scholarly journals A Clinical Overview of Hospital-Acquired Legionella Pneumonia: Prevention Is the Key?

2020 ◽  
Author(s):  
Yamely Mendez ◽  
Gloria Rueda ◽  
Ismael Garcia ◽  
Johanan Luna
Keyword(s):  
Legionella Pneumonia ◽  
Hospital Acquired ◽  
Clinical Overview

scholarly journals 2600. Mannose-Binding Lectin Polymorphisms are Important Modulating Factors in Community- and Hospital-Acquired Pneumonia Caused by Legionella spp.

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S903-S904
Author(s):  
Povilas Kavaliauskas ◽  
Ruta Prakapaite ◽  
Frederic Saab ◽  
Ruta Petraitiene ◽  
Sophie Jarraud ◽  
...  
Keyword(s):  
Nested Pcr ◽  
Developed Countries ◽  
Mannose Binding Lectin ◽  
Microbiological Analysis ◽  
Respiratory Pathogens ◽  
Legionella Pneumonia ◽  
Mannose Binding ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired ◽  
Binding Lectin

Abstract Background Community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) are the leading causes of death from infection in developed countries. Mannose-binding lectin (MBL) is a C-type serum lectin that plays a central role in the innate pulmonary host defenses against respiratory pathogens. We hypothesized that MBL polymorphisms may increase the risk of developing Legionella pneumonia. Therefore, the aim of this study was to evaluate the role of MBL polymorphisms in susceptibility to CAP and HAP caused by Legionella spp. Methods A total of 96 BAL and blood samples collected for routine microbiological analysis from Lithuanian patients presenting with CAP and HAP, were used for this study. MBL polymorphisms in the 54 codon (54 G/G, 54 G/A, and 54 A/A) were detected by BanIRFLP. Legionella spp. were detected by nested PCR. Results Polymorphisms in the 54 codon of MBL were determined in 96 patients. Among 96 patients with CAP and HAP, the most commonly observed 54 codon MBL variant was 54 G/G (69.8%, n = 67), followed by 54 G/A (21.9%, n = 21), and 54 A/A (8.3%, n = 8). By using nested PCR, Legionella pneumonia was detected among 15.6% (n = 15) of patients diagnosed with CAP and HAP. Legionella spp. were detected among 7 patients with MBL 54 codon G/G variant (10.4%), while 3 patients with MBL 54 G/A (14.3%), and 5 patients with MBL 54 codon A/A variant (62.5%). During this study Legionella spp. were detected more frequently (P < 0.05) among patients with the A/A variant of the 54 codon vs. those with other variants of MBL 54 codon. There were no significant differences found among those with Legionella infection and G/A (14.3%) or G/G (10.4%) variants of MBL gene 54 codon. Conclusion MBL gene 54 codon variant A/A polymorphisms may play an important role in increased susceptibility to lower respiratory infectionscaused by Legionella spp. Disclosures All authors: No reported disclosures.

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.

FATAL HOSPITAL-ACQUIRED LEGIONELLA PNEUMONIA IN A NEONATE

2010 ◽  
Vol 29 (3) ◽  
pp. 280-281 ◽  
Author(s):  
Yael Shachor-Meyouhas ◽  
Imad Kassis ◽  
Ellen Bamberger ◽  
Tova Nativ ◽  
Hannah Sprecher ◽  
...  
Keyword(s):  
Legionella Pneumonia ◽  
Hospital Acquired

Legionella Pneumonia

2011 ◽  
Vol 6 (4) ◽  
pp. 435-442
Author(s):  
Kazuhiro Tateda ◽  
Keyword(s):  
Hot Springs ◽  
Correct Diagnosis ◽  
Diagnostic Technique ◽  
Human Beings ◽  
Hospital Acquired Infection ◽  
Legionella Pneumonia ◽  
Legionella Species ◽  
Sources Of Infection ◽  
Urinary Antigen Detection ◽  
Hospital Acquired

Legionella pneumonia, an infectious disease with high fatality, produces symptoms after inhalation of an aerosol contaminated by Legionella species. Legionella bacteria are Gram-negative, glucose-nonfermentative, and proliferative in human macrophages and monocytes. Over 40 types of Legionella species are pathogenic in human beings. Of these,L. pneumophilahas the strongest pathogenicity. Hot springs and bathtubs with circulating systems are considered sources of infection and sometimes cause cases of hospital-acquired infection. The urinary antigen detection test is a new diagnostic technique, and proved to be effective for rapid and correct diagnosis ofL. pneumophilaserogroup-1 infection.

scholarly journals 2451. Hospital-acquired Legionella Pneumonia Outbreak at an Academic Medical Center. A Case–control Study of Risk Factors

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S847-S848
Author(s):  
Michael Kessler ◽  
Fay Osman ◽  
Aurora E Pop-Vicas ◽  
Nasia Safdar
Keyword(s):  
Risk Factors ◽  
Water Samples ◽  
Molecular Typing ◽  
Case Control Study ◽  
Univariate Analysis ◽  
Case Control ◽  
Solid Organ ◽  
Legionella Pneumonia ◽  
Hospital Acquired ◽  
Control Study

Abstract Background An outbreak of hospital-acquired Legionella pneumonia, associated with potable water contamination, occurred at our university hospital in November of 2018, despite a longstanding copper-silver ionization system. We conducted a case–control study to examine risk factors for Legionella pneumonia. Methods We matched controls to cases by dates of admission, hospital ward, and admitting service, in a 4:1 ratio. We reviewed patient charts for potential risk factors and exposures, and summarized demographic information using descriptive analyses. Univariate and multiple logistic regression analyses were also performed. We used pulsed-field gel electrophoresis for molecular typing of isolates from patient respiratory samples and hospital water samples. Results We identified 13 cases of nosocomial legionella pneumonia over a one-month period (Figure 1), with 8 males, 5 females, and a mean age of 63 years. The average time to diagnosis was 19 days following admission. Six patients were transplant recipients – two had solid organ, and six had bone marrow transplant. Urinary Legionella antigen was positive in all cases. Table 1 shows predictors for Legionella pneumonia in univariate analyses. Current smoking (OR = 7.5, 95% CI [1.11 – 50.84], p = 0.03], pre-admission steroid prescription (OR = 6.5, 95% CI [1.65 – 26.20], p = 0.008], documentation of shower (OR = 6.2, 95% CI [1.54 – 25.82], p = 0.01], and number of showers prior to hyper-chlorination (OR = 1.45, 95% CI [1.03 – 2.04], p = 0.03] were significant risk factors on univariate analysis. The multiple regression model was also significant (P < 0.001) with all of the above-identified predictors (Table 2). Molecular typing found Legionella strains from patient respiratory samples and water samples to be identical. Multiple interventions, including restriction of showering, hyper-chlorination, and optimization of water flow through the copper-silver ionization system were implemented, and were successful in mitigating the outbreak. Conclusion We found showering to be a modifiable risk factor for Legionella pneumonia in this outbreak. Interventions to reduce this risk might include point of use filters in showers in high-risk populations. Disclosures All authors: No reported disclosures.

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