar
  63. Engleberg, N. C., C. Carter, P. Demarch, D. J. Drutz, and B. I. Eisenstein 1986. A Legionella-specific DNA probe detects organisms in lung tissue homogenates from intranasally inoculated mice. Isr. J. Med. Sci. 22: 703–705.PubMedGoogle Scholar
  64. Fallon, R. J., and R. E. Johnston 1987. Heterogeneity of antibody response in infection with Legionella pneumophila serogroup 1. J. Clin. Pathol. 40: 569–572.PubMedPubMedCentralCrossRefGoogle Scholar
  65. Farr B. M., J. C. Gratz, J. C. Tartaglino, S. I. GetchellWhite, and D. H. Groschell 1989. Evaluation of ultraviolet light for disinfection of hospital water contaminated with Legionella. Lancet 2: 669–672.Google Scholar
  66. Feeley, J. C., R. J. Gibson, G. W. Gorman, M. C. Langford, J. K. Rasheed, D. C. Mackel, and W. B. Baine 1979. Charcoal Yeast Extract Agar: Primary isolation medium for Legionella pneumophila. J. Clin. Microbiol. 10: 437–441.PubMedPubMedCentralGoogle Scholar
  67. Feeley, J. C., G. W. Gorman, and R. J. Gibson 1978. Primary isolation media and methods, p. 108–107. In: Jones, G. L., and Hebert, G. A., (ed.), “Legionnaires”: The disease, the bacterium and methodology. Centers for Disease Control, Atlanta.Google Scholar
  68. Feeley, J. C., G. W. Gorman, R. E. Weaver, D. C. Mackel, and H. W. Smith 1978. Primary isolation media for Legionnaires’ disease bacterium. J. Clin. Microbiol. 8: 329–325.Google Scholar
  69. Fields, B. S., J. M. Barbaree, E. B. Shotts, Jr., J. C. Feeley, W. E. Morrill, G. N. Sanden, and M. J. Dykstra 1986. Comparison of guinea pig and protozoan models for determining virulence of Legionella species. Infect. Immun. 53: 553–559.PubMedPubMedCentralGoogle Scholar
  70. Fields, B. S., E. B. Shotts, Jr., J. C. Feeley, G. W. Gorman, and W. T. Martin 1984. Proliferation of Legionella pneumophila as an intracellular parasite of the ciliated protozoan Tetrahymena pyriformis. Appl. Environ. Microbiol. 47: 467–471.PubMedPubMedCentralGoogle Scholar
  71. Fisher-Hoch, S. P., C. L. R. Bartlett, J. O. Tobin, M. B. Gillett, A. M. Nelson, J. E. Pritchard, M. G. Smith, R. A. Swann, J. M. Talbot, and J. A. Thomas 1981. Investigation and control of an outbreak of Legionnaires’ disease in a district general hospital. Lancet 2: 932–936.CrossRefGoogle Scholar
  72. Fitzgeorge, R. B., A. S. Featherstone, and A. Baskerville 1988. Effects of polymorphonuclear leukocyte depletion on the pathogenesis of experimental Legionnaires’ disease. Br. J. Exp. Pathol. 69: 105–112.PubMedPubMedCentralGoogle Scholar
  73. Fliermans, C. B., G. E. Bettinger, and A. W. Fynsk 1982. Treatment of cooling systems containing high levels of Legionella pneumophila. Water Res. 16: 903–909.CrossRefGoogle Scholar
  74. Fliermans, C. B., W. B. Cherry, L. H. Orrison, S. J. Smith, D. L. Tison, and D. H. Pope 1981. Ecological distri- bution of Legionella pneumophila. Appl. Environ. Mi- crobiol. 41: 9–16.Google Scholar
  75. Flournoy D. J., K. A. Belobraydic, S. L. Silberg, C. H. Lawrence, and P. J. Guthrie 1988. False positive Legionella pneumophila direct immunofluorescent monoclonal antibody test caused by Bacillus cereus spores. Diagn. Microbiol. Infect. Dis. 9: 123–5.PubMedCrossRefGoogle Scholar
  76. Foy, H. M., C. V. Broome, P. S. Hayes, I. Allan, M. K. Cooney, and R. Tobe 1979. Legionnaires’ disease in a prepaid medical care group in Seattle 1963–1965. Lancet 1: 767–770, 1979.PubMedCrossRefGoogle Scholar
  77. Fraser, D. W., T. R. Tsai, W. Orenstein, W. E. Parkin, J. Beechaam, R. G. Sharrar, J. Harris, G. F. Mallison, S. M. Martin, J. E. McDade, C. C. Shepard, P. S. Brachman 1977. Legionnaires’ disease: description of an epidemic of pneumonia. N. Engl. J. Med. 297: 1189–1107.PubMedCrossRefGoogle Scholar
  78. Fraser, D. W., I. Wachsmuth. C. Bopp, J. C. Feeley, and T. F. Tsai 1978. Antibiotic treatment of guinea pigs infected with agent of Legionnaires’ disease. Lancet 1: 175–178.PubMedCrossRefGoogle Scholar
