Occurrence of macrolides resistance in Legionella pneumophila ST188: Results of the Belgian epidemiology and resistome investigation of clinical isolates
Objectives: The incidence of Legionnaires’ disease steadily increases worldwide. Although Legionella pneumophila is known as pathogenic, systematic investigations into antibiotic resistance are scarce, and reports of resistance in isolates are recently emerging. Methods: Clinical cases and metadata...
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Elsevier
2025-04-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971225000104 |
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| author | Charlotte Michel Fedoua Echahidi Geraldine De Muylder Max Sewell Ian Boostrom Olivier Denis Owen B. Spiller Denis Pierard |
| author_facet | Charlotte Michel Fedoua Echahidi Geraldine De Muylder Max Sewell Ian Boostrom Olivier Denis Owen B. Spiller Denis Pierard |
| author_sort | Charlotte Michel |
| collection | DOAJ |
| description | Objectives: The incidence of Legionnaires’ disease steadily increases worldwide. Although Legionella pneumophila is known as pathogenic, systematic investigations into antibiotic resistance are scarce, and reports of resistance in isolates are recently emerging. Methods: Clinical cases and metadata reported to the Belgian National Reference Centre between 2011 and 2022 were retrospectively analyzed. A total of 283 clinical isolates were typed by core genome multi-locus sequence typing (cgMLST). Acquired genes or mutations triggering resistance were extracted from all of them. Results: The number of Legionnaires’ disease cases has increased in Belgium. Urinary antigen testing remains the main used test, but polymerase chain reaction and serology allow the diagnostic in 14.8% and 2.4% of cases, respectively. cgMLST showed a good discrimination between sequence typing (ST) and minimal variation for ST47 isolates, whereas ST1s were more diverse. Genotypic screening identified a 23S ribosomal RNA mutation linked to a high-level macrolide resistance in one isolate of ST188, which is genetically closed to resistant isolates from France. Conclusion: The increase in incidence is of concern and likely an under-estimate due to the reliance on urine antigen testing. Routine typing by cgMLST allows good discrimination and the first clinical isolate reported as resistant for macrolides was cultured, underscoring the need to define resistance breakpoints and incorporate antimicrobial susceptibility testing as routine clinical investigation practice. |
| format | Article |
| id | doaj-art-afdbac6eaff14cd0a98103c7f45cbf53 |
| institution | Kabale University |
| issn | 1201-9712 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj-art-afdbac6eaff14cd0a98103c7f45cbf532025-02-12T05:30:44ZengElsevierInternational Journal of Infectious Diseases1201-97122025-04-01153107786Occurrence of macrolides resistance in Legionella pneumophila ST188: Results of the Belgian epidemiology and resistome investigation of clinical isolatesCharlotte Michel0Fedoua Echahidi1Geraldine De Muylder2Max Sewell3Ian Boostrom4Olivier Denis5Owen B. Spiller6Denis Pierard7National reference centre for Legionella pneumophila, Department of Microbiology, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels, Belgium; Corresponding authorNational reference centre for Legionella pneumophila, Department of Microbiology, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels, BelgiumDepartment of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050 Brussels, BelgiumDepartment of Medical Microbiology, Cardiff University School of Medicine, 6th floor University Hospital of Wales, Cardiff, Wales, CF14 4XN, UKDepartment of Medical Microbiology, Cardiff University School of Medicine, 6th floor University Hospital of Wales, Cardiff, Wales, CF14 4XN, UKNational reference centre for Legionella pneumophila, Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles (LHUB-ULB), Rue Haute 322, 1000 Brussels, BelgiumDepartment of Medical Microbiology, Cardiff University School of Medicine, 6th floor University Hospital of Wales, Cardiff, Wales, CF14 4XN, UKNational reference centre for Legionella pneumophila, Department of Microbiology, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels, BelgiumObjectives: The incidence of Legionnaires’ disease steadily increases worldwide. Although Legionella pneumophila is known as pathogenic, systematic investigations into antibiotic resistance are scarce, and reports of resistance in isolates are recently emerging. Methods: Clinical cases and metadata reported to the Belgian National Reference Centre between 2011 and 2022 were retrospectively analyzed. A total of 283 clinical isolates were typed by core genome multi-locus sequence typing (cgMLST). Acquired genes or mutations triggering resistance were extracted from all of them. Results: The number of Legionnaires’ disease cases has increased in Belgium. Urinary antigen testing remains the main used test, but polymerase chain reaction and serology allow the diagnostic in 14.8% and 2.4% of cases, respectively. cgMLST showed a good discrimination between sequence typing (ST) and minimal variation for ST47 isolates, whereas ST1s were more diverse. Genotypic screening identified a 23S ribosomal RNA mutation linked to a high-level macrolide resistance in one isolate of ST188, which is genetically closed to resistant isolates from France. Conclusion: The increase in incidence is of concern and likely an under-estimate due to the reliance on urine antigen testing. Routine typing by cgMLST allows good discrimination and the first clinical isolate reported as resistant for macrolides was cultured, underscoring the need to define resistance breakpoints and incorporate antimicrobial susceptibility testing as routine clinical investigation practice.http://www.sciencedirect.com/science/article/pii/S1201971225000104Legionella pneumophilaEpidemiologyGenomic investigationGenotypic resistanceAntimicrobial resistanceMacrolide resistance |
| spellingShingle | Charlotte Michel Fedoua Echahidi Geraldine De Muylder Max Sewell Ian Boostrom Olivier Denis Owen B. Spiller Denis Pierard Occurrence of macrolides resistance in Legionella pneumophila ST188: Results of the Belgian epidemiology and resistome investigation of clinical isolates International Journal of Infectious Diseases Legionella pneumophila Epidemiology Genomic investigation Genotypic resistance Antimicrobial resistance Macrolide resistance |
| title | Occurrence of macrolides resistance in Legionella pneumophila ST188: Results of the Belgian epidemiology and resistome investigation of clinical isolates |
| title_full | Occurrence of macrolides resistance in Legionella pneumophila ST188: Results of the Belgian epidemiology and resistome investigation of clinical isolates |
| title_fullStr | Occurrence of macrolides resistance in Legionella pneumophila ST188: Results of the Belgian epidemiology and resistome investigation of clinical isolates |
| title_full_unstemmed | Occurrence of macrolides resistance in Legionella pneumophila ST188: Results of the Belgian epidemiology and resistome investigation of clinical isolates |
| title_short | Occurrence of macrolides resistance in Legionella pneumophila ST188: Results of the Belgian epidemiology and resistome investigation of clinical isolates |
| title_sort | occurrence of macrolides resistance in legionella pneumophila st188 results of the belgian epidemiology and resistome investigation of clinical isolates |
| topic | Legionella pneumophila Epidemiology Genomic investigation Genotypic resistance Antimicrobial resistance Macrolide resistance |
| url | http://www.sciencedirect.com/science/article/pii/S1201971225000104 |
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