Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-30T20:04:00.575Z Has data issue: false hasContentIssue false

Active Surveillance of Legionnaires Disease During a Prospective Observational Study of Community-and Hospital-Acquired Pneumonia

Published online by Cambridge University Press:  02 January 2015

Erica Leoni*
Affiliation:
Department of Medicine and Public Health, Division of Hygiene, University of Bologna, Bologna, Italy
Rossella Sacchetti
Affiliation:
Department of Medicine and Public Health, Division of Hygiene, University of Bologna, Bologna, Italy
Manuela Aporti
Affiliation:
Sanitary Direction, St. Orsola-Malpighi General Hospital, Bologna, Italy
Claudio Lazzari
Affiliation:
Sanitary Direction, St. Orsola-Malpighi General Hospital, Bologna, Italy
Manuela Donati
Affiliation:
Department of Clinical and Experimental Medicine, Division of Microbiology, University of Bologna, Bologna, Italy
Franca Zanetti
Affiliation:
Department of Medicine and Public Health, Division of Hygiene, University of Bologna, Bologna, Italy
Giovanna De Luca
Affiliation:
Department of Medicine and Public Health, Division of Hygiene, University of Bologna, Bologna, Italy
Gian Franco Finzi
Affiliation:
Sanitary Direction, St. Orsola-Malpighi General Hospital, Bologna, Italy
Pier Paolo Legnani
Affiliation:
Department of Medicine and Public Health, Division of Hygiene, University of Bologna, Bologna, Italy
*
Dipartimento di Medicina e Sanità Pubblica, Via S. Giacomo 12, 40126 Bologna, Italy ([email protected])

Abstract

A prospective surveillance study of legionnaires disease and an environmental survey of Legionella species were performed simultaneously in a general hospital. During a period of 3 years, 705 patients with pneumonia were screened with a Legionella urinary antigen test, and pneumonia was confirmed by culture and serological tests. Twelve cases of legionnaires disease were identified, none of which were hospital acquired, despite the fact that 60% of hospital water samples were contaminated with Legionella pneumophila at a concentration of more than 103 colony-forming units/L. The probable source of infection was identified for only 2 community-acquired cases. The results show that environmental contamination alone is not able to predict the risk of legionnaires disease. If no cases are present, monitoring of hospital water systems is of little significance; clinical surveillance is much more important.

Type
Concise Communications
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Rota, MC, Caporali, MG, Losardo, M, Sedurio, M, Ricci, ML. La legionellosi in Italia nel 2004: rapporto annuale. Notiziario ISS 2006;19:38.Google Scholar
2. Borella, P, Montagna, MT, Romano Spica, V, et al. Legionella infection risk from domestic hot water. Emerg Infect Dis 2004;10:457464.Google Scholar
3. Borella, P, Montagna, MT, Stampi, S, et al. Legionella contamination in hot water of Italian hotels. Appl Environ Microbiol 2005;71:58055813.Google Scholar
4. Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections. Am J Infect Control 1988;16:128140.CrossRefGoogle ScholarPubMed
5. Leoni, E, Sacchetti, R, Zanetti, F, Legnani, PP. Control of Legionella pneumophila contamination in a respiratory hydrotherapy system with sulfurous spa water. Infect Control Hosp Epidemiol 2006;27:716721.Google Scholar
6. Mandell, LA, Marrie, TJ, Grossman, RF, Chow, AW, Hyland, RH. Canadian guidelines for the initial management of community-acquired pneumonia: an evidence-based update by the Canadian Infectious Diseases Society and the Canadian Thoracic Society. The Canadian Community-Acquired Pneumonia Working Group. Clin Infect Dis 2000;31:383421.Google Scholar
7. Nguyen, TM, Ilef, D, Jarraud, S, et al. A community-wide outbreak of legionnaires disease linked to industrial cooling towers—how far can contaminated aerosols spread? J Infect Dis 2006;193:102111.Google Scholar
8. Blazquez, RM, Espinosa, FJ, Martinez-Toldos, CM, Alemany, L, Garcia-Orenes, MC, Segovia, M. Sensitivity of urinary antigen test in relation to clinical severity in a large outbreak of Legionella pneumonia in Spain. Eur J Clin Microbiol Infect Dis 2005;24:488491.Google Scholar
9. Niederman, MS, Craven, DE, Bonten, MJ, et al. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. ATS Documents. Am J Respir Crit Care Med 2005;171:388416.Google Scholar
10. Ricketts, KD, Joseph, CA. Legionnaires' disease in Europe 2003-2004. Euro Surveill 2005;10:256259.Google Scholar
11. Centers for Disease Control and Prevention. Guidelines for preventing health-care-associated pneumonia, 2003. MMWR Recomm Rep 2004;53(RR-3):136.Google Scholar