Active Surveillance of Legionnaires Disease During a Prospective Observational Study of Community-and Hospital-Acquired Pneumonia

2007 ◽  
Vol 28 (9) ◽  
pp. 1085-1088 ◽  
Author(s):  
Erica Leoni ◽  
Rossella Sacchetti ◽  
Manuela Aporti ◽  
Claudio Lazzari ◽  
Manuela Donati ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Prospective Observational Study ◽  
Urinary Antigen Test ◽  
Serological Tests ◽  
Source Of Infection ◽  
Colony Forming Units ◽  
Clinical Surveillance ◽  
Hospital Acquired Pneumonia ◽  
Legionnaires Disease ◽  
Hospital Acquired

A prospective surveillance study of legionnaires disease and an environmental survey of Legionella species were performed simultaneously in a general hospital. During a period of 3 years, 705 patients with pneumonia were screened with a Legionella urinary antigen test, and pneumonia was confirmed by culture and serological tests. Twelve cases of legionnaires disease were identified, none of which were hospital acquired, despite the fact that 60% of hospital water samples were contaminated with Legionella pneumophila at a concentration of more than 103 colony-forming units/L. The probable source of infection was identified for only 2 community-acquired cases. The results show that environmental contamination alone is not able to predict the risk of legionnaires disease. If no cases are present, monitoring of hospital water systems is of little significance; clinical surveillance is much more important.

scholarly journals Urinary antigene and PCR can both be used to detect Legionella pneumophila in children’s hospital-acquired pneumonia

2019 ◽  
Vol 29 (2) ◽  
Author(s):  
Sayed-Yousef Mojtahedi ◽  
Aliakbar Rahbarimanesh ◽  
Samileh Noorbakhsh ◽  
Hossein Shokri ◽  
Saeedreza Jamali-Moghadam-Siyahkali ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Pediatric Intensive Care ◽  
Antigen Test ◽  
Urinary Antigen ◽  
Urinary Antigen Test ◽  
Legionella Pneumonia ◽  
Hospital Acquired Pneumonia ◽  
The Difference ◽  
Underlying Diseases ◽  
Hospital Acquired

Legionella pneumophila is the causative agent of more than 95% cases of severe Legionella pneumonia. Nosocomial pneumonias in different hospital wards is an important medical and pharmaceutical concern. This study aimed to detect Legionella with two methods: polymerase chain reaction (PCR) and detection of urine antigenic test (UAT) in patients suffering from nosocomial pneumonia admitted to pediatric intensive care unit (PICU) of children hospitals. This study was conducted in PICU wards of Rasool Akram and Bahrami children hospitals, Tehran, Iran during 2013 - 2014. In patients diagnosed with hospital-acquired pneumonia, intratracheal secretion samples for PCR and urine sample for UAT were taken. Simultaneously, PCR and urinary antigen test were conducted using commercial kits. The results of urinary antigen test and PCR were analyzed by SPSS v.19 for statistical comparison. In this study, 96 patients aging 2.77 years on average with two age peaks of less than 1 year and 7-8 year were enrolled. More than half of the patients were under 1 year old. The most common underlying diseases were seizure, Acute Lymphoblastic Lymphoma, Down syndrome and metabolic syndromes. The positivity rate of Legionella urinary antigen test was 16.7% and positivity rate of PCR test was 19.8%. There were no significant associations between the results obtained by both assays with age, gender or underlying diseases. In conclusion, PCR is a better detection method for Legionella infection than urinary antigen test, but the difference between the two methods was not significant.

scholarly journals Environmental Cultures and Hospital-Acquired Legionnaires' Disease: A 5-Year Prospective Study in 20 Hospitals in Catalonia, Spain