  79. Friedman, H. M. 1978. Legionnaires’ disease in non-Legionnaires. A report of five cases. Ann. Int. Med. 88: 294–302.PubMedCrossRefGoogle Scholar
  80. Friedman, R. L., B. H. Iglewski, and R. D. Miller 1980. Identification of a cytotoxin produced by Legionella pneumophila. Infect. Immun. 29: 271–274.PubMedPubMedCentralGoogle Scholar
  81. Friedman, R. L., J. E. Lochner, R. H. Bigley, and B. H. IgIewski 1982. The effect of Legionella pneumophila toxin on oxidative processes and bactericidal killing of human polymorphonuclear leukocytes. J. Infect. Dis. 146: 328–334.PubMedCrossRefGoogle Scholar
  82. Fuller, J., M. M. Levinson, J. R. Kline, and J. Copeland 1985. Legionnaires’ disease after heart transplantation. Ann. Thorac. Surg. 39: 308–311.PubMedCrossRefGoogle Scholar
  83. Garrity, G. M., A. Brown, and R. M. Vickers 1980. Tatlockia and Fluoribacter: Two new genera of organisms resembling Legionella pneumophila. Int. J. Syst. Bacteriol. 30: 609–614.Google Scholar
  84. Garrity, G. M., E. M. Elder, B. Davis, R. M. Vickers, and A. Brown 1982. Serologic and genetic diversity among serogroup 5-reacting environmental Legionella isolates. J. Clin. Microbiol. 15: 646–653.PubMedPubMedCentralGoogle Scholar
  85. George, J. R., L. Pine, M. W. Reeves, and W. K. Harrell 1980. Amino acid requirements of Legionella pneumophila. J. Clin. Microbiol. 11: 286–291.PubMedPubMedCentralGoogle Scholar
  86. Girod, J. C., R. C. Reichman, W. C. Winn, Jr., D. N. Klauke, R. L. Vogt, and R. Dolin 1982. Pulmonic and nonpulmonic forms of legionellosis. The result of a common-source exposure to Legionella pneumophila. Arch. Int. Med. 142: 545–547.CrossRefGoogle Scholar
  87. Glick, T. H., M. B. Gregg, B. Berman, G. Mallison, W. W. Rhodes, Jr., and I Kassanoff 1978. Pontiac fever. An epidemic of unknown etiology in a health department: I. Clinical and epidemiologic aspects. Am. J. Epidemiol. 107: 149–160.PubMedGoogle Scholar
  88. Gochenour, W. S., J. E. Smadel, E. B. Jackson, et al. 1952. Leptospiral etiology of Fort Bragg fever. Public Health Rep. 67: 811–813.PubMedPubMedCentralCrossRefGoogle Scholar
  89. Goldberg, D. J., A. G. Wrench, P. W. Collier, J. A. Emslie, R. J. Fallon, G. I. Forbes, T. M. McKay, A. C. McPherson, T. A. Marwick, and D. Reid 1989. Lochgoilhead fever: outbreak of non-pneumonic legionellosis due to Legionella micdadei. Lancet 1: 316–318.PubMedCrossRefGoogle Scholar
  90. Gorman, G. W., V. L. Yu, A. Brown, J. A. Hall, W. T. Martin, W. F Bibb, G. K. Morris, M. H. Magnussen, and D. W. Fraser 1980. Isolation of Pittsburgh pneumonia agent from nebulizers used in respiratory therapy. Ann. Int. Med. 93: 572–573.PubMedCrossRefGoogle Scholar
  91. Grace, R. D., N. E. Dewar, W. G. Barnes, and G. R. Hodges 1981. Susceptibility of Legionella pneumophila to three cooling tower microbicides. Appl. Environ. Microbiol. 41: 233–236.PubMedPubMedCentralGoogle Scholar
  92. Gress, F. M., and R. L. Myerowitz 1980. The ultrastructural morphologic features of Pittsburgh pneumonia agent. Am. J. Pathol. 101: 63–78.PubMedPubMedCentralGoogle Scholar
  93. Grimont, P. A. D., F Grimont, N. Desplaces, and P. Tchen 1985. DNA probe specific for Legionella pneumophila. J. Clin. Microbiol. 21: 431–437.PubMedPubMedCentralGoogle Scholar
  94. Hebert, G. A., C. S. Callaway, and E. P. Ewing 1984. Comparison of Legionella pneumophila, L. micdadei, L. bozemanii, and L. dumoffii, by transmission electron microscopy. J. Clin. Microbiol. 19: 116–121.PubMedPubMedCentralGoogle Scholar
  95. Hebert, G. A., A. G. Steigerwalt, and D. J. Brenner 1980. Legionella micdadei species nova: Classification of a third species of Legionella associated with human pneumonia. Curr. Microbiol. 3: 255–257.Google Scholar
