Legionnaires’ disease caused by Legionella longbeachae and Legionella pneumophila: comparison of clinical features, host-related risk factors, and outcomes

ABSTRACT A cross-sectional multicenter survey of Italian hotels was conducted to investigate Legionella spp. contamination of hot water. Chemical parameters (hardness, free chlorine concentration, and trace element concentrations), water systems, and building characteristics were evaluated to study risk factors for colonization. The hot water systems of Italian hotels were strongly colonized by Legionella; 75% of the buildings examined and 60% of the water samples were contaminated, mainly at levels of ≥103 CFU liter−1, and Legionella pneumophila was the most frequently isolated species (87%). L. pneumophila serogroup 1 was isolated from 45.8% of the contaminated sites and from 32.5% of the hotels examined. When a multivariate logistic model was used, only hotel age was associated with contamination, but the risk factors differed depending on the contaminating species and serogroup. Soft water with higher chlorine levels and higher temperatures were associated with L. pneumophila serogroup 1 colonization, whereas the opposite was observed for serogroups 2 to 14. In conclusion, Italian hotels, particularly those located in old buildings, represent a major source of risk for Legionnaires' disease due to the high frequency of Legionella contamination, high germ concentration, and major L. pneumophila serogroup 1 colonization. The possible role of chlorine in favoring the survival of Legionella species is discussed.

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Factors Influencing Legionella Contamination of Domestic Household Showers

Pathogens ◽

10.3390/pathogens8010027 ◽

2019 ◽

Vol 8 (1) ◽

pp. 27 ◽

Cited By ~ 6

Author(s):

Deanna Hayes-Phillips ◽

Richard Bentham ◽

Kirstin Ross ◽

Harriet Whiley

Keyword(s):

Risk Factors ◽

Water Temperature ◽

Legionella Pneumophila ◽

Public Awareness ◽

Water System ◽

South Australia ◽

Hot Water ◽

Factors Associated ◽

Potential Source ◽

Legionnaires Disease

Legionnaires’ disease is a potentially fatal pneumonia like infection caused by inhalation or aspiration of water particles contaminated with pathogenic Legionella spp. Household showers have been identified as a potential source of sporadic, community-acquired Legionnaires’ disease. This study used qPCR to enumerate Legionella spp. and Legionella pneumophila in water samples collected from domestic showers across metropolitan Adelaide, South Australia. A survey was used to identify risk factors associated with contamination and to examine awareness of Legionella control in the home. The hot water temperature was also measured. A total of 74.6% (50/68) and 64.2% (43/68) showers were positive for Legionella spp. and L. pneumophila, respectively. Statistically significant associations were found between Legionella spp. concentration and maximum hot water temperature (p = 0.000), frequency of shower use (p = 0.000) and age of house (p = 0.037). Lower Legionella spp. concentrations were associated with higher hot water temperatures, showers used at least every week and houses less than 5 years old. However, examination of risk factors associated with L. pneumophila found that there were no statistically significant associations (p > 0.05) with L. pneumophila concentrations and temperature, type of hot water system, age of system, age of house or frequency of use. This study demonstrated that domestic showers were frequently colonized by Legionella spp. and L. pneumophila and should be considered a potential source of sporadic Legionnaires’ disease. Increasing hot water temperature and running showers every week to enable water sitting in pipes to be replenished by the municipal water supply were identified as strategies to reduce the risk of Legionella in showers. The lack of public awareness in this study identified the need for public health campaigns to inform vulnerable populations of the steps they can take to reduce the risk of Legionella contamination and exposure.

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Clinical features and death risk factors in COVID-19 patients with cancer: a retrospective study

BMC Infectious Diseases ◽

10.1186/s12879-021-06495-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yi Zhou ◽

Qiao Yang ◽

Jun Ye ◽

Xiaocheng Wu ◽

Xianhua Hou ◽

...

