AUTHOR=Vaccaro Lucianna , Gomes Thiago Santos , Izquierdo Fernando , Magnet Angela , Llorens Berzosa Sergio , Ollero Dolores , Salso Santiago , Alhambra Almudena , Gómez Carmen , López Cano María , Pelaz Carmen , Bellido Samaniego Beatriz , del Aguila Carmen , Fenoy Soledad , Hurtado-Marcos Carolina 

TITLE=Legionella feeleii: Ubiquitous Pathogen in the Environment and Causative Agent of Pneumonia

JOURNAL=Frontiers in Microbiology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2021.707187

DOI=10.3389/fmicb.2021.707187

ISSN=1664-302X

ABSTRACT=<p><italic>L. feeleii</italic> is one of the most frequent <italic>Legionella</italic> species isolated from natural pools of the central region of Spain. This study aimed to evaluate its ecology and to identify this <italic>Legionella</italic> species as a respiratory pathogen. A PCR assay for detecting the <italic>L. feeleii</italic> mip gene was developed to identify it in clinical and environmental samples. Culture and PCR were performed in environmental samples from four drinking water treatment plants (DWTPs). Free <italic>L. feeleii</italic> was only detected in raw water samples (3.4%), while <italic>L. feeleii</italic> as an <italic>Acanthamoeba</italic> endosymbiont was found in 30.7% of raw water, 11.5% of decanter biofilm, and 32% of finished water samples. Therefore, <italic>Acanthamoeba</italic> spp. plays an essential role in the multiplication, persistence, and spread of <italic>Legionella</italic> species in the environment. The first case of Legionnaires’ disease caused by <italic>L. feeleii</italic> in Spain is described in this study. The case was diagnosed in an older woman through PCR and sequencing from urine and sputum samples. A respiratory infection could be linked with health care procedures, and the patient presented several risk factors (age, insulin-dependent diabetes, and heart disease). The detection of non-<italic>L</italic>. <italic>pneumophila</italic>, such as <italic>L. feeleii</italic>, is a factor that must be considered when establishing or reviewing measures for the control and prevention of legionellosis.</p>