An application for relating Legionella shower water monitoring results to estimated health outcomes.

Exposure models are useful tools for relating environmental monitoring data to expected health outcomes. The objective of this study was to (1) compare two Legionella shower exposure models, and (2) develop a risk calculator tool for relating environmental monitoring data to estimated Legionella infection risks and Legionnaires' Disease (LD) illness risks. Legionella infection risks for a single shower event were compared using two shower Legionella exposure models. These models varied in their description of partitioning of Legionella in aerosols and aerosol deposition in the lung, where Model 1 had larger and fewer aerosol ranges than Model 2. Model 2 described conventional vs. water efficient showers separately, while Model 1 described exposure for an unspecified shower type (did not describe it as conventional or water efficient). A Monte Carlo approach was used to account for variability and uncertainty in these aerosolization and deposition parameters, Legionella concentrations, and the dose-response parameter. Methods for relating infection risks to illness risks accounting for demographic differences were used to inform the risk calculator web application ("app"). Model 2 consistently estimated higher infection risks than Model 1 for the same Legionella concentration in water and estimated deposited doses with less variability. For a 7.8-min shower with a Legionella concentration of 0.1 CFU/mL, the average infection risks estimated using Model 2 were 4.8 × 10-6 (SD=3.0 × 10-6) (conventional shower) and 2.3 × 10-6 (SD=1.7 × 10-6) (water efficient). Average infection risk estimated by Model 1 was 1.1 × 10-6 (SD=9.7 × 10-7). Model 2 was used for app development due to more conservative risk estimates and less variability in estimated dose. While multiple Legionella shower models are available for quantitative microbial risk assessments (QMRAs), they may yield notably different infection risks for the same environmental microbial concentration. Model comparisons will inform decisions regarding their integration with risk assessment tools. The development of risk calculator tools for relating environmental microbiology data to infection risks will increase the impact of exposure models for informing water treatment decisions and achieving risk targets.

Virulence of Listeria monocytogenes Propagated in NaCl Containing Media at 4, 25 and 37°C.

Virulence, as determined in a mouse model, and virulence factor activities of catalase (CA), superoxide dismutase (SOD) and listeriolysin O (LLO), was examined in Listeria monocytogenes 10403S. Cells were propagated in media containing various concentrations of sodium chloride (NaCl) at 4, 25 and 37°C. Strain 10403S exhibited significant increases in CA activity and LLO when grown in media containing 428 mM of NaCl at 37°C. The CA activities at 4 and 25°C were significantly less, and the cells exhibited similar increases and decreases as cells grown at 37°C. When comparing the growth temperatures, the CA activity decreased as the growth temperature decreased. The SOD activity was significantly increased only when cells were propagated in media containing either 428 or 1,112 mM of NaCl. The SOD activity increased as the growth temperature decreased. No LLO activity was detected when cells were grown at 4 and 25°C. The production of these enzymes appeared to be thermoregulated. In addition, approximate lethal dose (ALD50) values were determined after intragastric (i.g.) and intraperitoneal (i.p.) infection. Each method of infection indicated that LLO was required for virulence, while growth in salt containing media, growth at 4°C, or the production of higher levels of CA, SOD and LLO did not appear to influence the virulence of L. monocytogenes .

Catalase, Superoxide Dismutase and Listeriolysin O Production by Listeria monocytogenes in Broth Containing Acetic and Hydrochloric Acids.

Cells of Listeria monocytogenes 10403S were propagated at 37°C in media acidified with either acetic or hydrochloric acid to determine the effect on the production of catalase (CA), superoxide dismutase (SOD) and listeriolysin O (LLO). The CA and LLO activities decreased while SOD activity increased as the pH of the growth media was decreased. Comparison of the acids indicated that neither acid caused significant differences in enzyme production except for SOD activity at pH 5.7. These results suggest that growth of L. monocytogenes in acid environments may influence the production of these enzymes, while growth in strong acids versus weak acids may not be significantly different.