Epidemiology of Legionella pneumonia and factors associated with Legionella-related mortality at a tertiary care center

Citation
Ls. Tkatch et al., Epidemiology of Legionella pneumonia and factors associated with Legionella-related mortality at a tertiary care center, CLIN INF D, 27(6), 1998, pp. 1479-1486
Citations number
48
Categorie Soggetti
Clinical Immunolgy & Infectious Disease",Immunology
Journal title
CLINICAL INFECTIOUS DISEASES
ISSN journal
10584838 → ACNP
Volume
27
Issue
6
Year of publication
1998
Pages
1479 - 1486
Database
ISI
SICI code
1058-4838(199812)27:6<1479:EOLPAF>2.0.ZU;2-M
Abstract
Legionella pneumophila is an important pathogen that may cause nosocomial a nd community-acquired pneumonia in patients with normal or altered immunity . The epidemiology of 40 cases of legionella pneumonia in patients hospital ized between 1986 and 1994 was studied. Fourteen patients (35%) were solid organ transplant recipients. The calculated annual incidence of L. pneumoph ila infection was highest among lung transplant recipients (2.07 cases per 1,000 transplant-years). There was a trend toward reduced mortality rates a nd less severe disease among transplant patients vs. nontransplant patients : mortality rate, 36% vs. 54%; incidence of intubation, 50% vs. 69%; rate o f concurrent infections, 29% vs. 38%; and overall rate of complications, 86 % vs. 96%; respectively. In a multivariate analysis, factors independently associated with an increased mortality rate were nosocomial acquisition, ne ed for intubation, formation of lung abscess or cavitation, and presence of pleural effusion. Thus, despite differing host immune responses, the most important prognostic factors affecting the outcome of legionellosis are nos ocomial acquisition and the development of pulmonary complications.