  96. Hedlund, K. W. 1981. Legionella toxin. Pharmacol. Ther. 15: 123–130.Google Scholar
  97. Helms C. M., R. M. Masasanari, R. P. Wenzel, M. A. Pfaller, N. P. Moyer, N. Hall 1988. Legionnaires’ disease associated with a hospital hot water system. A five-year progress report. JAMA 259: 2423–2427.PubMedCrossRefGoogle Scholar
  98. Helms, C. M., R. M. Massanari, R. Zeitler, S. Streed, M. J. R. Gilchrist, N. Hall, W. J. Hausler, J Sywassink, W. Johnson, L. Wintermyer, and W. U. Hierholzer 1983. Legionnaires’ disease associated with a hospital water system: A cluster of 24 nosocomial cases. Ann. Int. Med. 99: 172–178.PubMedCrossRefGoogle Scholar
  99. Herwaldt, L. A., G. W. Gorman, T. McGrath, S. Toma, B. Brake, and A. W. Hightower 1984. A new Legionella species, Legionella feeleii causes pontiac fever in an automobile plant. Ann. Int. Med. 84: 333–338.CrossRefGoogle Scholar
  100. Hindahl, M. S., and B. H. Iglewski 1986. Outer membrane proteins from Legionella pneumophila serogroups and other Legionella species. Infect. Immun. 51: 94–101.PubMedPubMedCentralGoogle Scholar
  101. Hoffman, R. S., L. Pine, and S. Bell 1983. Production of superoxide and hydrogen peroxide in medium used to culture Legionella pneumophila: Catalytic decomposition by charcoal. Appl. Environ. Microbiol. 45: 784–791.PubMedPubMedCentralGoogle Scholar
  102. Horwitz, M. A. 1983a. Formation of a novel phagosome by the Legionnaires’ disease bacterium, (Legionella pneumophila) in human monocytes. J. Exp. Med. 15: 1319–1331.CrossRefGoogle Scholar
  103. Horwitz, M. A. 1983b. The Legionnaires’ disease bacterium (Legionella pneumophila) inhibits phagosome-lysosome fusion in human monocytes. J. Exp. Med. 2108–2106.Google Scholar
  104. Horwitz, M. A. 1984. Phagocytosis of the Legionnaires’ disease bacterium (Legionella pneumophila) occurs by a novel mechanism: Engulfment within a pseudopod coil. Cell 36: 27.PubMedCrossRefGoogle Scholar
  105. Horwitz, M. A. 1987. Characterization of avirulent mutant Legionella pneumophila that survive but do not multiply within human phagocytes. J. Exp. Med. 166: 1310–1328.PubMedCrossRefGoogle Scholar
  106. Horwitz, M. A., and E. R. Maxfield 1984. Legionella pneumophila inhibits acidification of its phagosome in human monocytes. J. Cell. Biol. 99: 1936–1943.Google Scholar
  107. Horwitz, M. A., and S. C. Silverstein 1980. Legionnaires’ disease bacterium (Legionella pneumophila) multiplies intracellularly in human monocytes. J. Clin. Invest. 66: 441–450.PubMedPubMedCentralCrossRefGoogle Scholar
  108. Horwitz, M. A., and S. C. Silverstein 1981. Interaction of the Legionnaires’ disease bacterium (Legionella pneumophila) with human phagocytes. I. L. pneumophila resists killing by polymorphonuclear leukocytes, antibody and complement. J. Exp. Med. 153: 386–397.Google Scholar
  109. Johnson, J. T., V. L. Yu, M. B. Best, R. M. Vickers, A. Goetz, R. Wagner, H. Wicker, and A. Woo 1985. Nosocomial legionellosis in surgical patients with head and neck cancer: Implications for epidemiologic reservoir and mode of transmission. Lancet 2: 298–300.PubMedCrossRefGoogle Scholar
  110. Joly, J. R., Y. -Y. Chen, and D. Ramsay 1983. Serogrouping and subtyping of Legionella pneumophila with monoclonal antibodies. J. Clin. Microbiol. 18: 1040–1046.PubMedPubMedCentralGoogle Scholar
  111. Joly, J. R., R. M. McKinney, J. O. Tobin, W. E Bibb, I. D. Watkins, and D. Ramsay 1986. Development of a standardized subgrouping scheme for Legionella pneumophila serogroup 1 using monoclonal antibodies. J. Clin. Microbiol. 23: 768–771.PubMedPubMedCentralGoogle Scholar
  112. Kalweit, W. H., W. C. Winn, Jr., T. A. Rocco, and J. C. Girod 1982. Hemodialysis fistula infection caused by Legionella pneumophila. Ann. Int. Med. 92: 173–175.CrossRefGoogle Scholar