Keyword(s):

Risk Factors ◽

Retrospective Study ◽

Clinical Features ◽

C Reactive Protein ◽

Patients With Cancer ◽

Reactive Protein ◽

Related Risk ◽

The World ◽

Laboratory Results ◽

Severe Group

Abstract Background Coronavirus disease 2019 (COVID-19) has spread around the world. This retrospective study aims to analyze the clinical features of COVID-19 patients with cancer and identify death outcome related risk factors. Methods From February 10th to April 15th, 2020, 103 COVID-19 patients with cancer were enrolled. Difference analyses were performed between severe and non-severe patients. A propensity score matching (PSM) analysis was performed, including 103 COVID-19 patients with cancer and 206 matched non-cancer COVID-19 patients. Next, we identified death related risk factors and developed a nomogram for predicting the probability. Results In 103 COVID-19 patients with cancer, the main cancer categories were breast cancer, lung cancer and bladder cancer. Compared to non-severe patients, severe patients had a higher median age, and a higher proportion of smokers, diabetes, heart disease and dyspnea. In addition, most of the laboratory results between two groups were significantly different. PSM analysis found that the proportion of dyspnea was much higher in COVID-19 patients with cancer. The severity incidence in two groups were similar, while a much higher mortality was found in COVID-19 patients with cancer compared to that in COVID-19 patients without cancer (11.7% vs. 4.4%, P = 0.028). Furthermore, we found that neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) were related to death outcome. And a nomogram based on the factors was developed. Conclusion In COVID-19 patients with cancer, the clinical features and laboratory results between severe group and non-severe group were significantly different. NLR and CRP were the risk factors that could predict death outcome.

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Clinical Features of Stroke

10.4018/978-1-7998-7433-1.ch008 ◽

2022 ◽

pp. 120-137

Author(s):

Alper Uysal

Keyword(s):

Risk Factors ◽

Clinical Features ◽

Language Disorders ◽

Signs And Symptoms ◽

Neurological Dysfunction ◽

Related Risk ◽

Prolongation Of Life ◽

Ischemic Attack ◽

Speech And Language Disorders ◽

The Brain

Stroke is a clinical condition that causes neurological dysfunction due to focal infarction or haemorrhage in the brain, spinal cord, or retina. These clinical features may take 24 hours or more and result in death. Stroke is one of the leading causes of disability and death. With the prolongation of life in societies, stroke and stroke-related risk factors become more and more important. Age, gender, race, heredity, ethnicity, hypertension, atrial fibrillation, diabetes, hyperlipidemia, smoking, transient ischemic attack, and physical inactivity are risk factors of stroke. Signs and symptoms of stroke vary according to occluded vessel. Mental dysfunction, speech and language disorders, motor and sensory impairment may occur as a result of stroke.

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Clinical Features of Renal Insufficiency due to Multiple Myeloma and Related Risk Factors

The Chinese-German Journal of Clinical Oncology ◽

10.1007/s10330-003-0169-9 ◽

2005 ◽

Vol 4 (1) ◽

pp. 47-49 ◽

Cited By ~ 1

Author(s):

Xuemei LIU ◽

Jinlan XU ◽

Xuhua GUAN ◽

Liqiu LIU

Keyword(s):

Risk Factors ◽

Multiple Myeloma ◽

Renal Insufficiency ◽

Clinical Features ◽

Related Risk

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Analysis of Clinical Features and Related Risk Factors of Chronic Cervicitis

10.47939/mh.v1i2.67 ◽

2020 ◽

Keyword(s):

Risk Factors ◽

Clinical Features ◽

Related Risk ◽

Chronic Cervicitis

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Clinical Features and Death Risk Factors in COVID-19 Patients with Cancer: A Retrospective Study

10.21203/rs.3.rs-149362/v1 ◽

2021 ◽

Author(s):

Yi Zhou ◽

Qiao Yang ◽

Jun Ye ◽

Xiaocheng Wu ◽

Xianhua Hou ◽

...

