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1. 2. 1. 1 1 BCYEα 2 BCYEα 2 1 acid treatment 2 heat treatment 3 4 1 2 3 4 5 2. 1 1 Gimenez stain 2 3. 1 2 3

1 PCR L. pneumophila 2 DNA-DNA 3 1 5. (DNA) 1 2 6. 1 2 7. 1 (PFGE) 2 Sequence Based Typing (SBT) 3 Multiple-Locus Variable number tandem repeat (VNTR) Analysis (MLVA) 1. Legionella sp. 2 3. 1 L. pneumophila 1 2 L. cherrii 4. 1. 52

Legionella 5 66 3 5 1,2) 2 10 39 48 3) 1976 the Legion Legionella pneumophila Legionellaceae 1979 2011 8 52 http://www.bacterio.cict.fr/l/legionella.html Legionella pneumophila 3 fraseri, pascullei, pneumophila L. lytica L. drancourtii Legionella Legionella Fluoribacter Tatlockia P2 BSL2 2

1. 2 3 5 6 0 4-70 -80 2 8 2-20 2. 500 ml 25% 1/500 ph 6 18 4 8

PCR DNA PCR DNA 12 1 14 2 http://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-04-39.html 1 Legionella Legionella pneumophila 2 3 2 12 1 2 12 1

2 12 1 2 12 1 PCR 1 128 256 1 2

1. 1 3 3 6 L- 1 BCYEα buffered charcoal-yeast extract agar with 0.1 α-ketoglutalate ph 6.90±0.05 36±1 3 2 30 35 4 4 2 BCYEα BCYEα

100 ml (CFU/100 ml) 10 L- L- PCR (1) BCYEα ACES Buffer α- A Bacto agar L- L- 10 g 10 g 2.8 g 1 g 2 g 17 g 980 ml 0.4 g 10 ml 0.25 g 10 ml 121 15 50 0.22 μm L- 15 ml 20 ml (2) BCYEα BCYEα 1

BMPAα GVPC MWY WYO CCVC PAV B B B B B 80,000 U 4 mg 80 mg 80,000 U 1 mg 3 g 80 mg 50,000 U 1 mg 3 g 80 mg 10 mg 10 mg 100,000 U 5 mg 3 g 80 mg 4 mg 16 mg 0.5 mg 80 mg 40,000 U 80 mg 0.5 mg 50 BCYEα

1 BCYEα WYOα GVPC MWY CCVC PAC(BMPAα) PAV OXOID BD OXOID OXOID BD 4 BD 4 BD 4 Oxoid BD Difco BBL Oxoid BD Difco BMPAα MWY GVPN Oxoid GVPN GVPC Difco ACES Buffer 1 1.5 g 4 3

2 Bacillus (1) acid treatment ph 2.2 0.2M 5.3 ml 0.2M 25 ml 100 ml 25 4 5 5 20 0.1M 23.0 g/l 0.1M 21.0 g/l ph 2.2 (2) heat treatment 50 30 20 20 60 4

3 L- BCYE 5 BCYEα IsoVital X L. jordanis L. spiritensis L. oakridgensis L- 4 2 200 ml 3,000 g 5,000 7,000 rpm 30 20 2 ml 100 500 ml 47 mm 0.2 0.22 μm 5 ml 5 10 voltex mixer 100 20 KHz 130 W 24

5) 100 μl 2 2 100 μl 1 200 μl 20 KHz 130 W 24 10 2~3 100 μl 2 3 2 30~35 2

2. Gimenez Warthin-Starry 1 Gimenez stain a. 1 g 95 10 ml b. 1 ml 24 ml c. 65 ml a b c 37 48 a. 0.2M 2.84 g 100 ml b. 0.2M 2.76 g 100 ml a 3.5 ml b 15.5 ml 19.0 ml 1 ml 0.1M 9 ml 0.8 g 100 ml

30 6 9 6 9 2 fluorescent isothiocyanate FITC IFA IFA L. pneumophila 6 PBS ph7.2 NaH 2 PO 4 2H 2 O 9 g Na 2 HPO 4 12H 2 O 64.54 g NaCl 160 g 20 L ph 7.2 4 ph 9.0 9

