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Emerging Infectious Diseases Oct 2020Healthcare-associated Legionnaires' disease (HCA LD) can cause nosocomial outbreaks with high death rates. We compared community-acquired LD cases with HCA LD cases in...
Healthcare-associated Legionnaires' disease (HCA LD) can cause nosocomial outbreaks with high death rates. We compared community-acquired LD cases with HCA LD cases in Europe during 2008-2017 using data from The European Surveillance System. A total of 29 countries reported 40,411 community-acquired and 4,315 HCA LD cases. Of the HCA LD cases, 2,937 (68.1%) were hospital-acquired and 1,378 (31.9%) were linked to other healthcare facilities. The odds of having HCA LD were higher for women, children and persons <20 years of age, and persons >60 years of age. Out of the cases caused by Legionella pneumophila with a known serotype, community-acquired LD was more likely to be caused by L. pneumophila serogroup 1 (92.3%) than was HCA LD (85.1%). HCA LD patients were more likely to die. HCA LD is associated with specific patient demographics, causative strains, and outcomes. Healthcare facilities should consider these characteristics when designing HCA LD prevention strategies.
Topics: Child; Delivery of Health Care; Disease Outbreaks; Europe; Female; Humans; Legionella pneumophila; Legionnaires' Disease
PubMed: 32946366
DOI: 10.3201/eid2610.181889 -
Acta Bio-medica : Atenei Parmensis Aug 2023Legionnaires' disease is a severe form of pneumonia caused by the inhalation or aspiration of water droplets contaminated with Legionella pneumophila and other...
BACKGROUND AND AIM
Legionnaires' disease is a severe form of pneumonia caused by the inhalation or aspiration of water droplets contaminated with Legionella pneumophila and other Legionella species. These bacteria are commonly found in natural habitats and man-made water systems. Legionnaires' disease is a significant public health problem, especially in healthcare settings where patients may be exposed to contaminated environmental sources. Nosocomial outbreaks have been reported worldwide, leading to high morbidity and mortality rates, and increased healthcare costs. This study aimed to compare, the clonal relationship of clinical L. pneumophila strains from two different hospitals with L. pneumophila strains isolated from the water supply.
METHODS
In the period from 2019 to 2021, clinical and environmental strains involved in three cases of legionellosis were compared by means of pulsed field gel electrophoresis and sequence based typing techniques.
RESULTS
Our findings highlight the persistence of clonally distinct strains within each hospital examined. Furthermore, the L. pneumophila strains detected from hospital environmental sources were related to the clinical strains isolated, demonstrating the nosocomial origin of these cases.
CONCLUSIONS
Therefore, it is important to implement more accurate surveillance systems both for epidemiological studies and to check the effectiveness of remediation procedures. (www.actabiomedica.it).
Topics: Humans; Legionnaires' Disease; Cross Infection; Legionella pneumophila; Water Supply; Water
PubMed: 37773490
DOI: 10.23750/abm.v94iS3.15048 -
Indian Journal of Medical Microbiology 2018Legionella pneumophila was first recognised as a fatal cause of pneumonia more than four decades ago, during the 1976-American Legion convention in Philadelphia, USA.... (Review)
Review
Legionella pneumophila was first recognised as a fatal cause of pneumonia more than four decades ago, during the 1976-American Legion convention in Philadelphia, USA. Legionella spp. continue to cause disease outbreaks of public health significance, and at present, Legionnaires' disease (LD) has emerged as an important cause of community and hospital-acquired pneumonia. Parallel to this, the understanding of LD has also increased exponentially. However, the disease is likely to be underreported in many countries because of the dearth of common definitions, diagnostic tests and active surveillance systems. In this review, we outline the basic concepts of Legionella including clinical presentations, epidemiology, laboratory diagnosis and the status of LD in India. This article also summarises the progress of research related to Legionella in this country, identifying the research gaps and discussing priorities to explore this unexplored pathogen in India.
