Legionella Species and Legionnaires’ Disease

Edelstein, Paul H.; Cianciotto, Nicholas P.

doi:10.1007/0-387-30746-x_39

Cited by 5 publications

(7 citation statements)

References 592 publications

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“…As previously reported, other non-specific laboratory test abnormalities may occur in patients with legionellosis, that are consistent with pneumonia (37). These include hypophosphatemia, hyperbilirubinemia, increased levels of liver-associated enzymes, thrombocytopenia, leukopenia/leukocytosis, disseminated intravascular coagulation, pyuria, elevated creatine kinase, and elevated lactate dehydrogenase levels (38).…”

Section: Discussionsupporting

confidence: 61%

Legionella pneumophilapneumonia: A 5‑year retrospective clinical evaluation and commentary

et al. 2023

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Although legionellosis represents a widely underestimated disease for various reasons, the rate of Legionella pneumophila infections has increased steadily over the past 30 years. The present study describes the characteristics of patients hospitalized due to legionellosis. The present study retrospectively reviewed 10 cases of legionellosis during the defined period and documented the epidemiological and clinical characteristics of the patients, as well as the methods used for diagnosis and therapeutic management. The majority of the patients were male (80%) with a mean age of 55.8 years. The most common comorbidities were hypertension (40%) and tumors (20%). Fever was present in all the cases (100%) and the most frequent imaging finding was lung consolidation. Half of the cases exhibited hyponatremia, 40% of them had leukocytosis, and 50% of the patients presented elevated procalcitonin levels, as well as elevated levels of transaminases. In total, 2 patients (20%) required non-invasive oxygen support. All the cases presented a positive urinary antigen test for Legionella pneumophila serogroup 1. A total of 9 patients (90%) received levofloxacin-based therapy for a mean duration of 17.7 days. All the cases described herein were successfully discharged without any complications. On the whole, the present study demonstrates that a prompt clinical diagnosis along with early testing and treatment represent the cornerstone for positive outcomes in patients affected by Legionnaire's disease.

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Section: Discussionsupporting

confidence: 61%

Legionella pneumophilapneumonia: A 5‑year retrospective clinical evaluation and commentary

et al. 2023

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“…Many of the species can only be correctly identified using molecular methods. There is a broad panel of biochemical tests whose usefulness has been demonstrated in identification, but these methods have not been widely used or validated after their initial description [49]. Tests for nitrate reductase and urease are negative for all species.…”

Section: Discussionmentioning

confidence: 99%

“…L. pneumophila and a few other species hydrolyze hippurate [16,19,50]. The legionellae are chemoorganotropic and do not possess a glucose transport system, nor ferment or oxidize other carbohydrates [49,51]. These biochemical characteristics were observed for two selected isolates (VR 17 a 4 and VR 17 a 5 ).…”

Section: Discussionmentioning

confidence: 99%

Detection of <i>Legionella</i> spp. in Natural and Man-made Water Systems Using Standard Guidelines

Borges¹,

Simes²,

Martínez‐Murcia³

et al. 2012

MICROBIOLOGY

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Infections caused by Legionella spp. are considered at the present time, an emerging public health problem and are linked to high rates of mortality and morbidity, if not properly treated. In this study were analyzed 54 samples of water from 8 counties at Northern Portugal, with the aim of obtaining a collection of strains of the genus Legionella and to characterize them genetically and phenotypically. Another objective of this study was to evaluate the effectiveness of the technique of cultivation, a standard method according to International Organization for Standardization ISO 11731:1998, for detection and enumeration of species of Legionella. For laboratory processing, after the filtration of samples (1 L), the filtrate was resuspended in sterile distilled water (5 ml). Heat treatment for selective inhibition of non-Legionella bacteria was performed. Subsequently, 100 μl of the suspension was spread in GVPC selective agar medium, and incubated (7 to 10 days) at 37 ℃. Colonies that were morphologically characteristic of the genus were sub-cultured onto BCYE agar and blood agar for verification. According to the procedure recommended by the standard method, only the colonies which grew in BCYE agar and not on blood agar were considered as suspected Legionella strains. The identification of these initially selected colonies was performed by sequencing the 16S rRNA gene, which revealed that none of the isolates were identified as belonging to the genus Legionella. However, through the ISO 11731:1998 they were interpreted as positive, corresponding therefore to "false-positive" results. The methods used in this study allowed the isolation of a number of isolates (40), which form an independent group of all genus of the family Chitinophagaceae outlined so far, and that by their phylogenetic distance might be a genus not yet described and therefore a new species. The results obtained, highlighted the importance of using culture and genetic methods in parallel for the proper identification of microorganisms.