2004 ◽  
Vol 25 (12) ◽  
pp. 1072-1076 ◽  
Author(s):  
Miquel Sabrià ◽  
Josep M. Mòdol ◽  
Marian Garcia-Nuñez ◽  
Esteban Reynaga ◽  
Maria L. Pedro-Botet ◽  
...  
Keyword(s):  
Prospective Study ◽  
Potable Water ◽  
Environmental Study ◽  
Urinary Antigen ◽  
Hospital Acquired Pneumonia ◽  
Urinary Antigen Testing ◽  
Legionnaires Disease ◽  
Hospital Acquired ◽  
Antigen Testing

AbstractObjective:To determine whether environmental cultures forLegionellaincrease the index of suspicion for legionnaires' disease (LD).Design:Five-year prospective study.Setting:Twenty hospitals in Catalonia, Spain.Methods:From 1994 to 1996, the potable water systems of 20 hospitals in Catalonia were tested forLegionella, Cases of hospital-acquired LD and availability of an “in-house”Legionellatest in the previous 4 years were assessed. After the hospitals were informed of the results of their water cultures, a prospective 5-year-study was conducted focusing on the detection of new cases of nosocomial legionellosis and the availability and use of Legionella testing.Results:Before environmental cultures were started, only one hospital had conducted active surveillance of hospital-acquired pneumonia and usedLegionellatests includingLegionellaurinary antigen in all pneumonia cases. Only one other hospital had used the latter test at all. In six hospitals,Legionellatests had been completely unavailable. Cases of nosocomial LD had been diagnosed in the previous 4 years in only two hospitals. During prospective surveillance, 12 hospitals (60%) usedLegionellaurinary antigen testing in house and 11 (55%) found cases of nosocomial legionellosis, representing 64.7% (11 of 17) of those with positive water cultures. Hospitals with negative water cultures did not find nosocomial LD.Conclusions:The environmental study increased the index of suspicion for nosocomial LD. The number of cases of nosocomial LD increased significantly during the prospective follow-up period, and most hospitals began using theLegionellaurinary antigen test in their laboratories.

scholarly journals Legionnaires' disease outbreak associated with a cruise liner, August 2003: epidemiological and microbiological findings

2006 ◽  
Vol 135 (5) ◽  
pp. 802-810 ◽  
Author(s):  
K. BEYRER ◽  
S. LAI ◽  
J. DREESMAN ◽  
J. V. LEE ◽  
C. JOSEPH ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Case Control Study ◽  
Prolonged Exposure ◽  
Interdisciplinary Approach ◽  
Case Control ◽  
Case Definition ◽  
Source Of Infection ◽  
Legionnaires Disease ◽  
The Mean ◽  
Control Study

SUMMARYEight cases of Legionnaires' disease were identified among the 215 German passengers after a cruise to the Nordic Sea in August 2003. An unmatched case-control study was conducted to identify risk factors and the source of infection. In total, eight passengers fulfilled the case definition, one of these died. Forty-two passengers served as controls. The attack rate was 4%. The mean age was 60 years for cases and 62 years for controls. Prolonged exposure to the spa pool seemed to be a risk factor of infection (OR 4·85,P=0·09).Legionella pneumophilaserogroup 1, monoclonal antibody (mAb) subgroup ‘Knoxville’ was isolated from clinical and environmental samples. DNA sequence-based typing revealed that these isolates were indistinguishable from each other. The investigation showed the importance of an interdisciplinary approach of microbiology and epidemiology as not all sites on the ship that tested positive forL. pneumophilaactually posed a relevant risk for the passengers.