  113. Karr, D. E., W. F. Bibb, and C. W. Moss 1982. Isoprenoid quinones of the genus Legionella. J. Clin. Microbiol. 15: 1044–1048.PubMedPubMedCentralGoogle Scholar
  114. Kaufmann, A. E, J. E. McDade, C. M. Patton, J. V. Bennett, P. Skaliy, J. C. Feeley, D. C. Anderson, M. E. Potter, V. E Newhouse, M. B. Gregg, and P. S. Brachman 1981. Pontiac fever: isolation of the etiologic agent and demonstration of its mode of transmission. Am. J. Epidemiol. 114: 337–347.PubMedGoogle Scholar
  115. Kealthy, J. D., and W. C. Winn 1984. Comparison of media for recovery of Legionella pneumophila clinical isolates, p. 19–20. In: C. Thornesberry, A. Balows, J. C. Feeley, and W. Jakubowsky (ed.), Legionella. Proceedings of the 2nd International Symposium. American Society for Microbiology, Washington.Google Scholar
  116. Keen, M. G., and P. S. Hoffman 1984. Metabolic pathways and nitrogen metabolism in Legionella pneumophila. Curr. Microbiol. 11: 81–88.CrossRefGoogle Scholar
  117. Keen, M. G., and P. S. Hoffman 1989. Characterization of a Legionella pneumophila extracellular protease exhibiting hemolytic and cytotoxic properties. Infect. Immunity. 57: 732–738.Google Scholar
  118. Kirby, B. D. 1983. Legionnaires disease in surgical patients. Infect. Med. 61–66, 1983.Google Scholar
  119. Kirby, B. D., K. M. Snyder, R. M. Meyer, and S. M. Finegold 1980. Legionnaires’ disease: Report of 65 nosocomially acquired cases and review of the literature. Medicine (Baltimore) 69: 188–205.Google Scholar
  120. Kohler, R. B., S. D. Allen, L. J. Wheat, and A. C. White 1987. Development and evaluation of diagnostic radiometric assays for serogroup 4 L. pneumophila urinary antigens. Diagn. Microbiol. Infect. Dis. 6: 101–107.PubMedCrossRefGoogle Scholar
  121. Kurtz, J. B., C. J. R. Bartlett, U. A. Newton, R. A. White, and N. L. Jones 1982. Legionella pneumophila in cooling water systems; report of a survey of cooling towers in London and a pilot trial of selected biocides. J. Hyg. 88: 369–381.Google Scholar
  122. Lambert, M. A., and C. W. Moss 1989. Cellular fatty acid composition and isoprenoid quinone contents of 23 Legionella species. J. Clin. Microbiol. 27: 465–473.PubMedPubMedCentralGoogle Scholar
  123. Lattimer, G. L., L. V. Rhodes, J. E Salventi, and B. R. Cepil 1980. Isolation of Legionella pneumophila from clinical specimens: salutary effects of lung tissue dilution. Amer. Rev. Resp. Dis. 122: 101–105.PubMedGoogle Scholar
  124. Ludwig, W., and E. Stackebrandt 1983. A phylogenetic analysis of Legionella. Arch. Microbiol. 135: 45–50.PubMedCrossRefGoogle Scholar
  125. Mangione, E. J., R. S. Remis, K. A. Tait, H. B. McGee, G. W. Gorman, B. B. Wentworth, P. A. Baron, A. W. Hightower, J. M. Barbaree, and C. V. Broome 1985. An outbreak of Pontiac fever related to whirlpool use, Michigan, 1982. JAMA 253: 535–539.PubMedCrossRefGoogle Scholar
  126. Marre’, R., A. A. Medeiros, and A. W. Pasculle 1982. Characterization of the Blactamases of 6 species of Legionellaceae. J. Bacteriol. 151: 216–220.Google Scholar
  127. Marrie, T. J., J. George, S. McDonald, and D. Haase 1986. Are health care workers at risk for infection during an outbreak of nosocomial Legionnaires’ disease ? Am. J. Infect. Control 14: 209–213.PubMedCrossRefGoogle Scholar
  128. Marrie, T. J., E. V. Haldane, M. A. Noble, R. S. Faulkner, M. A. Martin, and S. H. Lee 1981. Causes of atypical pneumonia: Results of a 1 year prospective study. Can. Med. Assoc. J. 125: 1118–1128PubMedPubMedCentralGoogle Scholar
  129. Nolte, E S., C. A. Conlin, A. J. Roisin, and S. R. Redmond 1984. Plasmids as epidemiological markers in nosocomial Legionnaires’ disease. J. Infect. Dis. 149: 251–256.PubMedCrossRefGoogle Scholar
  130. Orrison, L. H., W. B. Cherry, and D. Milan 1981. Isolation of Legionella pneumophila from cooling towers by filtration. Appl. Environ. Microbiol. 45: 536–545.Google Scholar
