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Przeglad Epidemiologiczny 2015The objective of the article is to assess the epidemiological situation of legionellosis in Poland in 2013 in comparison to the preceding years. MATERIAL AND METHODS....
OBJECTIVE
The objective of the article is to assess the epidemiological situation of legionellosis in Poland in 2013 in comparison to the preceding years. MATERIAL AND METHODS. The analysis of epidemiological situation was based on the data published in the annual bulletin: "Infectious diseases and poisonings in Poland in 2013" and its prior versions as well as the legionellosis case reports sent to the Department of Epidemiology of NIPH-NIH.
RESULTS
In Poland, all cases of legionellosis, including Legionnaires' disease--a form of disease accompanied by pneumonia and mild, influenza-like form of infection--Pontiac fever are routinely reported to the surveillance. In 2013, a total of 11 legionellosis cases were reported (all 11 were cases of Legionnaires' disease and no one case of Pontiac fever); the incidence was 0.029 per 100,000 population which was a bit higher compared to the previous year but was 40 % lower from the median incidence for 2007-2011. The infections were reported in 7 provinces. The incidence in males (0.04 per 100,000) was slightly higher compared to females (0.02). No legionellosis outbreaks were registered--all infections were of sporadic nature. All cases were hospitalized., of these, seven were infected in the country, including three hospital acquired infections. Four infections were associated with travels abroad (one to Austria, one to Bulgaria, one to Germany and one to Italy). All the four cases connected with travel abroad survived., but 5 cases from 7 infected in Poland were fatal. The sanitary inspection reported that four fatal cases were over the age of 50, but one girl was 14 years old
CONCLUSIONS
In 2013, no changes of fundamental features of legionellosis epidemiological situation in Poland were observed. It is recommended to enhance the surveillance for legionellosis, with emphasis on conducting environmental investigation in areas where infections have occurred.
Topics: Adolescent; Adult; Age Distribution; Aged; Child; Child, Preschool; Disease Outbreaks; Female; Humans; Immunoglobulin M; Incidence; Infant; Infant, Newborn; Infection Control; Legionellosis; Legionnaires' Disease; Male; Middle Aged; Poland; Registries; Rural Population; Sex Distribution; Urban Population; Young Adult
PubMed: 26233078
DOI: No ID Found -
Public Health Reports (Washington, D.C.... 2022Racial and socioeconomic disparities in the incidence of Legionnaires' disease have been documented for the past 2 decades; however, the social determinants of health... (Review)
Review
OBJECTIVES
Racial and socioeconomic disparities in the incidence of Legionnaires' disease have been documented for the past 2 decades; however, the social determinants of health (SDH) that contribute to these disparities are not well studied. The objective of this narrative review was to characterize SDH to inform efforts to reduce disparities in the incidence of Legionnaires' disease.
METHODS
We conducted a narrative review of articles published from January 1979 through October 2019 that focused on disparities in the incidence of Legionnaires' disease and pneumonia (inclusive of bacterial pneumonia and/or community-acquired pneumonia) among adults and children (excluding articles that were limited to people aged <18 years). We identified 220 articles, of which 19 met our criteria: original research, published in English, and examined Legionnaires' disease or pneumonia, health disparities, and SDH. We organized findings using the Healthy People 2030 SDH domains: economic stability, education access and quality, social and community context, health care access and quality, and neighborhood and built environment.
RESULTS
Of the 19 articles reviewed, multiple articles examined disparities in incidence of Legionnaires' disease and pneumonia related to economic stability/income (n = 13) and comorbidities (n = 10), and fewer articles incorporated SDH variables related to education (n = 3), social support (none), health care access (n = 1), and neighborhood and built environment (n = 6) in their analyses.
CONCLUSIONS
Neighborhood and built-environment factors such as housing, drinking water infrastructure, and pollutant exposures represent critical partnership and research opportunities. More research that incorporates SDH and multilevel, cross-sector interventions is needed to address disparities in Legionnaires' disease incidence.
