nspf 2016 water-id -biotica presentation

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

https://en.wikipedia.org/wiki/List_of_Legionnaires'_disease_outbreaks

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 – 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 ® 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?


APPLICATIONS

MAIN ADVANTAGES


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


APPLICATIONS

MAIN ADVANTAGES


PrimeLab &

Legipid® Legionella Fast Detection won the

Innovative Products Awards at

Piscina & Wellness 2015 (Barcelona, Spain)


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


APPLICATIONS

MAIN ADVANTAGES


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


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!

nspf 2016 water-id -biotica presentation

Technology