0.2M Na 2 HPO 4 1 4 IFA 10 15 37 30 PBS ph 7.2 PBS 5 2 2 FITC 4

3. 1 L. pneumophila 15 70 DNA-DNA hybridization mip (macrophage infectivity potentiator gene) L. pneumophila 1 L. pneumophila 15 1 L. bozemanae L. longbeachae L. feeleii L. hackeliae L. quinlivanii L. sainthelensi L. spiritensis L. erythra 2 L. pneumophila 1 6 L. bozemanae 1 L. gormanii L. dumoffii L. micdadei 10 L. pneumophila 7 15 L. longbeachae 1 L. longbeachae 2 L. hacckeliae 1&2 L. feeleii 1 L. feeleii 2 Oxoid L. pneumophila 1 L. pneumophila 2-14 L. longbeachae 1 2 L. bozemanae 1 2 L. dumoffii L. gormanii L. jordanis L. micdadei L. anisa 60 L. pneumophila 1 L. pneumophila BCYEα McFarland No. 7 5 10 10 /ml 100 1 121 30 3,000 3,500 rpm 15 1 3

5 L. bozemanae L. dumoffii L. gormanii L. micdadei DDH 2 Duopath Legionella 30 L. pneumophila 3) (1) PCR L. pneumophila L. pneumophila PCR LEG Lmip PCR LEG (genus Legionella 16S rrna gene) Lmip (L. pneumophila macrophage infectivity potentiator gene) PCR L. pneumophila LEG Legionella sp. LEG LEG 448A 5 -GAGGGTTGATAGGTTAAGAGC-3 LEG 854B 5 -CGGTCAACTTATCGCGTTTGCT-3 Lmip Mahbubani Lmip L920 5 -GCTACAGACAAGGATAAGTTG-3 Lmip R1548 5 -GTTTTGTATGACTTTAATTCA-3 BCYE-α 1 μl 50 μl 100 5 15,000 rpm 5 2 μl LEG PCR (2 46 μl) 10 reaction buffer 5.0 μl dntp mixture 4.0 μl ultra-pure water 35.75 μl LEG F (20 μm)0.5 μl LEG R (20 μm)0.5 μl Taq polymerase (5 U/μl) 0.25 μl 200 μl PCR 23 μl

2 μl PCR 94 60 61 60 72 60 40 3% 430 bp Lmip 94 60 50 60 72 60 35 PCR 650 bp EmviroAmp Legionella Kit PCR 5S rrna : Forward primer (5-29) 5'-GGCGACTATAGCGPTTTGGAA-3' Reverse primer (91-112) 5'-GCGATGACCTACTTTCPCATGA-3' mip L. pneumophila : Forward primer (948-965) 5'-GCATTGGTGCCGATTTGG-3' Reverse primer (1092-1115) 5'-GRTTTGCCATCAAATCTTTRTGAA-3' *P=A/G, R=C/T DNA 20 µl 100 10 spin down 10,000 rpm PCR 25 µl Forward primer 10 pmol/µl 1 µl Reverse primer 10 pmol/µl 1 µl 10 Reaction buffer 2.5 µl 2.5 mm dntp mixture 2 µl Chromosomal DNA 0.5 µl Ultra-pure water 14.8 µl AmpliTaq DNA polymerase 0.2 µl Perkin Elmer Model 9700 2 3

2 95 30 95 30 63 45 30 72 7 3 95 30 95 30 55 30 72 30 30 72 7 2% 5 µl 5S rrna 108 bp mip 168 bp 5S rrna mip PCR mip PCR LAMP Loop-mediated Isothermal Amplification L. londiniensis LAMP (2) DNA-DNA DNA 70% DNA-DNA L. pneumophila 25 DNA DDH DNA-DNA 4 L. busanensis L. gresilensis L. londiniensis L. natarum L. quinlivanii L. geestiana