Topics: Adult; Child; Community-Acquired Infections; Humans; Incidence; Legionnaires' Disease; Pneumonia; Social Determinants of Health
PubMed: 34185609
DOI: 10.1177/00333549211026781 -
Journal of Molecular Biology Oct 2019Legionella pneumophila is the causative agent of the severe pneumonia Legionnaires' disease. L. pneumophila is ubiquitously found in freshwater environments, where it... (Review)
Review
Legionella pneumophila is the causative agent of the severe pneumonia Legionnaires' disease. L. pneumophila is ubiquitously found in freshwater environments, where it replicates within free-living protozoa. Aerosolization of contaminated water supplies allows the bacteria to be inhaled into the human lung, where L. pneumophila can be phagocytosed by alveolar macrophages and replicate intracellularly. The Dot/Icm type IV secretion system (T4SS) is one of the key virulence factors required for intracellular bacterial replication and subsequent disease. The Dot/Icm apparatus translocates more than 300 effector proteins into the host cell cytosol. These effectors interfere with a variety of cellular processes, thus enabling the bacterium to evade phagosome-lysosome fusion and establish an endoplasmic reticulum-derived Legionella-containing vacuole, which facilitates bacterial replication. In turn, the immune system has evolved numerous strategies to recognize intracellular bacteria such as L. pneumophila, leading to potent inflammatory responses that aid in eliminating infection. This review aims to provide an overview of L. pneumophila pathogenesis in the context of the host immune response.
Topics: Animals; Cytokines; Endoplasmic Reticulum; Humans; Legionella pneumophila; Legionnaires' Disease; Macrophages, Alveolar
PubMed: 31351897
DOI: 10.1016/j.jmb.2019.07.028 -
European Journal of Internal Medicine Feb 2024The optimal antimicrobial regimen for adults with respiratory failure due to Legionella pneumonia remains controversial. A systematic review was performed to assess the...
The optimal antimicrobial regimen for adults with respiratory failure due to Legionella pneumonia remains controversial. A systematic review was performed to assess the impact on outcomes comparing quinolones versus macrolides. A literature search was conducted in PubMed, Cochrane Library and Web of Science between 2012 and 2022. It yielded 124 potentially articles and ten observational studies met the inclusion criteria. A total of 4271 patients were included, 2879 (67 %) were male. A total of 1797 (42 %) subjects required intensive care unit (ICU) admission and 942 (52 %) mechanical ventilation. Fluoroquinolones and macrolides alone were administered in 1397 (33 %) and 1500 (35 %) subjects, respectively; combined therapy in 204 (4.8 %) patients. Overall mortality was 7.4 % (319 patients), with no difference between antibiotics. When data from the three studies with severe pneumonia were pooled together, mortality with fluoroquinolones alone was statistically superior to macrolides alone (72.8 % vs 30.8 %, p value 0.027). Hospital length of stay and complications were comparable. Our findings suggest that macrolides and quinolones were comparable for hospitalized Legionella pneumonia. However, in severe pneumonia, a randomized clinical trial is an unmet clinical need. PROSPERO registration number: CRD42023389308.
Topics: Adult; Humans; Male; Female; Macrolides; Quinolones; Anti-Bacterial Agents; Legionnaires' Disease; Fluoroquinolones; Legionella; Respiratory Insufficiency; Randomized Controlled Trials as Topic
PubMed: 37730517
DOI: 10.1016/j.ejim.2023.09.013 -
The Journal of the Association of... Mar 2024has a higher prevalence in India than in the world. Legionaries' disease most commonly involves the lungs but because of increased awareness, extrapulmonary...
BACKGROUND
has a higher prevalence in India than in the world. Legionaries' disease most commonly involves the lungs but because of increased awareness, extrapulmonary manifestations are also being diagnosed more frequently.