  131. Orrison, L. H., W. B. Cherry, R. L. Tyndall, C. B. Flier-mans, S. G. Gough, M. A. Lambert, L. K. McDougal, W. E Bibb, and D. J. Brenner 1983. Legionella oakridgensis: unusual new species isolated from cooling tower water. Appl. Environ. Microbiol. 45: 536–545.Google Scholar
  132. Osterholm, M. T., T. D. Chin, D. O. Osborne, H. B. Dull, A. G. Dean, D. W. Fraser, P. S. Hayes and W. N. Hall 1983. An outbreak of Legionnaires’ disease associated with a meat packing plant. Am. J. Epidemiol. 117: 6067.Google Scholar
  133. Pasculle, A. W., J. N. Dowling, E N. Frola, D. A. McDevitt, and M. Levi 1985.. Antimicrobial therapy of experimental Legionella micdadei infection in guinea pigs. Antimicrob. Agents Chemo. 28: 730–734.Google Scholar
  134. Pasculle, A. W., J. N. Dowling, R. S. Weyant, J. M. Sniffen, G. W. Gorman, and J. C. Feeley 1981. Susceptibility of Pittsburgh pneumonia agent (Legionella micdadei) and other newly recognized members of the genus Legionella to nineteen antimicrobial agents. Antimicrob. Agents Chemother. 20: 793–799.PubMedPubMedCentralCrossRefGoogle Scholar
  135. Pasculle, A. W., J. C. Feeley, R. J. Gibson, L. G. Cordes, R. L. Myerowitz, C. M. Patton, G. W. Gorman, C. L. Carmack, J. W. Ezzell, and J. N. Dowling 1980. Pittsburgh pneumonia agent: Direct isolation from lung tissue. J. Infect. Dis. 141: 727–732.PubMedCrossRefGoogle Scholar
  136. Pasculle, A. W., G. E. Veto, S. Krystofiak, K. McKelvey, and K. Vrsalovic 1989. Laboratory and clinical evaluation of a commercial DNA probe for the detection of Legionella spp. J. Clin. Microbiol. 27: 2350–2358.PubMedPubMedCentralGoogle Scholar
  137. Payne, N. R., and M. A. Horwitz 1987. Phagocytosis of Legionella pneumophila is mediated by human monocyte complement receptors. J. Exp. Med. 166: 1377–1389.PubMedCrossRefGoogle Scholar
  138. Pine, L. J. R. George, M. W. Reeves, and W. K. Harrell 1979. Development of a chemically defined liquid medium for growth of Legionella pneumophila. J. Clin. Microbiol. 9: 615–626.PubMedPubMedCentralGoogle Scholar
  139. Pine, L., P. S. Hoffman, G. B. Malcolm, R. F. Benson, and M. G. Keen 1984. Determination of catalase, peroxidase, and superoxide dismutase within the genus Legionella. J. Clin. Microbiol. 20: 421–429.PubMedPubMedCentralGoogle Scholar
  140. Plouffe, J. E, M. F. Para, W. E. Maher, B. Hackman, and L. Webster 1983. Subtypes of Legionella pneumophila associated with different attack rates. Lancet. 649–650.Google Scholar
  141. Reeves, M. W., L. Pine, J. B. Nielands, and A. Balows 1983. Absence of siderophore activity in Legionella species grown in iron-deficient media. J. Bacteriol. 154: 324–329.PubMedPubMedCentralGoogle Scholar
  142. Reichnitzer, C., and J. Blom 1989. Engulfment of the Philadelphia strain of Legionella pneumophila within pseudopod coils in human phagocytes. Comparison with other Legionella strains and serotypes. APMIS (Denmark) 97: 105–114.CrossRefGoogle Scholar
  143. Reingold A. L. 1988. Role of legionellae in acute infections of the lower respiratory tract. Rev. Infect. Dis. 10: 1018–1028.PubMedCrossRefGoogle Scholar
  144. Reingold, A. L., B. M. Thomason, B. J. Brake, L. Thacker, H. W. Wilkinson, and J. N. Kuritsky 1984. Legionella pneumophila in the Unites States; the distribution of serogroups and species causing human illness. J. Infect. Dis. 149: 819–829Google Scholar
  145. Rihs, J. D., V. L. Yu, J. J. Zuravleff, A. Goetz, and R. R. Muder 1985. Isolation of Legionella from blood with the BACTEC system: a prospective study yielding positive results. J. Clin. Microbiol. 22: 422–424.PubMedPubMedCentralGoogle Scholar
  146. Ristagno R. L., and L. D. Saravolatz 1985. A pseudoepi- demic of Legionella infections Chest 88: 466–467.Google Scholar