(3) 16S rrna PCR DNA 20 μl 100 10 spin down 10,000 rpm 27f Forward primer (8-27) 5'-AGAGTTTGATCCTGGCTCAG-3' 1429r Reverse primer (1492-1510) 5'-GGCTACCTTGTTACGACTT-3' PCR 25 μl Forward primer 2 pmol/μl 2.5 μl Reverse primer 2 pmol/μl 2.5 μl 10 Reaction buffer 2.5 μl 2.5 mm dntp mixture 2.5 μl Chromosomal DNA 2.5 μl Ultra-pure water 12.25 μl AmpliTaq DNA polymerase 0.25 μl 95 2 95 1 50 1 72 1 30 30 72 5 4 PCR QIAquick PCR Purification Kit QIAGEN 1 PCR 5 PB buffer 2 2 ml collection tube QIAquick spin column

3 10,000 g 60 4 collection tube QIAquick spin column 5 0.75 ml PE buffer QIAquick spin column 6 10,000 g 60 7 collection tube QIAquick spin column 8 PE buffer 10,000 g 60 9 1.5 ml tube QIAquick spin column 10 EB buffer 50 μl QIAquick spin column 11 1 12 10,000 g 60 13 r1l Reverse primer (518-536) 5'- GTA TTA CCG CGG CTG CTG G -3' r2l Reverse primer (803-821) 5'- CAT CGT TTA CGG CGT GGA C -3' r2l Reverse primer (786-805) 5'- GAC TAC CAG GGT ATC TAA TC -3' r3l Reverse primer (1093-1111) 5'- TTG CGC TCG TTG CGG GAC T -3' r4l Reverse primer (1389-1406) 5'- ACG GGC GGT GTG TAC AAG -3' re1l Forward primer (327-345) 5'-GTA GGA GTC TGG ACC GTG T-3' f1l Forward primer (9-27) 5'- GAG TTT GAT CCT GGC TCA G-3' f2l Forward primer (518-536) 5'- CCA GCA GCC GCG GTA ATA C-3' 926f Forward primer (907-926) 5'- AAA CTC AAA GGA ATT GAC GG-3' f3l Forward primer (1094-1112) 5'- GTC CCG CAA CGA GCG CAA C -3' BigDye Terminator v3.1 Cycle Sequencing Kit 96 1 96 10 50 5 60 4 25 4

Applied Biosystems 3130/3130xl Genetic Analyzer 500 bp DNA Data Bank of Japan BLAST version 2.2.24 http://blast.ddbj.nig.ac.jp/top-j.html 16S rrna mip http://www.hpa.org.uk/cfi/bioinformatics/dbases.htm 16S rrna L. londiniensis L. nautarum L. nautarum

4 1) 15 70-80% L. pneumophila 1 80% 100% BinaxNow Q ELISA 4 HRP (horseradish peroxidase) L. pneumophila 1 1 L. pneumophila L. pneumophila 1 PCR 37

5. DNA 1) PCR PCR LAMP DNA L. pneumophila mip 16S rrna 5S rrna LAMP PCR LAMP mip L. pneumophila PCR (1)DNA 1 ml 0.1 ml lysozyme (5 mg/ml ) 37 100 0.1 ml proteinase K (1 mg/ml) 0.1 ml 20%SDS 55 DNA 50 µl 10 µl 1st step PCR 2nd step PCR 1 µl 1st step PCR (2) 1st step primers: LmipL920 5'-GCTACAGACAAGGATAAGTTG-3' LmipR1548 5'-GTTTTGTATGACTTTAATTCA-3' 2nd step primers: LmipL997 5'-TAATCCGGAAGCAATGGCTA-3' LmipR1466 5'-GGGCCAATAGGTCCGCCAAC-3' (3) 100 µl 100 mm Tris-HCl (ph8.3) 1.5 mm MgCl 2 200 µm dntp 40 µm primers 2.5 U AmpliTaq (4) 2 94 1

