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2016 ; 93
(ä): 276-288
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Determination of viable legionellae in engineered water systems: Do we find what
we are looking for?
#MMPMID26928563
Kirschner AKT
Water Res
2016[Apr]; 93
(ä): 276-288
PMID26928563
show ga
In developed countries, legionellae are one of the most important water-based
bacterial pathogens caused by management failure of engineered water systems. For
routine surveillance of legionellae in engineered water systems and outbreak
investigations, cultivation-based standard techniques are currently applied.
However, in many cases culture-negative results are obtained despite the presence
of viable legionellae, and clinical cases of legionellosis cannot be traced back
to their respective contaminated water source. Among the various explanations for
these discrepancies, the presence of viable but non-culturable (VBNC) Legionella
cells has received increased attention in recent discussions and scientific
literature. Alternative culture-independent methods to detect and quantify
legionellae have been proposed in order to complement or even substitute the
culture method in the future. Such methods should detect VBNC Legionella cells
and provide a more comprehensive picture of the presence of legionellae in
engineered water systems. However, it is still unclear whether and to what extent
these VBNC legionellae are hazardous to human health. Current risk assessment
models to predict the risk of legionellosis from Legionella concentrations in the
investigated water systems contain many uncertainties and are mainly based on
culture-based enumeration. If VBNC legionellae should be considered in future
standard analysis, quantitative risk assessment models including VBNC legionellae
must be proven to result in better estimates of human health risk than models
based on cultivation alone. This review critically evaluates current methods to
determine legionellae in the VBNC state, their potential to complement the
standard culture-based method in the near future, and summarizes current
knowledge on the threat that VBNC legionellae may pose to human health.