Topics: Biomedical Research; Clinical Laboratory Techniques; Community-Acquired Infections; Cross Infection; Humans; India; Legionella pneumophila; Legionnaires' Disease
PubMed: 30429383
DOI: 10.4103/ijmm.IJMM_18_298 -
Tidsskrift For Den Norske Laegeforening... Dec 2000
Topics: Antigens, Bacterial; Humans; Immunoassay; Legionella pneumophila; Legionnaires' Disease
PubMed: 11215965
DOI: No ID Found -
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 -
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 -
Postepy Higieny I Medycyny... Jul 2008Legionella are widespread in natural aquatic environments and are able to exist in water of different temperatures, pH level, and nutrient and oxygen content. Their... (Review)
Review
Legionella are widespread in natural aquatic environments and are able to exist in water of different temperatures, pH level, and nutrient and oxygen content. Their occurrence in nature can be attributed to their relationships with other microorganisms. When Legionella co-exist with algae and other bacteria, especially in biofilms, the availability of nutrients increases. They also are able to infect protozoa and subsequently reproduce within these organisms. As a result of these relationships, Legionella are protected against adverse conditions, including standard water disinfection techniques. Consequently, they are also prevalent in anthropogenic water such as drinking water, whirlpools, and cooling tower reservoirs. Aerosol-generating systems aid in the transmission of Legionella from water to the air. Human inhalation of contaminated aerosols leads to Legionella infection and disease outbreaks. Legionellosis in humans has typically been characterized as either a potentially fatal pneumonic condition, known as Legionnaires' disease, or an acute, self-limiting, non-pneumonic condition known as Pontiac fever. In addition, Legionella spp. cause extrapulmonary infection, especially in immunosuppressed patients. Timely treatment of Legionnaires' disease is extremely important for the patient's recovery. Although erythromycin has historically been used to treat patients with Legionnaires' disease, newer macrolides and fluoroquinolones are gaining acceptance as the first choice for treatment. Although 52 species of Legionella are known, Legionella pneumophila serogroup 1 is responsible for more than 80% of hospital- and community-acquired cases of Legionnaires' disease.
Topics: Adult; Aged; Animals; Biofilms; Cross Infection; Disease Outbreaks; Disease Reservoirs; Disease Transmission, Infectious; Erythromycin; Eukaryota; Europe; Host-Parasite Interactions; Humans; Legionella; Legionnaires' Disease; Middle Aged; Prevalence; Species Specificity; Water Microbiology
PubMed: 18633335
DOI: No ID Found -
International Journal of Environmental... Jan 2022are gram-negative bacteria most commonly found in freshwater ecosystems and purpose-built water systems. In humans, the bacterium causes Legionnaires' disease (LD) or a...
are gram-negative bacteria most commonly found in freshwater ecosystems and purpose-built water systems. In humans, the bacterium causes Legionnaires' disease (LD) or a Pontiac fever. In this study, the different waters (drinking water, pool water, cooling towers) in which has been isolated were studied to assess the possible risk of bacterial spreading in the population. The influence of physical and chemical parameters, and interactions with on , were analyzed by Heterotrophic Plate Count, the Colony-forming units (CFU) methods, transmission electron microscopy (TEM), and Sequence-Based Typing (SBT) analysis. During the study period (2013-2019), a total of 1932 water samples were analyzed, with the average annual rate of -positive water samples of 8.9%, showing an increasing trend. The largest proportion of -positive samples was found in cooling towers and rehabilitation centers (33.9% and 33.3%, respectively). Among the isolates, SGs 2-14 was the most commonly identified strain (76%). The survival of was enhanced in the samples with higher pH values, while higher electrical conductivity, nitrate, and free residual chlorine concentration significantly reduced the survival of Our results show that growth in amoeba does not affect the allelic profile, phenotype, and morphology of the bacterium but environmental becomes more resistant to pasteurization treatment.
Topics: Amoeba; Ecosystem; Humans; Legionella; Legionella pneumophila; Legionnaires' Disease; Pasteurization; Public Health; Risk Factors; Water Microbiology
PubMed: 35162120
DOI: 10.3390/ijerph19031099 -
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