Pittsburgh pneumonia agent was recently reported by Pasculle and colleagues (1) to cause pneumonia. It was further characterized by Hébert and associates (2). Most cases of Pittsburgh pneumonia recognized so far have affected immunosuppressed patients (3) and have appeared to be hospital acquired. However, the source of bacteria and means of transmission have not been defined. In our search for L. pneumophila in the hospital environment, we have found Pittsburgh pneumonia agent in respiratory nebulizers. Our findings imply that Pittsburgh
Figure 1. Schematic diagram of ultrasonic nebulizer. Pittsburgh pneumonia agent was isolated from couplant water which transmits sonic energy from transducer to putatively sterile nebulized solution. If nebulizer is not properly assembled (see text) couplant water may inadvertently be aerosolized.
pneumonia agent, like L. pneumophila, may be disseminated in environmental aerosols.
Samples were taken from the couplant reservoirs (Figure 1)