-
Epidemiology and Infection Jan 2024Legionellosis is a disease caused by the bacterium that most commonly presents as Legionnaires' disease (LD), a severe form of pneumonia. From 2015 to 2019, an average...
Legionellosis is a disease caused by the bacterium that most commonly presents as Legionnaires' disease (LD), a severe form of pneumonia. From 2015 to 2019, an average of 438 LD cases per year were reported in Canada. However, it is believed that the actual number of cases is much higher, since LD may be underdiagnosed and underreported. The purpose of this study was to develop an estimate of the true incidence of illnesses, hospitalizations, and deaths associated with LD in Canada. Values were derived using a stochastic model, based on Canadian surveillance data from 2015 to 2019, which were scaled up to account for underdiagnosis and underreporting. Overall, there were an estimated 1,113 (90% CrI: 737-1,730) illnesses, 1,008 (90% CrI: 271-2,244) hospitalizations, and 34 (90% CrI: 4-86) deaths due to domestically acquired waterborne LD annually in Canada from 2015 to 2019. It was further estimated that only 36% of illnesses and 39% of hospitalizations and deaths were captured in surveillance, and that 22% of illnesses were caused by serogroups and species other than serogroup 1 (non-Lp1). This study highlights the true burden and areas for improvement in Canada's surveillance and detection of LD.
Topics: Humans; Legionnaires' Disease; Canada; Legionella pneumophila; Legionellosis; Legionella; Cost of Illness
PubMed: 38204334
DOI: 10.1017/S0950268824000013 -
Frontiers in Cellular and Infection... 2024, one of the main pathogens that causes community-acquired pneumonia, can lead to , a condition characterized predominantly by severe pneumonia. This disease, caused by...
, one of the main pathogens that causes community-acquired pneumonia, can lead to , a condition characterized predominantly by severe pneumonia. This disease, caused by the bacterium , can quickly progress to critical pneumonia and is often associated with damage to multiple organs. As a result, it requires close attention in terms of clinical diagnosis and treatment. Omadacycline, a new type of tetracycline derivative belonging to the aminomethylcycline class of antibiotics, is a semi-synthetic compound derived from minocycline. Its key structural feature, the aminomethyl modification, allows omadacycline to overcome bacterial resistance and broadens its range of effectiveness against bacteria. Clinical studies have demonstrated that omadacycline is not metabolized in the body, and patients with hepatic and renal dysfunction do not need to adjust their dosage. This paper reports a case of successful treatment of with omadacycline in a patient who initially did not respond to empirical treatment with moxifloxacin. The patient also experienced electrolyte disturbance, as well as dysfunction in the liver and kidneys, delirium, and other related psychiatric symptoms.
Topics: Humans; Tetracyclines; Anti-Bacterial Agents; Legionnaires' Disease; Legionella pneumophila; Treatment Outcome; Male; Community-Acquired Infections; Moxifloxacin; Middle Aged
PubMed: 38836055
DOI: 10.3389/fcimb.2024.1380312 -
Emerging Infectious Diseases May 2024We investigated molecular evolution and spatiotemporal dynamics of atypical Legionella pneumophila serogroup 1 sequence type 1905 and determined its long-term...
We investigated molecular evolution and spatiotemporal dynamics of atypical Legionella pneumophila serogroup 1 sequence type 1905 and determined its long-term persistence and linkage to human disease in dispersed locations, far beyond the large 2014 outbreak epicenter in Portugal. Our finding highlights the need for public health interventions to prevent further disease spread.
Topics: Legionella pneumophila; Portugal; Humans; Legionnaires' Disease; Spatio-Temporal Analysis; Evolution, Molecular; Disease Outbreaks; History, 21st Century; Recurrence; Phylogeny; Serogroup
PubMed: 38666647
DOI: 10.3201/eid3005.231383 -
Cureus May 2024Legionnaires' disease is a potentially severe type of pneumonia most often caused by the organism . Exposure to this bacterial pathogen typically happens in the...
Legionnaires' disease is a potentially severe type of pneumonia most often caused by the organism . Exposure to this bacterial pathogen typically happens in the community but may also occur in the hospital setting. This report describes the case of a patient who presented due to 10 days of fever, shortness of breath, and diarrhea, with initial imaging demonstrating multifocal pneumonia. The patient was appropriately started on empiric antibiotics for community-acquired pneumonia and admitted to the medicine floor. The patient showed no meaningful improvement in his initial hospital course on empiric antibiotics with continued oxygen requirements. Meanwhile, urine Legionella antigen testing returned positive on hospital day four, and after tailoring antibiotics accordingly, the patient's clinical status improved significantly. This case report highlights the efficacy of broad testing in the initial admission and the need for constant re-evaluation in the context of a patient not improving with appropriate therapy.