Severe Sepsis With Septic Shock as a Consequence of a Severe Hospital-Acquired Pneumonia Resulting From Legionella Pneumophila in Children: A Case Series and Literature Review

2020 ◽  
Author(s):  
Min Ding ◽  
Chunfeng Yang ◽  
Yu-mei Li
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Next Generation Sequencing ◽  
Antibiotic Therapy ◽  
Legionella Pneumophila ◽  
High Risk Population ◽  
Next Generation ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired ◽  
Generation Sequencing

Abstract BackgroundLegionella pneumophila is responsible for hospital or community-acquired pneumonia in adults. Immunocompromised patients with Legionella pneumophila infection are associated with rapidly severe clinical course and high mortality rates. Legionella pneumophila infection is rare in children, especially combined with extrapulmonary manifestations. In this report, we describe 2 children of severe hospital-acquired pneumonia and septic shock resulting from Legionella pneumophila. Standardized metagenomics next-generation sequencing allowed early diagnosis. Appropriate antibiotic therapy and timely extracorporeal life support were effective in achieving complete recovery. This is the first report of children with septic shock related to Legionella pneumophila infections diagnosed by metagenomics next-generation sequencing and recovered successfully.Case presentationThere were 2 cases about septic shock resulting from Legionella pneumophila. One was a six-month girl with congenital biliary atresia who underwent liver transplantation. She was suspected for rejecting the liver and admitted to hospital. The other one was a five-year-old boy with Burkitt lymphoma who was in the end of early chemotherapy. They both presented with fever, cough or shortness of breath during hospitalization. And they were transferred to PICU because of worsening dyspnea and decreased blood pressure. Patients were diagnosed by severe sepsis with septic shock likely resulting from hospital-acquired pneumonia. Metagenomics next-generation sequencing indicated L. pneumophila in blood and sputum. Aggressive intravenous fluids resuscitation and vasopressors were initiated on arrival to PICU, and they were placed on mechanical ventilation and continuous renal replacement therapy. Intravenous antibiotic therapy followed by azithromycin. Finally, the patients recovered without any long-term sequelae.ConclusionsThough sepsis or sepsis shock caused by Legionella pneumophila is rare in children, it can occur at high-risk population. Metagenomics next-generation sequencing is useful for conforming hard-to-culture pathogens and severely ill patients. The report remind pediatric physicians that we should be aware that Legionella pneumophila can cause severe sepsis or sepsis shock, especially in immunocompromised children. It is significant to select appropriate samples and pathogen detection methods in the early stage of disease.

scholarly journals Unusual clinical picture in an overweight patient with Legionella pneumophila: A case report

2017 ◽  
Vol 4 (3) ◽  
pp. 31
Author(s):  
Leonidas Grigorakos ◽  
Daria Lazarescu ◽  
Anthi Georgiadou ◽  
Maria Bikou ◽  
Magda Gkouni ◽  
...  
Keyword(s):  
Case Report ◽  
Legionella Pneumophila ◽  
Clinical Picture ◽  
Clinical Condition ◽  
Antigen Test ◽  
Overweight Patient ◽  
Urinary Antigen ◽  
Urinary Antigen Test ◽  
Legionnaires Disease ◽  
Continue Therapy

This case report describes a case of a patient with Legionnaires’ disease (LD) manifested three days upon his return from a medical conference, which took place in a hotel close to the seaside. Our patient presented to the hospital febrile, weak, confused and with mild difficulty in breathing. After being subjected to several tests, he was diagnosed with LD. Even though his initial urinary antigen test (UAT) was negative, subsequent immunofluorescent assays (IFA) were positive for Legionella pneumophila (LP). The patient was immediately initiated specific antibiotics therapy and supportive measures. After 11 days he was released from the hospital with considerable melioration of his clinical condition and with specific instructions to continue therapy at home.

scholarly journals Clusters of Healthcare-Associated Legionnaires’ Disease in Two Hospitals of Central Greece

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Maria A. Kyritsi ◽  
Varvara A. Mouchtouri ◽  
Anna Katsiafliaka ◽  
Foteini Kolokythopoulou ◽  
Elias Plakokefalos ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Environmental Samples ◽  
Distribution Systems ◽  
Water Distribution ◽  
Control Measures ◽  
Aerosol Therapy ◽  
Environmental Investigation ◽  
Source Of Infection ◽  
Legionnaires Disease ◽  
Healthcare Associated

