Integrated approach for legionellosis risk analysis in touristic-recreational facilities

Legionellosis is a severe pneumonia caused by the inhalation of aerosols containing Legionella , Gram-negative bacteria present in water systems touristic-recreational facilities. The purpose this study was to develop scoring tool predict risk both environmental contamination and Legionnaires' disease cases such facilities Apulia region southern Italy. We analyzed 47 structural management parameters/risk factors related buildings, systems, air conditioning at A Poisson regression model used compute an overall score for each facility with respect three outcomes: samples positive (risk range: 7–54), average load exceeding 1000 colony-forming units per liter (CFU/L) 22–179,871), clinical Legionnaire's 6–31). cut-off values outcomes were determined receiver operating characteristic curves (first outcome, facility: 19; second CFU/L: 2062; third 22). Above these values, there significant probability observing outcome. constructed predictive using 70% large dataset (18 years surveillance) tested on remaining 30% demonstrate its reliability. Our enables assessment touristic creation conceptual framework link analysis prevention measures.