PubMed: 38854237
DOI: 10.7759/cureus.59979 -
International Journal of Environmental... Oct 2023, the bacterium that causes Legionnaires' disease, can grow and spread in building water systems and devices. The COVID-19 pandemic impacted building water systems...
, the bacterium that causes Legionnaires' disease, can grow and spread in building water systems and devices. The COVID-19 pandemic impacted building water systems through reductions in water usage. growth risk factors can be mitigated through control measures, such as flushing, to address stagnation, as part of a water management program (WMP). A national lodging organization (NLO) provided WMP data, including environmental testing results for periods before and during the pandemic. The statistical analysis revealed an increased risk of water samples testing positive for during the pandemic, with the greatest increase in risk observed at the building's cold-water entry test point. Sample positivity did not vary by season, highlighting the importance of year-round control activities. The NLO's flushing requirements may have prevented an increased risk of growth during the pandemic. However, additional control measures may be needed for some facilities that experience detections. This analysis provides needed evidence for the use of flushing to mitigate the impacts of building water stagnation, as well as the value of routine testing for WMP validation. Furthermore, this report reinforces the idea that WMPs remain the optimal tool to reduce the risk of growth and spread in building water systems.
Topics: United States; Humans; Legionella; Pandemics; COVID-19; Water Microbiology; Legionnaires' Disease; Water Supply; Water; Legionella pneumophila
PubMed: 37835155
DOI: 10.3390/ijerph20196885 -
Respirology Case Reports Feb 2024is the most common cause of Legionnaires' disease in Australasia. species are considered a rare cause of pleural infection, and empyema and lung abscess due to has...
is the most common cause of Legionnaires' disease in Australasia. species are considered a rare cause of pleural infection, and empyema and lung abscess due to has not previously been reported. Our patient presented with a 2-3 week history of breathlessness, lethargy, dry cough and headaches. Initial chest radiograph showed extensive left sided consolidation with an associated pleural effusion. An area of necrotising pneumonia evident on computed tomography scan evolved into a multiloculated intrapulmonary abscess. Sputum culture isolated which prompted culture of pleural fluid on buffered charcoal yeast extract agar and isolation of the organism. This case provides evidence that can cause both empyema and lung abscess, and in areas where it is prevalent, increased use of specific agar for pleural fluid culture should be considered.
PubMed: 38314099
DOI: 10.1002/rcr2.1281 -
Internal Medicine (Tokyo, Japan) Oct 2023A 79-year-old man presented with chest pain, and urinary antigen tests for Legionella pneumophila (ImmunoCatch Legionella and Ribotest Legionella) were negative on...
A 79-year-old man presented with chest pain, and urinary antigen tests for Legionella pneumophila (ImmunoCatch Legionella and Ribotest Legionella) were negative on admission. The next day, rapid respiratory failure suggested Legionella pneumonia, and levofloxacin was added. Since a lung infiltration shadow appeared on the other side as well on day 4, non-infectious diseases were considered, and steroid therapy was started. Urinary antigen tests for Legionella pneumophila became positive on day 5. In the present case, retesting with Ribotest Legionella, which could be negative early after the disease onset, was useful for diagnosing Legionella pneumonia, which led to the discontinuation of unnecessary steroid treatment.
Topics: Male; Humans; Aged; Legionella; Legionnaires' Disease; Legionella pneumophila; Pneumonia; Steroids
PubMed: 36889700
DOI: 10.2169/internalmedicine.0766-22 -
Occupational and Environmental Medicine Mar 2024Certain workers are at increased risk for acquiring Legionnaires' disease compared with other workers. This study aims to identify occupations at increased risk for...
BACKGROUND
Certain workers are at increased risk for acquiring Legionnaires' disease compared with other workers. This study aims to identify occupations at increased risk for acquiring Legionnaires' disease.
METHODS
Using data from the US Centers for Disease Control and Prevention's Supplemental Legionnaires' Disease Surveillance System, this study identified Legionnaires' disease confirmed patients ≥16 years of age in 39 states with reported symptom onset during 2014-2016. Age-adjusted and sex-adjusted incidence rate ratios (IRR) stratified by occupation group were calculated by comparing Legionnaires' disease patients in an occupation group (eg, transportation) to those in all other occupation groups (eg, non-transportation).