CASE DESCRIPTION
We present a case of a young female with acute onset of fever and chest pain. On initial investigation, an electrocardiogram (ECG) reported widespread pulse rate (PR) depression suggestive of pericarditis which was confirmed by ECG. High-resolution computed tomography (HRCT) thorax suggested mild bilateral pleural effusion with normal lung parenchyma. elevated erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) added to the diagnosis of serositis. Serological study for atypical organisms was remarkable for positive immunoglobulin M (IgM) for . She was treated with a high dose of steroids and azithromycin successfully.
CONCLUSION
Isolated extrapulmonary presentation of legionaries disease is often overlooked and is common. So it should be always included in the diagnostic armamentarium as treatment is highly efficacious if started early.
Topics: Humans; Female; Serositis; Azithromycin; Adult; Anti-Bacterial Agents; Legionellosis; Legionella; Electrocardiography; Tomography, X-Ray Computed; Legionnaires' Disease
PubMed: 38736126
DOI: 10.59556/japi.72.0361 -
Clinical Microbiology Reviews Jan 2015Legionnaires' disease (LD) is an often severe and potentially fatal form of bacterial pneumonia caused by an extensive list of Legionella species. These ubiquitous... (Review)
Review
Legionnaires' disease (LD) is an often severe and potentially fatal form of bacterial pneumonia caused by an extensive list of Legionella species. These ubiquitous freshwater and soil inhabitants cause human respiratory disease when amplified in man-made water or cooling systems and their aerosols expose a susceptible population. Treatment of sporadic cases and rapid control of LD outbreaks benefit from swift diagnosis in concert with discriminatory bacterial typing for immediate epidemiological responses. Traditional culture and serology were instrumental in describing disease incidence early in its history; currently, diagnosis of LD relies almost solely on the urinary antigen test, which captures only the dominant species and serogroup, Legionella pneumophila serogroup 1 (Lp1). This has created a diagnostic "blind spot" for LD caused by non-Lp1 strains. This review focuses on historic, current, and emerging technologies that hold promise for increasing LD diagnostic efficiency and detection rates as part of a coherent testing regimen. The importance of cooperation between epidemiologists and laboratorians for a rapid outbreak response is also illustrated in field investigations conducted by the CDC with state and local authorities. Finally, challenges facing health care professionals, building managers, and the public health community in combating LD are highlighted, and potential solutions are discussed.
Topics: Bacterial Typing Techniques; Disease Outbreaks; Humans; Legionella pneumophila; Legionnaires' Disease
PubMed: 25567224
DOI: 10.1128/CMR.00029-14 -
Journal of Medical Case Reports Jun 2023Infections have been recognized as an uncommon cause of rhabdomyolysis, with evidence indicating a worse prognosis when compared to rhabdomyolysis caused by other...
BACKGROUND
Infections have been recognized as an uncommon cause of rhabdomyolysis, with evidence indicating a worse prognosis when compared to rhabdomyolysis caused by other etiologies. Diseases caused by Legionella pneumophila can present variably, ranging from mild to severe illness, as is sometimes the case with pneumonia. In particular, the triad of Legionnaire's disease, rhabdomyolysis, and acute kidney injury is associated with a significant increase in the morbidity and mortality, with most patients requiring initiation of renal replacement therapy such as hemodialysis. While the exact mechanism of both the muscle and kidney injury in this setting remains unknown, several hypotheses exist, with some research suggesting multiple yet distinct processes occurring in both target organs.
CASE PRESENTATION
In this case report, we describe a 53-year-old African American man who presented with Legionella pneumophila pneumonia complicated by rhabdomyolysis and acute kidney injury. He was treated with aggressive fluid resuscitation and a 2-week course of azithromycin. His clinical status improved without necessitating renal replacement therapy or mechanical ventilation. We postulate that early recognition and treatment were key to his recovery. He was discharged 10 days later without recurrence of rhabdomyolysis at the time of this report.
