Thus, when a case of legionellosis is recognized others may become infected from the same source if appropriate control measures are not taken

to reduce the risk of further transmission. The source of the outbreak or incident can be determined by epidemiological investigation together with characterization of legionellae isolated from patients and putative environmental sources [1, 2]. As the vast majority of cases of legionellosis are caused by Legionella pneumophila, and this species is very common in the environment, discriminatory typing methods are needed to differentiate between isolates if a convincing epidemiological link between patient and source is to be established. Consequently a large number of molecular methods Idasanutlin in vitro have been investigated for epidemiological typing purposes and one of these, devised by members of the European LY2228820 nmr Working Group for Legionella Infections (EWGLI) and termed sequence-based typing (SBT), has become PXD101 in vivo established internationally as the typing method of choice [3, 4]. This method is a variant of the classic multi-locus sequence typing (MLST) schemes used to identify bacterial lineages, the utility of which has been previously described [5]. The availability of a substantial quantity of international SBT typing data has led to the recognition that the majority of legionellosis is caused by a relatively small subset of all strains recovered from

the environment [6, 7]. This poses the question of whether some clonal lineages have characteristics that make them more likely to cause human infection than others that are more, or equally, prevalent in the environment [6]. Requirements to answer this question

are; a means to subdivide the L. pneumophila population into clusters which are genetically similar so that we can describe the shared phenotypes of these clusters, and knowledge of the frequency Resveratrol of horizontal gene transfer (HGT) and recombination. This latter is crucial since these molecular events may result in the rapid development of novel phenotypes previously unseen in a clonal lineage and high levels of recombination may make clustering of organisms into related groups problematic [8]. Early studies using electrophoretic analysis of protein polymorphism (multi locus enzyme electrophoresis, MLEE) described 62 electrophoretic types and concluded that L. pneumophila was clonal in nature [9]. More recently a study examining four genes in the dot/icm complex [10] demonstrated clear evidence of intraspecific genetic exchange in L. pneumophila. Whilst initial studies using SBT data [11, 12] supported evidence for the clonal nature of L.pneumophila, it was acknowledged that intergenic recombination events could not be ruled out. Subsequent work analysing intragenic recombination in the six SBT loci and additional non-coding loci concluded that recombination was frequent in Legionella spp. [13, 14].