  147. Ristroph, J. D., K. W. Hedlund, and R. G. Allen 1980. Liquid medium for growth of Legionella pneumophila. J. Clin. Microbiol. 11: 19–21.PubMedPubMedCentralGoogle Scholar
  148. Roberts, K. P., C. M. August, and J. D. Nelson 1987. Relative sensitivities of environmental legionellae to selective isolation procedures. Appl. Environ. Microbiol. 53: 2704–2707.PubMedPubMedCentralGoogle Scholar
  149. Rowbotham, T. J. 1980. Preliminary report on the pathogenicity of Legionella pneumophila for freshwater and soil amoebae. J. Clin. Microbiol. 33: 1179–1183.Google Scholar
  150. Saha, A. K., J. N. Dowling, A. W. Pasculle, and R. H. Glew 1988. Legionella micdadei phosphatase catalyze the hydrolysis of phosphatidylinositol 4,5-biphsophate in human neutrophils. Arch. Biochem. Biophys. 265: 94–104.Google Scholar
  151. Saito, A. K., H. Koga, L. Shegeno, K. Watanabe, S. Mori, Y. Kohno, Y. Shigeno, K. Suzuama, M. Yamaguchi, and M. Hirota 1986. The antimicrobial activity of ciprofloxacin against Legionella species and the treatment of experimental Legionella pneumonia in guinea pigs. J. Antimicrob. Chemother. 18: 251–260.PubMedCrossRefGoogle Scholar
  152. Sampson, J. S., B. B. Plikaytis, and H. W. Wilkinson 1986. Immunologic response of patients with legionellosis against major protein-containing antigens of Legionella pneumophila serogroup 1 and shown by immunoblot analysis. J. Clin. Microbiol. 23: 92–99.PubMedPubMedCentralGoogle Scholar
  153. Sathapatayavongs, B., R. B. Kohler, L. J. Wheat, A White, W. C. Winn, J. R., C. Girod, and P. H. Edelstein 1982. Rapid diagnosis of Legionnaires’ disease by urinary antigen detection. Comparison of ELISA and radioimmunoassay. Am. J. Med. 72: 576–582.PubMedCrossRefGoogle Scholar
  154. Selander, R. K., R. M. McKinney, T. S., Whittam, W. F. Bibb, D. J. Brenner, E S. Nolte, and P. E. Pattison 1985. Genetic structure of populations of Legionella pneumophila. J. Bacteriol. 163: 1021–1027.PubMedPubMedCentralGoogle Scholar
  155. Shands, K. N., J. L. Ho, R. D. Meyer, G. W. Gorman, P. H. Edelstein, G. F. Mallison, S. M. Finegold, and D. W. Fraser 1985. Potable water as a source of Legionnaires’ disease. JAMA 253: 1412–1416.PubMedCrossRefGoogle Scholar
  156. Skaliy, P., T. A. Thompson, G. W. Gorman, G. K. Morris, H. V. McEachern, and D. C. Mackel 1980. Laboratory studies of disinfectants against Legionella pneumophila. Appl. Environ. Microbiol. 40: 607–700.Google Scholar
  157. Starnbach, M. N., S. Falkow, and L. S. Tompkins 1989. Species-specific detection of Legionella pneumophila in water by DNA amplification and hybridization. J. Clin. Microbiol. 27: 1257–1261.PubMedPubMedCentralGoogle Scholar
  158. States, S. J., L. E Conley, J. M. Kuchta, B. M. Oleck, M. J. Lipovich, R. S. Wolford, R. M. Wadowsky, A. M. McNamara, J. L. Sykora, G. Keleti, and R. B. Yee 1987. Survival and multiplication of Legionella pneumophila in municipal drinking water systems. Appl. Environ. Microbiol. 53: 979–986.PubMedPubMedCentralGoogle Scholar
  159. States, S. J. L. F. Conley, S. G. Towner, R. S. Wolford, T. E. Stephenson, A. M. McNamara, R. M. Wadowsky, and R. B. Yee 1987b. An alkaline approach to treating cooling towers for control of Legionella pneumohila. Appl. Environ. Microbiol. 53: 1775–1779.PubMedPubMedCentralGoogle Scholar
  160. Stout, J. E., M. G. Best, and V. L. Yu 1985. Isolation of Legionella pneumophila from the cold water of hospital ice machines: implications for origin and transmission of the organism. Infect. Control 6: 141–146PubMedGoogle Scholar
  161. Stout, J. E., V. L. Yu, and M. G. Best 1985. Ecology of Legionella pneumophila within water distribution systems. Appl. Environ. Microbiol. 49: 221–228.PubMedPubMedCentralGoogle Scholar
  162. Stout, J. E., V. L. Yu, and P. Muraca 1985. Isolation of Legionella pneumophila from the cold water of hospital ice machines: Implications for origin and transmission of the organism. Infect. Control. 6: 141–146.Google Scholar
