Serological evidence of<i>Legionella</i>species infection in acute exacerbation of COPD

Lieberman, David; Shmarkov, O.; Gelfer, Y.; Ben‐Yaakov, Miriam; Lazarovich, Zilia; Boldur, I

doi:10.1183/09031936.02.02042002

Cited by 24 publications

(4 citation statements)

References 29 publications

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“…Notably, in previous epidemiological studies, type 1 Legionella pneumophila infection was the most common among patients with symptomatic Legionella pneumophila pneumonia. 18,40 Among the 15 cases of Legionella infection in this study, only three cases were identified as Legionella type 1, whereas nine were Legionella type 6. Legionella type 1 is generally considered to be more pathogenic than other serotypes of Legionella, but none of the 15 patients showed typical symptoms of Legionella infection, such as high fever, cough with orange sputum, muscle aches, abdominal pain, or diarrhea.…”

Section: Discussionmentioning

confidence: 76%

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Atypical Pathogen Distribution in Chinese Hospitalized AECOPD Patients: A Multicenter Cross-Sectional Study

Feng¹,

Xu²,

Kang³

et al. 2021

COPD

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The proportion of atypical pathogens in patient with AECOPD within mainland China is unknown. The objectives of this study were to determine the distribution of atypical pathogens among Chinese patients with AECOPD, to evaluate the clinical characteristics of different atypical pathogen infections, and to compare different detection methods for atypical pathogens. Patients and Methods: Specimens were collected from patients with AECOPD from March 2016 to November 2018 at eleven medical institutions in eight cities in China. Double serum, sputum, and urine samples were obtained from 145 patients. Serological and nucleic acid tests were used to assess for Mycoplasma pneumonia and Chlamydia pneumoniae; serological, urinary antigen, and nucleic acid tests were applied to detect Legionella pneumophila. The clinical characteristics of atypical pathogen-positive andnegative groups were also compared. Results: The overall positivity rate for Mycoplasma pneumoniae was 20.69% (30/145), with the highest rate being 20.00% (29/145) when determined by passive agglutination.The overall positive rates for Chlamydia pneumoniae and Legionella pneumophila were 29.66% (43/145) and 10.34% (15/145), respectively. The most common serotype of Legionella pneumophila was type 6. The maximum hospitalized body temperature, ratio of eosinophils, C-reactive protein (CRP) level, and procalcitonin (PCT) level of the Mycoplasma pneumoniae-positive group were significantly higher than those of the Mycoplasma pneumoniae-negative group. Patients in the Chlamydia pneumoniae-positive group smoked more, had higher proportions of comorbidities and frequent aggravations in the previous two years than those in the Chlamydia pneumoniae-negative group. Furthermore, the forced expiratory volume in one second to forced vital capacity (FEV 1 / FVC) ratio assessment of lung function was higher, and the concentration of arterial blood bicarbonate (HCO 3 − ) was lower in the Legionella pneumophila-positive group than in the Legionella pneumophila-negative group. Conclusion: Overall, atypical pathogens play an important role in AECOPD. Regarding the testing method, serological testing is a superior method to nucleic acid testing.

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Section: Discussionmentioning

confidence: 76%

“…There are few studies onLegionella pneumophila. A study by Lieberman et al 40 detected Legionella in 16.7% of patients. The findings of the abovementioned studies are similar to the results of this study.…”

Section: Discussionmentioning

confidence: 94%

Atypical Pathogen Distribution in Chinese Hospitalized AECOPD Patients: A Multicenter Cross-Sectional Study

Feng¹,

Xu²,

Kang³

et al. 2021

COPD

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“…[86] and M. pneumoniae [87] were added to the list, although the role of Legionella spp. in AECOPD remains controversial [88]. One of seven respiratory viruses was identified in close to one half of patients who were hospitalized with AECOPD [89].…”

Section: Infectious Etiologies Of Aecopdmentioning

confidence: 99%

Management of respiratory infections in the elderly

Lieberman¹,

Lieberman

2003

Expert Review of Anti-infective Therapy

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Respiratory infections are common at all ages but are particularly sinister among the elderly because of the fragility and chronic comorbidity associated with this age group. The three types of respiratory infection in the elderly are community-acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease and nonpneumonic respiratory tract infection. The etiology of these three types of infection includes classic bacteria, atypical pathogens and respiratory viruses. The relative frequency of each of the etiological groups as the causative agent of the infection varies significantly among these types of infection, but in all three types a significant proportion of infections involves more than one pathogen. The causative agent of respiratory infection in the elderly cannot be determined on the basis of clinical manifestation or the results of routine imaging procedures or laboratory tests. Thus, initial antibiotic therapy in these patients should be empiric, based on accepted guidelines. In recent years, the antipneumococcal fluoroquinolones have gained in stature as one of the best options to treat these infections. Pneumococcal and influenza vaccinations can reduce morbidity and mortality from respiratory infections in the elderly, so it is important that all elderly individuals are vaccinated through a structured program in the framework of primary care. The economic impact of respiratory infections in the elderly is primarily associated with the requirement for hospitalization in many of the cases. Any action that can reduce hospitalization rates has important economic ramifications. In light of the difficulty in reaching an early etiologic diagnosis in respiratory infections, it is essential to invest in the development of a compact diagnostic kit for the early stages of the disease, which could change reality in this important area of medicine.

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“…70 Even with respect to the more classical serological studies based on the measurement of immunoglobulin-G, reasonable doubts have been raised concerning the specificity of this test for certain agents, such as C pneumoniae and Legionella species. 71…”

Section: Serologymentioning

confidence: 99%

Guidelines for the Diagnosis and Treatment of Community-Acquired Pneumonia. Spanish Society of Pulmonology and Thoracic Surgery (SEPAR)

Assembly¹

2005

Archivos de Bronconeumología ((English Edition))

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Serological evidence ofLegionellaspecies infection in acute exacerbation of COPD

Cited by 24 publications

References 29 publications

Atypical Pathogen Distribution in Chinese Hospitalized AECOPD Patients: A Multicenter Cross-Sectional Study

Atypical Pathogen Distribution in Chinese Hospitalized AECOPD Patients: A Multicenter Cross-Sectional Study

Management of respiratory infections in the elderly

Guidelines for the Diagnosis and Treatment of Community-Acquired Pneumonia. Spanish Society of Pulmonology and Thoracic Surgery (SEPAR)

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