nspf 2016 water-id -biotica presentation
TRANSCRIPT
1 hour Legionella spp. Test with a
Multi-Parameter Photometer using
JENCOLOR optic system
Presented by:
Andreas Hock CEO Water-i.d. GmbH
(Germany)
José Luis Alarcón International Sales / Biotica
(Spain)
LEGIONELLA – What is it?
‘‘Legionella‘‘ is the name of a bacteria group with
at least 50 species and 70 serogroups identified. The name ‘‘Legionella“ results from when an outbreak occured in July 1976 in Philadelphia during a convention of the Amercan Legion, an association of U.S. military veterans. 221 people became ill and 34 of them died because of a Legionella outbreak caused by the air-conditioning system. Once the formerly unknown bacteria was identified by the CDC in January 1977, it was called ‘‘Legionella‘‘ in reference to the outbreak in July 1976. Source: www.Wikipedia.org
LEGIONELLA – Species and Impact
One of the 50 Legionella species identified is called ‘‘Legionella pneumophila‘‘ and its serogoup ‘‘1“ is responsible for causing the Pontiac fever or even Pneumonia (lung infection) which is then called ’’Legionnaires’ disease“. Swallowing contaminated water is less of a concern. Legionella species need to be inhaled in order to grow in humans’ lungs and cause Pontiac fever and/or Pneumonia. Legionella bacteria prefer to grow in standing waters and in an environment of 25°C-50°C (77°F – 122°F). Temperatures above 60°C (140°F) and treatment with disinfectants, such as chlorine dioxide, will kill Legionella bacteria.
Source: www.Wikipedia.org
Source: CDC
LEGIONELLA – Where are they?
Legionella bacteria can be found in naturally occuring freshwater environments such as lakes and streams. It becomes a health concern when Legionella pneumophila serogroup 1 grows, spreads in human-made water systems (25 – 50°C / 77 – 122°F) and gets inhaled. Human-made water systems can be: • Hot water tanks and heaters • Large plumbing systems • Hot tubs and spas • Showers • Cooling towers and even car washes • Air conditioning systems for big buildings • Decorative Fountains
Source: www.google.com
LEGIONELLA – Previous OUTBREAKS
Once 2 or more people fall sick after inhaling mist contaminated with Legionella bacteria, it is called a Legionella outbreak. Common places for Legionella outbreaks are hotels, hospitals, cruise ships, … anything which is associated with buildings or structures which use complex water systems or huge cooling facilities. Legionella can travel huge distances. Cases of infection have been reported at a radius of up to 6 miles away from the source. Once Legionella reaches our lungs, it will begin to colonize, and in a few days Pneumonia can develop. Legionellosis is a systemic infectious disease that primarily affects the lungs and has a mortality rate between 5% to 30%. Of the total cases reported, 95-98% can be attributed to Legionella pneumophila with an average mortality rate of 12-15%, easily reaching 30-50% when people with weakened immunities, or those without instant access to antibiotica, are affected.