  163. Stout, J. E., V. L. Yu, and P Muraca 1987. Legionnaires’ disease acquired within the homes of two patients. JAMA 257: 1215–1217.PubMedCrossRefGoogle Scholar
  164. Strampfer, M. J., and B. A. Cunha 1987. Clinical and laboratory aspects of Legionnaires’ disease. Semin. Respir. Infect. 2: 228–234.Google Scholar
  165. Tang, P. W., and S. Toma 1986. Broad-spectrum enzyme-linked immunosorbent assay for detection of Legionella soluble antigens. J. Clin. Microbiol. 24: 556–558.PubMedPubMedCentralGoogle Scholar
  166. Tatlock H. 1944. A rickettsia-like organism recovered from guinea pigs. Proc. Soc. Exp. Biol. Med. 57: 95–99.CrossRefGoogle Scholar
  167. Tatlock, H. 1982. Clarification of the cause of Fort Bragg Fever (pretibial fever)-January 1982. Rev. Infect. Dis. 4: 157–158.PubMedCrossRefGoogle Scholar
  168. Tenover, E C., P. H. Edelstein, L. C. Goldtein, J. C. Sturge, and J. J. Plorde 1986. Comparison of cross-staining reactions by Pseudomonas spp. and fluorescein-labeled polyclonal and monoclonal antibodies directed against Legionella pneumophila. J. Clin. Microbial. 23: 647–649.Google Scholar
  169. Tesh, M. J., S. A. Morse, and R. D. Miller 1983. Intermediary metabolism in Legionella pneumophila: utilization of amino acids and other compounds as energy sources. J. Bacteriol. 154: 1104–1109.PubMedPubMedCentralGoogle Scholar
  170. Thacker, S. B., J. V. Bennett, T. E Tsai, D. W. Fraser, J. E. McDade, C. C. Shepard, K. H. Williams, Jr., W. H. Stuart, H. B. Dull, and T. C. Eickhoff 1978. An outbreak of severe respiratory illness caused by the Legionnaires’ disease bacterium. J. Infect. Dis. 138: 512–519.PubMedCrossRefGoogle Scholar
  171. Thacker, L., R. M. McKinney, C. W. Moss, H. M. Sommers, M. L. Spivack, and T. F. O’Brien 1981. Thermophilic sporeforming bacilli that mimic fastidious growth characteristics and colonial morphology of Legionella. J. Clin. Microbiol. 13: 749–797.Google Scholar
  172. Thacker, W. L., B B. Plikaytis, and H. W. Wilkinson 1985. Identification of 22 Legionella species and 33 serotypes with the slide agglutination test. J. Clin. Microbiol. 21: 779–782.PubMedPubMedCentralGoogle Scholar
  173. Thomason, B. M., E. W. Chandler, and D. G. Hollis 1979. Flagella on Legionnaires’ disease bacteria: and interim report. Ann. Int. Med. 91: 224–226.PubMedCrossRefGoogle Scholar
  174. Thompson, M R, R. D. Miller, and B. H. Iglewski 1981. In vitro production of an extracellular protease by Legionella pneumophila. Infect. Immun. 34: 299–302.PubMedPubMedCentralGoogle Scholar
  175. Tison, D. L., D. H. Pope, W. B. Cherry, and C. B. fliermans 1980. Growth of Legionella pneumophila in association with blue-green algae (cyanobacteria). Appl. Environ. Microbiol. 39: 456–459.PubMedPubMedCentralGoogle Scholar
  176. Tobin, J. O., J. Beame, M. S. Dunnill, S. Fisher-Hoch, M. French, R. G. Mitchel, P. J. Morris, and M. E. Muers 1980. Legionnaires’ disease in a transplant unit: isolation of the causative agent from shower baths. Lancet 2: 118–121.PubMedCrossRefGoogle Scholar
  177. Tompkins, L. C., B. J. Roessler, S. C. Redd, L. E. Markovitz, and M. L. Cohen 1988. Legionella prosthetic valve endocarditis. JAMA 318: 530–535.Google Scholar
  178. Tompkins, L. S., N. J. Troup, T. Woods, W. Bibb, and R. M. McKinney 1987. Molecular epidemiology of Legionella species by restriction endonuclease and alloenzyme analysis. J. Clin. Microbiol. 25: 1875–1880.PubMedPubMedCentralGoogle Scholar
  179. Vickers, R. M., A. Brown, and G. M. Garrity 1981. Dye-containing buffered charcoal yeast extract medium for differentiation of members of the family Legionellaceae. J. Clin Microbiol. 13: 380–382.PubMedPubMedCentralGoogle Scholar