CONCLUSION
While there are several well-established and more common causes of rhabdomyolysis, clinicians should recognize Legionella sp. as an etiology, given its association with significant morbidity and mortality.
Topics: Male; Humans; Middle Aged; Legionella; Legionnaires' Disease; Pneumonia; Acute Kidney Injury; Rhabdomyolysis
PubMed: 37344851
DOI: 10.1186/s13256-023-04000-1 -
Nursing Mar 2020
Topics: Guidelines as Topic; Health Facilities; Humans; Legionnaires' Disease; Risk Factors; Water Supply
PubMed: 32068708
DOI: 10.1097/01.NURSE.0000651660.70883.b4 -
European Journal of Cell Biology Dec 2023The study of virulence of Legionella pneumophila and its interactions with its hosts has been predominantly conducted in cellulo in the past decades. Although easy to... (Review)
Review
The study of virulence of Legionella pneumophila and its interactions with its hosts has been predominantly conducted in cellulo in the past decades. Although easy to implement and allowing the dissection of molecular pathways underlying host-pathogen interactions, these cellular models fail to provide conditions of the complex environments encountered by the bacteria during the infection of multicellular organisms. To improve our understanding of human infection, several animal models have been developed. This review provides an overview of the invertebrate and vertebrate models that have been established to study L. pneumophila infection and that are alternatives to the classical mouse model, which does not recall human infection with L. pneumophila well. Finally we provide insight in the main contributions made by these models along with their pros and cons.
Topics: Animals; Mice; Humans; Legionnaires' Disease; Legionella pneumophila; Invertebrates; Vertebrates; Disease Models, Animal
PubMed: 37926040
DOI: 10.1016/j.ejcb.2023.151369 -
Environmental Health Perspectives Aug 2015Legionella pneumophila, Mycobacterium avium, and Pseudomonas aeruginosa are opportunistic premise plumbing pathogens (OPPPs) that persist and grow in household plumbing,... (Review)
Review
BACKGROUND
Legionella pneumophila, Mycobacterium avium, and Pseudomonas aeruginosa are opportunistic premise plumbing pathogens (OPPPs) that persist and grow in household plumbing, habitats they share with humans. Infections caused by these OPPPs involve individuals with preexisting risk factors and frequently require hospitalization.
OBJECTIVES
The objectives of this report are to alert professionals of the impact of OPPPs, the fact that 30% of the population may be exposed to OPPPs, and the need to develop means to reduce OPPP exposure. We herein present a review of the epidemiology and ecology of these three bacterial OPPPs, specifically to identify common and unique features.
METHODS
A Water Research Foundation-sponsored workshop gathered experts from across the United States to review the characteristics of OPPPs, identify problems, and develop a list of research priorities to address critical knowledge gaps with respect to increasing OPPP-associated disease.
DISCUSSION
OPPPs share the common characteristics of disinfectant resistance and growth in biofilms in water distribution systems or premise plumbing. Thus, they share a number of habitats with humans (e.g., showers) that can lead to exposure and infection. The frequency of OPPP-infected individuals is rising and will likely continue to rise as the number of at-risk individuals is increasing. Improved reporting of OPPP disease and increased understanding of the genetic, physiologic, and structural characteristics governing the persistence and growth of OPPPs in drinking water distribution systems and premise plumbing is needed.
CONCLUSIONS
Because broadly effective community-level engineering interventions for the control of OPPPs have yet to be identified, and because the number of at-risk individuals will continue to rise, it is likely that OPPP-related infections will continue to increase. However, it is possible that individuals can take measures (e.g., raise hot water heater temperatures and filter water) to reduce home exposures.
Topics: Housing; Humans; Legionella pneumophila; Legionnaires' Disease; Mycobacterium avium; Pseudomonas Infections; Pseudomonas aeruginosa; Tuberculosis; Water Supply
PubMed: 25793551
DOI: 10.1289/ehp.1408692