Source: CNN
Source: ABC7NY
Source: ABC7NY
Source: worldpress.com
Legionella outbreaks happened long before the bacteria was identified by the CDC in 1977. To list just a few examples of outbreaks before and after the identification: Hormel Foods Corporation/Austin (1957): 78 people infected (plant‘s cooling tower) St. Elisabeth hospital/Washington D.C. (1965): 81 people infected, 14 died (sprinkling water system) Health department/Pontiac (1968):144 people infected (leak in building‘s air duct) Bellevue Straford hotel/Philadelphia (1974): 20 people infected, 2 died (air conditioning) Benidorm/Spain (1973-1980): 150 British tourists infected (potable water system) Los Angeles Wadsworth hospital/LA (1981-1997): 250 people infected (potable water system) Several towns in West Virginia (1996): 23 people infected (whirlpool spa in a show room) Stafford district hospital/England (1985): 175 people infected, 28 died (air conditioning/cooling tower) Flower exhibition/the Netherlands (1990): 318 people infected, 32 died Norway (2005) 56 infected/10 died; Spain (2001): 800 infected, 6 died; Nursing home in Toronto/Canada (2005): 21 died; Melbourne/Australia (2000): 125 infected, 4 died
LEGIONELLA – Previous OUTBREAKS
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Apartment complex in West Harlem / NY (July 2016): 2 people infected Plant in Marietta/Georgia (July 2016): 2 people infected Personal care home Middletown/PA (June 2016): 4 people infected, 2 died Hotel in Blowing Rock/NC (June 2016): 3 people infected Condo in Ocean City/MD (June 2016): 2 people infected Sydney/Australia (March 2016): 9 people infected, 1 died Manzanares/Spain (January 2016): 230 people infected, 3 died (fountain) Morris Park/NY (July-Sept 2015): 133 people infected, 12 died Quebec/Canada (08/2015): 18 people infected, 2 died (cooling tower) San Quentin/CA (08/2015): 30 people infected Veterans Nursing home/IL (08/2015): 54 people infected, 12 died NYC/NY (07/2015): 120 people infected, 12 died According to CDC, each year between 8,000 and 18,000 cases are identified in the US alone! See a list of outbreaks under: https://en.wikipedia.org/wiki/List_of_Legionnaires%27_disease_outbreaks All 2016‘s outbreaks under: http://hcinfo.com/about/outbreaks/recent/
LEGIONELLA – 2015 and 2016 OUTBREAKS
Source: www.claritywatertech.com
LEGIONELLA – How to TEST it?
As with all microorganisms, the common method of testing is to add it to a suitable agar and to let it grow and become visible. This method is called ‘‘culture method‘‘ where a sample of 1 litre of water is filtered and the filtered Legionella are plated on agar and then incubated to encurage growth. The major disadvantage of this method is that it takes about 10 to 14 days to let the bacteria grow enough to become countable In most cases, there is just not enough time to wait 2 weeks to receive a result, but because the bacteria takes this long to grow, there is just no other choice. The major disadvantage of having to wait for almost 2 weeks can lead to: • Closed facilities after a Legionella contamination while waiting for confirmation that the measures taken have lead to a the contamination being erased • A risk of infections / human losses Meanwhile, there are multiple rapid tests but none of them has been officially approved as equal to and to replace the culture method.
Source: www.Wikipedia.org
LEGIONELLA – RAPID tests
Source: Biotica
As mentioned in the previous slide, there are various rapid Legionella tests available but besides the LEGIPID® method, none can compete with the officially recognized culture method. A very common rapid method might be the PCR method. Besides a quite high investment of many thousand US$, PCR‘s biggest disadvantage is that so called ‘‘false positive“ results might be displayed due to the fact that PCR also detects non-viable and dead Legionella as well as free DNA. Following a Legionella contamination and subsequent disinfection, PCR will not help to get an accurate picture unless the sample is pre-treated to remove the dead Legionella. Fast Path is another popular rapid test for Legionella. The disadvantage of this method is that the detection limit is 100,000 cfu/L (colony forming units per litre), whereas 500 cfu/L is already considered a danger and 5,000 cfu/L requires action (disinfection, closing of facility…). Besides that, FastPath detects Legionella pneumorphila serogroup 1 only. In line with the previous slides and the above explanation, only the culture method is officially recognized and is required to comply with national regulations. LEGIPID®, as a new and innovative approach to testing Legionella, has recently been accredited as a Legionella testing method in labs in Australia and Spain.
Source: www.rapidmicrobiology.com
Source: www.nalco.com
LEGIONELLA – RAPID tests
LEGIONELLA – LEGIPID ®
WEEKS
DAY
HOUR!!