  180. Voss, L., K. S. Button, M. S. Rheins, and O. H. Tuovinen 1984. Sampling methodology for enumeration of Legionella sp. in water distribution systems, p. 292–294. In: C. Thornesberry, A. Balows, J. C. Feeley, and W. Jakubowsky (ed.), Legionella. Proceedings of the 2nd International Symposium. American Society for Microbiology, Washington.Google Scholar
  181. Wadowsky, R. M, L. J. Butler, M. K. Cook, S. M. Verma, M. A. Paul, B. S. Fields, G. Keleti, J. L. Sykora, and R. B. Yee 1988. Growth supporting activity for Legionella pneumophila in tap water cultures and Implication of hartmanellid amoebae as growth factors. Appl. Environ. Microbiol. 54: 2677–2682.PubMedPubMedCentralGoogle Scholar
  182. Wadowsky, R. M., and R. B. Yee 1981. A glycine-containing selective medium for isolation of Legionellaceae from environmental specimens. Appl. Environ. Microbiol. 42: 768–772.PubMedPubMedCentralGoogle Scholar
  183. Wadowsky, R. M., and R. B. Yee 1983. Satellite growth of Legionella pneumophila with an environmental isolate of Flavobacterium breve. Appl. Environ. Microbiol. 42: 1447–1449.Google Scholar
  184. Wadowsky, R. M., and R. B. Yee 1985. Effect of non-Legionellaceae bacteria on the multiplication of Legionella pneumophila in potable water. Appl. Environ. Microbiol. 49: 1206–1210.PubMedPubMedCentralGoogle Scholar
  185. Wadowsky, R. M., R. B. Yee, L. Mezmar, and J. N. Dowling 1982. Hot water systems as sources of Legionella pneumophila in hospital and non-hospital plumbing systems. Appl. Environ. Microbiol. 43: 1104–1110PubMedPubMedCentralGoogle Scholar
  186. Warren, W. J., and R. D. Miller 1979. Growth of Legionnaires’ disease bacterium (Legionella pneumophila) in a chemically defined medium. J. Clin. Microbiol. 10: 50–55.PubMedPubMedCentralGoogle Scholar
  187. Watkins, I. D., J. O. Tobin, R J. Dennis, W. Brown, R. Newham, and J. B. Kurtz 1985. Legionella pneumophila serogroup 1 subgrouping by monoclonal antibodies-an epidemiological tool. J. Hyg. 95: 211–216.Google Scholar
  188. Wilkinson, H. W. 1987. Hospital laboratory diagnosis of Legionella infections, p. 23–25. Centers for Disease Control, Atlanta.Google Scholar
  189. Wilkinson, H. W., D. D. Cruce, and C. V. Broome 1981. Validation of Legionella pneumophila indirect immunofluorescence using epidemic sera. J. Clin. Microbiol. 13: 139–146.PubMedPubMedCentralGoogle Scholar
  190. Wilkinson, H. W., A. L. Reingold, B. J. Brake, D. L. McGiboney, G. W. Gorman, and C. V. Broome 1983. Reactivity of serum from patients with suspected legionellosis against 29 antigens of Legionellaceae by indirect immunofluorescence assay. J. Infect. Dis. 147: 23–31.PubMedCrossRefGoogle Scholar
  191. Wilkinson, H. W., J. S. Sampson, and B. B. Plikaytis 1986. Evaluation of a commercial gene probe for identification of Legionella cultures. J. Clin. Microbiol. 23: 217–220.PubMedPubMedCentralGoogle Scholar
  192. Winn, W. C., G. S. Davis, D. W. Gump, J. E. Craighead, and H. E. Beaty 1982. Legionnaires’ pneumonia after intratracheal inoculation of guinea pigs and rats. Lab. Invest. 47: 568–578.PubMedGoogle Scholar
  193. Winn, W. C., Jr., and R. L. Myerowitz 1981. The pathology of the Legion pneumonias. A review of 74 cases and the literature. Hum. Pathol. 12: 401–422.PubMedCrossRefGoogle Scholar
  194. Yu, V. L., E J. Kroboth, A. Brown, S. McDearman, and M. Magnussen 1982. Legionnaires’ disease: new clinical perspectives from a prospective pneumonia study. Am. J. Med. 73: 357–361.PubMedCrossRefGoogle Scholar
  195. Zuravleff, J. L., V. L. Yu, and J. L. Shonnard 1983. Diagnosis of Legionnaires’ disease: and update of laboratory methods with new emphasis on isolation by culture. JAMA 250: 1981–1985.PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media New York 1992

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  • A. William Pasculle

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