RESULTS
A total of 2553 patients had a known occupation group. The two occupations with the highest burden were transportation (N=287; IRR=2.11) and construction (N=269; IRR=1.82). Truck drivers comprised the majority (69.7%) of the transportation occupation group and construction labourers comprised almost half (49%) of the construction occupation group. The healthcare support occupation had the highest IRR (N=75; IRR=2.16).
CONCLUSION
Transportation and construction workers, who are generally not covered by guidance related to building water systems, have increased risk of Legionnaires' disease compared with other workers. One hypothesised risk factor for truck drivers is the use of non-genuine windshield cleaner in their vehicles. A simple intervention is to use genuine windshield cleaner with bactericidal properties (ie, includes isopropanol/methanol) which can reduce the risk of growth and transmission. To improve surveillance of Legionnaires' disease and identification of similar exposures, the authors encourage the collection of occupation and industry information for all patients with Legionnaires' disease.
Topics: Humans; Legionnaires' Disease; Occupations; Risk Factors; Transportation; Industry; Disease Outbreaks
PubMed: 38360725
DOI: 10.1136/oemed-2023-109108 -
Annals of Agricultural and... Dec 2023The occurrence of bacteria of the genus Legionella sp. in hot water supply systems in buildings is a real threat to human health, especially for patients in hospitals...
INTRODUCTION AND OBJECTIVE
The occurrence of bacteria of the genus Legionella sp. in hot water supply systems in buildings is a real threat to human health, especially for patients in hospitals and residents of nursing homes. The aim of the study was determination of the degree of colonization of hot water systems in hospitals and nursing homes in the Świętokrzyskie Province in south-east Poland.
MATERIAL AND METHODS
Between 2014 - 2018, samples were collected from hot water systems in 30 hospitals and 32 nursing homes in order to determine the degree of contamination. 631 samples collected of the bacteria Legionella sp were analyzed.
RESULTS
Excessive contamination (≥ 100CFU/100 ml) with the bacteria Legionella sp. was detected in 12.12% (n=71) of samples. Contamination was significantly more frequently detected in samples from hot water systems in nursing homes, compared to hospitals (16.48% vs. 10.37%). Above-standard contamination of hot water systems with Legionella sp. bacteria occurred in 34.43% of the facilities, and was more frequent in hospitals (41.38%) than in the nursing homes (28.13%). In 21.3% of the facilities, contamination was detected many times during the study period.
CONCLUSIONS
Excessive contamination of hot water systems with Legionella sp. bacteria in the examined facilities was a common phenomenon. The presence of the pathogen in the installations of these facilities may constitute a considerable health hazard for patients and residents.
Topics: Humans; Legionella; Poland; Hot Temperature; Water Supply; Hospitals; Nursing Homes; Water; Water Microbiology; Legionella pneumophila
PubMed: 38153068
DOI: 10.26444/aaem/176501 -
Journal of Clinical Microbiology Apr 2024Many pneumonia patients do not produce sputum, and it is unknown whether purulent sputum is required for the identification of species. This study aimed to evaluate...
Many pneumonia patients do not produce sputum, and it is unknown whether purulent sputum is required for the identification of species. This study aimed to evaluate the identification rate of species based on sputum quality and the factors predictive of infection. This study included pneumonia patients at Kurashiki Central Hospital from November 2000 to December 2022. Sputum quality, based on gram staining, was classified as the following: Geckler 1/2, 3/6 and 4/5. Geckler 4/5 was defined as purulent sputum. The sputa of 104 of 124 pneumonia patients were cultured. Fifty-four patients (51.9%) were identified with species, most of which were serogroup 1 (81.5%). The identification rates of species according to sputum quality were 57.1% (16/28) in Geckler 1/2 sputum, 50.0% (34/68) in Geckler 3/6 sputum, and 50.0% (4/8) in Geckler 4/5 sputum, which were not significantly different ( = 0.86). On multivariate analysis, pre-culture treatment with anti- antimicrobials (odds ratio [OR] 0.26, 95% confidence interval [CI] 0.06-0.91), Pneumonia Severity Index class ≥IV (OR 2.57 [95% CI 1.02-6.71]), and intensive care unit admission (OR 3.08, 95% CI 1.06-10.09) correlated with the ability to identify species, but sputum quality did not (OR 0.88, 95% CI 0.17-4.41). The identification rate of species in non-purulent sputum was similar to that in purulent sputum. For the diagnosis of pneumonia, sputum should be collected before administering anti- antibiotics and cultured regardless of sputum quality.
Topics: Humans; Legionella; Sputum; Legionnaires' Disease; Legionella pneumophila; Pneumonia
PubMed: 38501659
DOI: 10.1128/jcm.01665-23