Legionella pneumophilaPneumonia in a Newborn after Water Birth: A New Mode of Transmission

Abstract

We report a case of Legionella pneumophila pneumonia in a 7-day old neonate. Because the hospital water, and particularly the pool water for water birthing, was contaminated by L. pneumophila serogroup 1, the newborn was infected following prolonged delivery in contaminated water, perhaps by aspiration. This is the first case of nosocomial Legionella pneumonia in neonate after water birth.

Neonatal Sudden Death Due to Legionella Pneumonia Associated with Water Birth in a Domestic Spa Bath

“…474, 1998 [in Japanese]) in which L. pneumophila serogroups 1 and 6 caused pneumonia in four neonates and caused one of them to die. The newest case was a newborn infected by L. pneumophila serogroup 1 after water birth in a hospital in Italy in December 1999 (2). In contrast with all these cases of nosocomial infection, our case is a rare example of community-acquired Legionella pneumonia in a neonate.…”

“…But only 10 sporadic cases of Legionnaires' disease in neonates have been reported (2,6). Besides those published cases, in 1996 there was a nosocomial outbreak of Legionnaires' disease in Japan (N. Yamashita, S. Kuida, Y. Morikawa, K. Kawasaki, N. Okazaki, N. Matsuo, and K. Yamaguchi, Abstr.…”

Legionellosis following water birth in a hot tub in a Canadian neonate

“…Although adherence to infection-control strategies helps to limit risk, contamination may still occur from the water source. 19,20 Our case serves to highlight a severe and potentially fatal adverse neonatal outcome of underwater birth, especially when prefilled heated pools are used. Practitioners may wish to consider Legionella testing even if routine cultures identify a plausible pathogen in infants presenting with severe necrotizing pneumonia that progresses to respiratory failure within two weeks of an underwater birth.…”

Gebären im Wasser: Erfahrung nach 1825 Wassergeburten

“…Die befürchteten Komplikationen, von der Aspiration bis zum Ertrinken und der erhöhten Infektionsgefahr für das Neugeborene [15,16] , sind mit wenigen Ausnahmen ausgeblieben, da der so genannte Luftanhaltereflex («diving reflex») intrauterin, während der Geburt und unmittelbar danach im Wasser voll wirksam ist. Nur bei intrauterinen Azidosen sind diese Schutzfunktionen bzw.…”