Two Nursing Home Outbreaks of Respiratory Infection with <i>Legionella sainthelensi</i>

Loeb, Mark; Simor, Andrew E.; Mandell, Lionel A.; Krueger, Paul; McArthur, Margaret; James, Marilyn; Walter, Stephen D.; Richardson, Elizabeth; Lingley, Michael; Stout, Janet E.; Stronach, David; McGeer, Allison

doi:10.1111/j.1532-5415.1999.tb02568.x

Cited by 44 publications

(25 citation statements)

References 30 publications

(39 reference statements)

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“…From this literature it is apparent that L pneumophila serogroup 1 and Legionella longbeachae serogroup 2 were present in the water supplies of Nova Scotia hospitals (13) and that L pneumophila, Legionella micdadei and Legionella dumoffi had been recovered from clinical and or environmental specimens in the Quebec City area (14,15). L pneumophila serogroups 1, 3, 6 and 12, Legionella sainthelensi, and Legionella feelei have been reported from Ontario (16)(17)(18)(19)(20)(21); L pneumophila serogroup 1 from Manitoba (22); and Legionella maccachernii from Saskatchewan (23). Nicolle et al (24) reported nine patients with community-acquired Legionellosis who were hospitalized at the Health Sciences Centre in Winnipeg between 1986 and 1991.…”

Section: Discussionmentioning

confidence: 99%

Legionnaires′ Disease ‐ Results of a Multicenter Canadian Study

Marrie

Carolis

et al. 2003

Canadian Journal of Infectious Diseases and Medical Microbiolog

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BACKGROUND: There has never been a cross-Canada surveillance project to determine the rate ofLegionellaspecies as a cause of community-acquired pneumonia requiring hospitalization and to determine whether there are any regional differences in the rates of Legionnaires' disease in Canada. Anecdotally, Legionnaires' disease is thought to be uncommon in Western Canada.METHODS: From January, 1996 through to October 31, 1997, a prospective study of the etiology of community acquired pneumonia requiring admission to 15 tertiary care hospitals in eight Canadian provinces was conducted. A urine sample from each patient was tested forLegionella pneumophilaserogroup 1 antigen using a commercially available ELISA assay. A culture of sputum or other respiratory specimens for Legionellaceae was carried out at the discretion of the attending physician. Two hundred thirty-four patients had acute and 6-week convalescent serum samples tested for antibodies toL pneumophilaserogroups 1 through 6 using an ELISA method.RESULTS: 28 of the 850 patients (3.2%) had Legionnaires' disease; 18 of 823 (2.1%) were positive forL pneumophilaserogroup 1 by urinary antigen testing. The rate of Legionnaires' disease, based on urinary antigen, at the Halifax site was higher than that at the other sites (seven of 163 patients versus 11 of 660 [P=0.04]). Of the 28 cases of Legionnaires' disease identified using all methods, 11 of 277 patients (3.9%) were enrolled from Western provinces versus 17 of 573 patients (2.9%) from Eastern provinces (P=nonsignificant).CONCLUSIONS: Legionnaires' disease is just as common in Western as in Eastern Canada.L pneumophilaserogroup 1 may be more common in Halifax than at the other sites studied.

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Section: Discussionmentioning

confidence: 99%

Legionnaires′ Disease ‐ Results of a Multicenter Canadian Study

Marrie

Carolis

et al. 2003

Canadian Journal of Infectious Diseases and Medical Microbiolog

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“…Aspiration of water containing Legionella has also been suggested to be a common transmission route (102), although the frequency with which this occurs is unclear. Reports have suggested that immunocompromised patients in health care settings may be at risk from contaminated respiratory equipment (103)(104)(105)(106)(107)(108); in these specific instances, the use of sterile potable water may be advised (109)(110)(111).…”

Section: Epidemiology and Diseasementioning

confidence: 99%

Current and Emerging Legionella Diagnostics for Laboratory and Outbreak Investigations

2015

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SUMMARY Legionnaires' disease (LD) is an often severe and potentially fatal form of bacterial pneumonia caused by an extensive list of Legionella species. These ubiquitous freshwater and soil inhabitants cause human respiratory disease when amplified in man-made water or cooling systems and their aerosols expose a susceptible population. Treatment of sporadic cases and rapid control of LD outbreaks benefit from swift diagnosis in concert with discriminatory bacterial typing for immediate epidemiological responses. Traditional culture and serology were instrumental in describing disease incidence early in its history; currently, diagnosis of LD relies almost solely on the urinary antigen test, which captures only the dominant species and serogroup, Legionella pneumophila serogroup 1 (Lp1). This has created a diagnostic “blind spot” for LD caused by non-Lp1 strains. This review focuses on historic, current, and emerging technologies that hold promise for increasing LD diagnostic efficiency and detection rates as part of a coherent testing regimen. The importance of cooperation between epidemiologists and laboratorians for a rapid outbreak response is also illustrated in field investigations conducted by the CDC with state and local authorities. Finally, challenges facing health care professionals, building managers, and the public health community in combating LD are highlighted, and potential solutions are discussed.

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“…However, one study of pneumonia patients admitted to 3 acute care hospitals in Pittsburgh 6 found that 6% of patients admitted from nursing homes had Legionella infection and 6% had C pneumoniae infection. There are reports of endemic 41 and epidemic 42 Legionella infection occurring in long-term care facilities. Outbreaks of C pneumoniae infection have also been reported.…”

Section: E T I O L O G Ymentioning

confidence: 96%