Neumonía comunitaria por Legionella pneumophila: estudio de 136 casos

Romay-Lema, Eva; Corredoira-Sánchez, Juan; Ventura-Valcárcel, Pablo; Íñiguez-Vázquez, Iria; Pais, María-José García; Garcı́a-Garrote, Fernando; Rey, Ramón Rabuñal

doi:10.1016/j.medcli.2018.03.011

Cited by 3 publications

(3 citation statements)

References 25 publications

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“…While included analyses of EHR data from the USA do not give a clear picture of the impact of increased testing incidence, two international analyses present convincing evidence that incidence is increasing at a faster rate than testing [ 33 , 34 ]. An epidemiological study of LD in Hong Kong found that between 2010 and 2015, UAT frequency increased by 127% and LD case frequency by 230% [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…An epidemiological study of LD in Hong Kong found that between 2010 and 2015, UAT frequency increased by 127% and LD case frequency by 230% [ 33 ]. Similarly, an epidemiological study of community-acquired Legionella infections in a Spanish hospital found that the number of UAT orders increased 3.4 times and case incidence increased 5.9 times when comparing 2001–2005 with 2011–2015 data [ 34 ]. Further, a qualitative study about Swiss physicians’ approach to CAP diagnosis concluded that awareness about LD is generally high and that changing awareness does not appear to explain increasing incidence trends in Switzerland [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

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Legionellosis on the rise: A scoping review of sporadic, community-acquired incidence in the United States

Moffa,

Rock,

Galiatsatos

et al. 2023

Epidemiol. Infect.

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Over the past two decades, the incidence of legionellosis has been steadily increasing in the United States though there is noclear explanation for the main factors driving the increase. While legionellosis is the leading cause of waterborne outbreaks in the US, most cases are sporadic and acquired in community settings where the environmental source is never identified. This scoping review aimed to summarise the drivers of infections in the USA and determine the magnitude of impact each potential driver may have. A total of 1,738 titles were screened, and 18 articles were identified that met the inclusion criteria. Strong evidence was found for precipitation as a major driver, and both temperature and relative humidity were found to be moderate drivers of incidence. Increased testing and improved diagnostic methods were classified as moderate drivers, and the ageing U.S. population was a minor driver of increasing incidence. Racial and socioeconomic inequities and water and housing infrastructure were found to be potential factors explaining the increasing incidence though they were largely understudied in the context of non-outbreak cases. Understanding the complex relationships between environmental, infrastructure, and population factors driving legionellosis incidence is important to optimise mitigation strategies and public policy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Legionellosis on the rise: A scoping review of sporadic, community-acquired incidence in the United States

Moffa,

Rock,

Galiatsatos

et al. 2023

Epidemiol. Infect.

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“…L. pneumophila infection is associated with a poor outcome: In a retrospective study of 136 consecutive cases of communautary L. pneumophila infection in Spain between 2001 and 2015, 85% of patients were hospitalized, including 11.7% in intensive care unit, and the mortality rate was 4.4%[13]. Of the 11 patients described, 2 died with unrecorded treatment, 7 patients survived with adequate antibiotic course, and the outcome of the 2 last was unknown.…”

Section: Discussionmentioning

confidence: 99%

FatalLegionella pneumophilaserogroup 1 pleural empyema: A case report

Maillet

Bonnet

Billard-Pomarès

et al. 2019

WJCCM

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BACKGROUNDLegionella pneumophila (L. pneumophila) is a gram-negative intracellular bacillus composed of sixteen different serogroups. It is mostly known to cause pneumonia in individuals with known risk factors as immunocompromised status, tobacco use, chronic organ failure or age older than 50 years. Although parapneumonic pleural effusion is frequent in legionellosis, pleural empyema is very uncommon. In this study, we report a case of fatal pleural empyema caused by L. pneumophila serogroup 1 in an 81-year-old man with multiple risk factors.CASE SUMMARYAn 81-year-old man presented to the emergency with a 3 wk dyspnea, fever and left chest pain. His previous medical conditions were chronic lymphocytic leukemia, diabetes mellitus, chronic kidney failure, hypertension and hyperlipidemia, without tobacco use. Chest X-ray and comouted tomography-scan confirmed a large left pleural effusion, which puncture showed a citrine exudate with negative standard bacterial cultures. Despite intravenous cefotaxime antibiotherapy, patient’s worsening condition after 10 d led to thoracocentesis and evacuation of 2 liters of pus. The patient progressively developed severe hypoxemia and multiorgan failure occurred. The patient was treated by antibiotherapy with cefepime and amikacin and with adequate symptomatic shock treatment, but died of uncontrolled sepsis. The next day, cultures of the surgical pleural liquid samples yielded L. pneumophila serogroup 1, consistent with the diagnosis of pleural legionellosis.CONCLUSIONL. pneumophila should be considered in patients with multiple risk factors and undiagnosed pleural empyema unresponsive to conventional antibiotherapy.

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