Healthcare-associated Legionnaires’ disease often leads to fatal respiratory tract infection among hospitalized patients. In this report, three cases of Legionnaires’ disease among patients in two different hospitals (Hospital A and Hospital B) were investigated. After conducting an epidemiologic and environmental investigation, the water distribution systems (WDSs) were identified as the possible source of infection, as Legionella pneumophila serogroup 1 (Lp1) was isolated from both clinical and environmental samples. Patients received aerosol therapy with nebulizers during their hospitalization. Based on the results of the investigation, the hospitals’ infection control committees reviewed their policies for Legionnaires’ disease prevention and implemented control measures focusing on using sterile fluids for aerosol treatments.

Recommended Precautions for Patients with Legionnaires' Disease

1982 ◽  
Vol 3 (5) ◽  
pp. 401-404 ◽  
Author(s):  
William R. Jarvis
Keyword(s):  
Antimicrobial Therapy ◽  
Legionella Pneumophila ◽  
Diagnostic Techniques ◽  
Legionella Species ◽  
Legionnaires Disease ◽  
Hospital Acquired

AbstractAs diagnostic techniques for the identification of Legionella species have become readily available, recognition of the pneumonic form of Legionellosis has increased. In particular, cases of hospital-acquired Legionella pneumophila are being identified and this has led to concern over possible person-to-person transmission. In most epidemiologic investigations where a source has been identified, water has been implicated. Person-to-person transmission has not been convincingly documented. Therefore, we discourage expensive or inconvenient special precautions for patients hospitalized with Legionnaires' Disease. Rather, we recommend that such patients be placed in secretion precautions until effective antimicrobial therapy has eradicated the organism.

Clinical utility of urinary antigen test and molecular method for detection of Legionella pneumophila.

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Thana’a R AbdulRahman
Keyword(s):  
Legionella Pneumophila ◽  
Point Of View ◽  
P Value ◽  
Antigen Test ◽  
Rt Pcr ◽  
Urinary Antigen ◽  
Urinary Antigen Test ◽  
Serum Samples ◽  
High Prevalence ◽  
Legionnaires Disease

Legionella pneumophila is gram-negative bacterium which causes Legionnaires’ disease and Pontiac fever.To determine the frequency of serogroup 1 and other serogroup of Legionellapneumophila in pneumonic patients and the clinical utilityofLegionellapneumoniaurinary antigen test (LPUAT)in terms of sensitivity and specificity andcomparethe results with q Real Time PCR using serum samples. A total of 100 pneumonic patients were enrolled in this studyduring a period between October 2016 to April 2017; all patients under therapy with antibiotics.Serum and urine specimens were obtained from all patients; urine samples were processed for urinary antigen test. Serum samples were collected and submitted to DNA extraction for detection of L. pneumophila mip gene by q RT PCRassay. The percentage of L. pneumophila in two hospitals In Baghdad was 30%. Of these 26% was serogroup 1 detected by UAT. In the other hand, 23 % of samples were positive by q RT- PCR based mip gene,of these 19 % were serogroup 1 and 4% were other serogroups. The sensitivity of UAT is high (P value< 0.001), which means statistically highlysignificance than q RT PCR. Legionellapneumophila urinary antigen test is a rapid tool for early diagnosis of Legionella infection which highlights the need of using this test in hospitals and health institutions and there is a high prevalence of L.pneumophila in Iraqthat refer to the necessity of considering this microorganism point of view in future studies for detection and treatment in pneumonic patients.

Usefulness of linezolid in the treatment of hospital-acquired pneumonia caused by MRSA: a prospective observational study

2012 ◽  
Vol 18 (2) ◽  
pp. 160-168 ◽  
Author(s):  
Akira Watanabe ◽  
Hajime Goto ◽  
Hiroo Wada ◽  
Takuma Yokoyama ◽  
Kazui Soma ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired
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