Keyword(s):

Risk Factors ◽

Retrospective Study ◽

Clinical Features ◽

C Reactive Protein ◽

Propensity Score Matching Analysis ◽

Patients With Cancer ◽

Reactive Protein ◽

Related Risk ◽

Laboratory Results ◽

Severe Group

Abstract Purpose: Coronavirus disease 2019 (COVID-19) has spread around the world. This retrospective study aims to analyze the clinical features of COVID-19 patients with cancer and identify death outcome related risk factors.Methods: From February 10th to April 15th, 2020, 103 COVID-19 patients with cancer were enrolled. Difference analyses were performed between severe and non-severe patients. A propensity score matching analysis, including 103 COVID-19 patients with cancer and 206 matched non-cancer COVID-19 patients were performed. Next, we identified death related risk factors and developed a nomogram for predicting the probability.Results: In 103 COVID-19 patients with cancer, the main cancer categories were breast cancer, lung cancer and bladder cancer. Compared to non-severe patients, severe patients had a higher median age, and a higher proportion of smokers, diabetes, heart disease and dyspnea. In addition, most of the laboratory results between two groups were significant different. PSM analysis found that the proportion of dyspnea was much higher in COVID-19 patients with cancer. The severity incidence in two groups were similar, while a much higher mortality was found in COVID-19 patients with cancer compared to that in COVID-19 patients without cancer (11.7% vs. 4.4%, P = 0.028). Furthermore, we found that neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) were related to death outcome. And a nomogram based on the factors was developed.Conclusion: In COVID-19 patients with cancer, the clinical features and laboratory results between severe group and non-severe group were significant different. NLR and CRP were the risk factors that could predict death outcome.

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Role of pulse oximetric monitoring during gastrointestinal endoscopy. Prospective multicenter study of the Gastroenterological Working Group of the Veszprém Regional Committee of the Hungarian Academy of Sciences (VEAB)

Orvosi Hetilap ◽

10.1556/oh.2013.29613 ◽

2013 ◽

Vol 154 (21) ◽

pp. 825-833

Author(s):

Zoltán Döbrönte ◽

Mária Szenes ◽

Beáta Gasztonyi ◽

Lajos Csermely ◽

Márta Kovács ◽

...

Keyword(s):

Risk Factors ◽

Multicenter Study ◽

Hungarian Academy ◽

Prospective Multicenter Study ◽

Standard Requirement ◽

Long Duration ◽

Related Risk ◽

American Society ◽

Academy Of Sciences ◽

Endoscopic Investigation

Introduction: Recent guidelines recommend routine pulse oximetric monitoring during endoscopy, however, this has not been the common practice yet in the majority of the local endoscopic units. Aims: To draw attention to the importance of the routine use of pulse oximetric recording during endoscopy. Method: A prospective multicenter study was performed with the participation of 11 gastrointestinal endoscopic units. Data of pulse oximetric monitoring of 1249 endoscopic investigations were evaluated, of which 1183 were carried out with and 66 without sedation. Results: Oxygen saturation less than 90% was observed in 239 cases corresponding to 19.1% of all cases. It occurred most often during endoscopic retrograde cholangiopancreatography (31.2%) and proximal enteroscopy (20%). Procedure-related risk factors proved to be the long duration of the investigation, premedication with pethidine (31.3%), and combined sedoanalgesia with pethidine and midazolam (34.38%). The age over 60 years, obesity, consumption of hypnotics or sedatives, severe cardiopulmonary state, and risk factor scores III and IV of the American Society of Anestwere found as patient-related risk factors. Conclusion: To increase the safety of patients undergoing endoscopic investigation, pulse oximeter and oxygen supplementation should be the standard requirement in all of the endoscopic investigation rooms. Pulse oximetric monitoring is advised routinely during endoscopy with special regard to the risk factors of hypoxemia. Orv. Hetil., 2013, 154, 825–833.

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