Legionnaires' disease caused by Legionella longbeachae: Clinical features and outcomes of 107 cases from an endemic area

Respirology - Tập 21 Số 7 - Trang 1292-1299 - 2016
Heather Isenman1, Stephen T. Chambers1,2, Alan Pithie1, Sharyn MacDonald3, Justin M. Hegarty3, Joanna L. Fenwick3, Michael J. Maze1, Sarah Metcalf1, David R. Murdoch2,4
1Department of Infectious Diseases, Christchurch Hospital, Christchurch, New Zealand
2Department of Pathology, University of Otago, Christchurch, New Zealand
3Department of Radiology, Christchurch Hospital, Christchurch, New Zealand
4Microbiology Unit, Canterbury Health Laboratories, Christchurch, New Zealand

Tóm tắt

AbstractBackground and objectiveLegionella longbeachae is a predominant cause of Legionnaires' disease in some parts of the world, particularly in Australasia. Clinical reports of L. longbeachae infection are limited to case reports or small case series, and culture‐confirmed cases.MethodsWe reviewed the clinical characteristics and outcomes of L. longbeachae pneumonia in a large case series from Christchurch, New Zealand during a 4‐year period when both PCR and cultures were used as routine diagnostic tools for Legionnaires' disease. Cases of Legionella pneumophila pneumonia were reviewed for comparison.ResultsA total of 107 cases of L. longbeachae infection were identified by PCR and/or culture. The median age was 65 years (range 25–90 years), 63% were male, and most became unwell during spring or summer. Presenting clinical features were similar to those reported for community‐acquired pneumonia, with headache, myalgia and diarrhoea being common. Elevated C‐reactive protein, hyponatraemia and abnormal liver function tests were also common. History of productive cough, involvement of both lungs, and high bacterial load were independently associated with culture of Legionella from lower respiratory samples. One quarter required intensive care unit admission, and 5% died. Among patients given antimicrobial therapy before admission, those given agents without anti‐Legionella activity were more likely to be admitted to the intensive care unit. Limited comparisons were made with the 19 L. pneumophila cases over the same time period.ConclusionCharacteristics of L. longbeachae pneumonia are broadly similar to those reported for community‐acquired pneumonia from a variety of other populations, except for the spring/summer seasonality.

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Tài liệu tham khảo

10.1056/NEJM197712012972201

10.1056/NEJM197712012972202

10.1128/CMR.15.3.506-526.2002

10.1086/342884

10.1016/S1473-3099(14)70713-3

10.1128/CMR.00052-09

10.1017/S0950268811000975

10.1093/cid/cit504

10.3201/eid1704.100446

10.1099/jmm.0.035857-0

10.1017/S095026880600656X

10.1128/CMR.00029-14

10.1183/09031936.00191913

10.1111/j.1469-0691.2009.03125.x

Centers for Disease Control and Prevention, 2000, Legionnaires' Disease associated with potting soil – California, Oregon, and Washington, May–June 2000, MMWR Morb. Mortal. Wkly Rep., 49, 777

10.1111/j.1469-0691.2006.01562.x

10.3109/00365548709018486

10.1007/s10096-003-1071-7

10.1007/BF01584366

10.1099/jmm.0.47556-0

Lam S, 1982, Legionella longbeachae pneumonia diagnosed by bronchial brushing, Can. Med. Assoc. J., 127, 223

10.3201/eid1801.110579

10.1086/386322

10.7326/0003-4819-94-6-739

10.1086/523003

10.2807/1560-7917.ES2013.18.50.20656

Reynaldos Canton Migotto T, 2014, ARDS with septic shock due to Legionella longbeachae pneumonia in a patient with polymyalgia rheumatica, Heart Lung Vessel., 6, 114

10.1016/j.ijid.2013.10.004

10.1128/JCM.14.6.674-677.1981

10.1007/BF01644179

10.1136/thorax.58.5.377

Laing R, 2001, Community‐acquired pneumonia in Christchurch and Waikato 1999–2000: microbiology and epidemiology, N Z Med J., 114, 488

10.1136/thx.51.10.1010

10.1378/chest.100.4.1007

10.1186/1471-2466-9-4

Granados A, 1989, Pneumonia due to Legionella pneumophila and pneumococcal pneumonia – similarities and differences on presentation, Eur. Respir. J., 2, 130, 10.1183/09031936.93.02020130

10.1378/chest.109.5.1243

10.1378/chest.113.5.1195

10.1016/0007-0971(87)90130-6

10.1378/chest.125.4.1335

10.1183/09031936.03.00080203

10.1016/j.amjmed.2014.03.042

10.3109/23744235.2015.1021830

10.1186/1471-2334-13-585

10.1099/jmm.0.000215

10.1111/1469-0691.12524

10.1128/JCM.32.1.209-210.1994

10.1128/JCM.36.9.2718-2722.1998

10.1128/JCM.35.4.954-956.1997

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Respirology

Tập 21 Số 7

1292-1299

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