55 1 72 1 30 5 PCR 489 bp DNA DNA 2) PCR PCR LAMP DNA (1) 500 ml 5 ml 2 ml 2 ml 13,000 15,000 rpm 4 5 100 μl (2) DNA 2 TE 1 M NaCl 10% TritonX-100 50 20 10 μl 100 μl 2 90 μl 20 mg/ml Proteinase K 10 μl 60 1 75 5 15,000 rpm 3 160 180 μl (3) DNA Buffer AL 200 μl 200 μl DNA

5,000 rpm 1 1.5 ml Buffer AW1 300 μl 10,000 rpm 1 1 1.5 ml Buffer AW2 300 μl 12,000 15,000 rpm 2 2 1.5 ml Buffer AE 50 μl 2 10,000 rpm 1 100 μl DNA DNA (4) DNA 5 μl DNA 5 μl 10 ml L. londiniensis 16S rrna 5S rrna mip PCR LAMP (5) DNA 3 DNA 5 μl PCR 10 100 ml

6. ELISA L. pneumophila 1-6 1) 1 3 6 256 128 4 1 BCYEα 35 48 BCYE 2 1% PBS ph7.2 10 ml 1 3,000 rpm 30 0.1% PBS ph7.2 McFarlandNo.4 5 Egg Yolk Enrichment 50% (Becton, Dickinson) 0.5 10 9 /ml 400 500 600 PBS ph7.2 0.5% 4 4 2 IFA 18 5 mmφ UV 100 15

3 U 25 μl 1 BSA PBS ph 7.2 3 75 μl 2 1 5 μl 16 25 μl 16 1,024 4 IFA 2 IFA 10 μl 37 40 PBS ph 7.2 PBS 5 4 50 FITC IgG IgM IgA 10 μl 37 40 PBS PBS 5 4 ProLong Gold Antifade Reagent (Invitrogen) 30 5 4 3 2 1 50 2

4 128 256 1mm 100 2 IgG IgM 2 3 5 6 L. pneumophila 1-6 L. bozemanae L. dumoffii L. gormanii L. micdadei 1 BCYEα 2 3 100 1 121 30 3,000 rpm 15 0.1w/v% PBS 8 10 9 /ml 2 10 1 1 75 μl 2 1 150 μl 2 56 30 1 BSA 0.1% 350 μl 50 μl 1:8 3 11 1 96 U 1 1 11 25 μl 1:8 25 μl

1:16 25 μl 2 25 μl 16 4 4 16 4 128 256 5 1 3 6 1:128 1 1:128 1:256

7. PFGE Sequence Based Typing SBT Multiple-Locus Variable number tandem repeat (VNTR) Analysis (MLVA) IOD (Index of Discriminationn) 51) 1) PFGE PFGE 4 2 (1) BCYEα 35 48 100 200 μl 5 50 55 1% SeaKem R Gold Agarose plug mold (Bio-Rad (2) (0.1mg/ml proteinase K, 1% N-lauroylsarcosine, 0.5 M EDTA, ph 8.0) 1 ml 50 1 (3) 4 mm Pefabloc SC(Roche Diagnostics) TE 10 mm Tris-HCl, 1 mm EDTA, ph 8.0 1ml 50 30 4mM Pefabloc SC TE 50 30 TE 1 ml 30 (50 mm NaCl, 10 mm Tris-HCl, 10 mm MgCl2, 1 mm dithiothreitol, 100 μg/ml bovine serum albumin) 200 μl 30 (4) 50 units/sample SfiI Roche 100 μl 50 4 0.5 TBE Tris-borate 45 mm, EDTA 1 mm 4 (5) 1% SeaKem R Gold Agarose CHEF DR System (Bio-Rad) 0.5 TBE 5 50 6 V/cm 21 14 0.5 μg/ml 30 3

2) Sequence Based Typing SBT SBT L. pneumophila 7 flaa pile asd mip momps proa neua L. pneumophila EWGLI (http://www.hpa-bioninformatics.org.uk/legionella/legionella_sbt/pht/sbt_homepage.php) Multiple-Locus Variable number tandem repeat VNTR Analysis MLVA MLVA VNTR VNTR PCR MLVA SBT PFGE

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1. Legionella sp.

2. 3. 1 L. pneumophila 1 2 L. cherrii 4.