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“…Legionnaires’ disease infections occur primarily among older or immunocompromised individuals, and an estimated 97% of identified cases are hospitalized [ 1 , 18 ]. We used the National Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project (HCUP) to identify Legionnaires’ disease hospitalizations between 2000 and 2011 throughout the US.…”

Section: Methodsmentioning

confidence: 99%

“…The bacteria are abundant in aqueous environments [ 15 ] and survive by parasitizing amoebae, including many that persist in environmental biofilms [ 16 , 17 ]. The bacteria optimally grow in wet, warm conditions (between 25 and 42 °C) and flourish in sessile biofilm communities [ 18 , 19 ] in the natural and built environment [ 20 , 21 ]. Environmental events that mobilize biofilms may be an important driver of infection by increasing the bacterial load in plumbed water [ 22 – 24 ], water used for industrial processes [ 25 , 26 ], and surface water where direct exposure can occur [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

The effect of seasonal and extreme floods on hospitalizations for Legionnaires’ disease in the United States, 2000–2011

Lynch

Shaman

2022

BMC Infect Dis

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Background An increasing severity of extreme storms and more intense seasonal flooding are projected consequences of climate change in the United States. In addition to the immediate destruction caused by storm surges and catastrophic flooding, these events may also increase the risk of infectious disease transmission. We aimed to determine the association between extreme and seasonal floods and hospitalizations for Legionnaires’ disease in 25 US states during 2000–2011. Methods We used a nonparametric bootstrap approach to examine the association between Legionnaires’ disease hospitalizations and extreme floods, defined by multiple hydrometeorological variables. We also assessed the effect of extreme flooding associated with named cyclonic storms on hospitalizations in a generalized linear mixed model (GLMM) framework. To quantify the effect of seasonal floods, we used multi-model inference to identify the most highly weighted flood-indicator variables and evaluated their effects on hospitalizations in a GLMM. Results We found a 32% increase in monthly hospitalizations at sites that experienced cyclonic storms, compared to sites in months without storms. Hospitalizations in months with extreme precipitation were in the 89th percentile of the bootstrapped distribution of monthly hospitalizations. Soil moisture and precipitation were the most highly weighted variables identified by multi-model inference and were included in the final model. A 1-standard deviation (SD) increase in average monthly soil moisture was associated with a 49% increase in hospitalizations; in the same model, a 1-SD increase in precipitation was associated with a 26% increase in hospitalizations. Conclusions This analysis is the first to examine the effects of flooding on hospitalizations for Legionnaires’ disease in the United States using a range of flood-indicator variables and flood definitions. We found evidence that extreme and seasonal flooding is associated with increased hospitalizations; further research is required to mechanistically establish whether floodwaters contaminated with Legionella bacteria drive transmission.

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Legionella Species and Legionnaires’ Disease

Cited by 5 publications

References 592 publications

Legionella pneumophilapneumonia: A 5‑year retrospective clinical evaluation and commentary

Legionella pneumophilapneumonia: A 5‑year retrospective clinical evaluation and commentary

Detection of <i>Legionella</i> spp. in Natural and Man-made Water Systems Using Standard Guidelines

The effect of seasonal and extreme floods on hospitalizations for Legionnaires’ disease in the United States, 2000–2011

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