Scope
Isolate
Identify
Detect
Strategy
GROWTH
bacteria
AMPLIFY
gen sequence
CONCENTRATE
bacteria
Intended Use
EPIDEMIOLOGY
(DISEASE)
EPIDEMIOLOGY
(DISEASE)
PREVENTION
(WATER)
IMMUNODETECTION immobilization of antibodies onto the surface of magnetic beads
Outbreak (year)
% Mortality
Use of Legipid
NYC/NY (2015) 10
Veterans Nursing home/IL (2015)
22.22
Morris Park/NY (2015)
9.03
Manzanares /Spain (2015)
1.30
LEGIONELLA – LEGIPID ®
LEGIONELLA – outbreak time schedule DAY
0
1
2 3 4 5 6 7 8 9
10 11 12
DAY
0
1
2
HOW DOES IT WORK? PRODUCT PRESENTATIONS
APPLICATIONS
MAIN ADVANTAGES
LEGIONELLA – LEGIPID ®
LEGIONELLA – LEGIPID ® how does it work? LEGIPID ® is a patented method for testing Legionella species without the need to let the bacteria grow. Because of this, the time of the test can be reduced from 14 days to just 1 hour with no impact on accuracy. On the contrary, LEGIPID ® even allows testing on ranges as low as 60 cfu/L and up to 106 cfu/L How does it work? As with all Legionella tests, first a water sample of 1 litre needs to be filtered to concentrate any Legionella present. Filtered Legionella are then released by a first reagent (10ml). A second reagent is added in next step. This reagent contains magnetic microparticles, covered with antibodies binding to living Legionella. This binding is selective only to viable cells in order to reduce false positive results. Due to the magnetic core of the micro particles, which are now bound to the living Legionella, both can be pulled aside with a magnet while the rest of the liquid is removed. Several washing steps with different reagents follow, before a color tracer, again combined with antibodies, is added to attach to the microparticles joined to the Legionella. Depending on the quantity of such units which are created, the color of the solution turns more or less intense. The color obtained can be compared to a colour chart or can be accurately read by the PrimeLab Multitest Photometer.
POLYSTYRENE
MAGNETITE
The particles join to the specific antibody - antigen
S
P Antigen Antigen
Magnetic immunobeads
POLYSTYRENE
MAGNETITE
LEGIONELLA – LEGIPID ® how does it work?
Result
2 minutes stop
read absorbance
by colorimeter
compare with
colour chart
LEGIONELLA – LEGIPID ® how does it work?
LEGIONELLA – LEGIPID ®
HOW DOES IT WORK? PRODUCT PRESENTATIONS
APPLICATIONS
MAIN ADVANTAGES
LEGIONELLA – LEGIPID ®
LEGIONELLA – LEGIPID ® presentations
1 2
5
15
MP4-00 40 / 100 Test Kit
Automated dosage
MP4-SP 10 Test Kit
Manual dosage
1 control
+
3 samples
1 control + up
to 19 samples
HOW DOES IT WORK? PRODUCT PRESENTATIONS
APPLICATIONS
MAIN ADVANTAGES
LEGIONELLA – LEGIPID ®
PrimeLab &
Legipid® Legionella Fast Detection won the
Innovative Products Awards at
Piscina & Wellness 2015 (Barcelona, Spain)
LEGIONELLA – LEGIPID ®
LEGIONELLA – LEGIPID ® applications
Outbreak
SAFETY PLAN
Evaluation
CULTURE
ACTION
positive
Positive
Legipid
NO FURTHER ACTION
Negative
103
104
>104
Timely management action
WATER MANAGEMENT BY LEGIPID®
Monitoring critical
points
Mapping risks
Inspection and self-control LEGIONELLA – LEGIPID ® applications
HOW DOES IT WORK? PRODUCT PRESENTATIONS
APPLICATIONS
MAIN ADVANTAGES
LEGIONELLA – LEGIPID ®
Test result in 1 hour. Rapid method that allows timely remedial actions
Quantitative (60 – 106 cfu/L)
Only living Legionella detected
Validated and AOAC certified
Patented technology
Successfully tested by EM-lab (ELITE)
Cost-effective:
- affordable hardware (from $500 on)
- affordable reagents costs (from $25/test)
It can be easily implemented and accredited
Accepted for S.P. Control by national authorities
LEGIONELLA – LEGIPID ®
PrimeLab 1.0 Multitest
More than 140 parameter methods due to JENCOLOR sensor
Only Photometer worldwide covering 400 wavelengths
simultaneously
Choose and pay for only those parameters you really need
Powerful software and App
Free cloud service for instant synch between PrimeLab,
software and App
Activate more parameters at any time
Dosage recommendations at a push of a button, based on
your individual water treatment chemicals
Easy reporting as test results are always linked to accounts
(water bodies)
PrimeLab 1.0 Multitest
Any questions? Please ask!