Legionnaires’ disease at a medical center in southern Taiwan

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Abstract

Background/purpose: Legionella pneumophila had been recognized as a pathogen for both healthcare-associated and community-acquired pneumonia. We aimed to evaluate clinical features and outcomes of patients with Legionnaires’ disease at a tertiary medical center in southern Taiwan. Methods: From January 2005 to December 2013, a retrospective study of adult cases of Legionnaires’ disease was conducted in a 1200-bed tertiary hospital. Their medical records were reviewed for further evaluation and analysis. Results: A total of 61 cases of Legionnaires’ disease were identified during the study period. Their mean age was 61.1 years, with male predominance (43, 70.5%). Among them, 30 (49.2%) had healthcare-associated pneumonia (HCAP), 20 (32.8%) had community-acquired pneumonia, and notably 11 (18.0%) were caregivers. Patients with healthcare-associated pneumonia tend to have higher Charlson comorbidity scores than those with community-acquired pneumonia (3.6 ± 2.4 vs. 1.9 ± 1.9, p = 0.008) and caregivers (0.5 ± 0.5, p < 0.001). Six patients died, resulting in an in-hospital mortality rate of 9.8%. Underlying cancer (66.7% vs. 20.0%, p = 0.028) and a higher Charlson comorbidity score (4.7 ± 2.6 vs. 2.2 ± 2.2, p = 0.013) were related to a fatal outcome. Conclusion: L. pneumophila remains an important pathogen for pneumonia acquired from the community or associated with healthcare facility. Healthy caregivers may potentially be at risk for Legionella infection in certain clinical settings.

Original languageEnglish
Pages (from-to)352-358
Number of pages7
JournalJournal of Microbiology, Immunology and Infection
Volume51
Issue number3
DOIs
Publication statusPublished - 2018 Jun 1

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Legionnaires' Disease
Taiwan
Pneumonia
Caregivers
Delivery of Health Care
Legionella pneumophila
Comorbidity
Legionella
Fatal Outcome
Hospital Mortality
Tertiary Care Centers
Medical Records
Retrospective Studies
Mortality
Infection
Neoplasms

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

Cite this

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title = "Legionnaires’ disease at a medical center in southern Taiwan",
abstract = "Background/purpose: Legionella pneumophila had been recognized as a pathogen for both healthcare-associated and community-acquired pneumonia. We aimed to evaluate clinical features and outcomes of patients with Legionnaires’ disease at a tertiary medical center in southern Taiwan. Methods: From January 2005 to December 2013, a retrospective study of adult cases of Legionnaires’ disease was conducted in a 1200-bed tertiary hospital. Their medical records were reviewed for further evaluation and analysis. Results: A total of 61 cases of Legionnaires’ disease were identified during the study period. Their mean age was 61.1 years, with male predominance (43, 70.5{\%}). Among them, 30 (49.2{\%}) had healthcare-associated pneumonia (HCAP), 20 (32.8{\%}) had community-acquired pneumonia, and notably 11 (18.0{\%}) were caregivers. Patients with healthcare-associated pneumonia tend to have higher Charlson comorbidity scores than those with community-acquired pneumonia (3.6 ± 2.4 vs. 1.9 ± 1.9, p = 0.008) and caregivers (0.5 ± 0.5, p < 0.001). Six patients died, resulting in an in-hospital mortality rate of 9.8{\%}. Underlying cancer (66.7{\%} vs. 20.0{\%}, p = 0.028) and a higher Charlson comorbidity score (4.7 ± 2.6 vs. 2.2 ± 2.2, p = 0.013) were related to a fatal outcome. Conclusion: L. pneumophila remains an important pathogen for pneumonia acquired from the community or associated with healthcare facility. Healthy caregivers may potentially be at risk for Legionella infection in certain clinical settings.",
author = "Hung, {Tzu Lun} and Ming-Chi Li and Wang, {Li Rong} and Ching-Chuan Liu and Chia-Wen Li and Po-Lin Chen and Ling-Shan Syue and Nan-Yao Lee and Wen-Chien Ko",
year = "2018",
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pages = "352--358",
journal = "Journal of Microbiology, Immunology and Infection",
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TY - JOUR

T1 - Legionnaires’ disease at a medical center in southern Taiwan

AU - Hung, Tzu Lun

AU - Li, Ming-Chi

AU - Wang, Li Rong

AU - Liu, Ching-Chuan

AU - Li, Chia-Wen

AU - Chen, Po-Lin

AU - Syue, Ling-Shan

AU - Lee, Nan-Yao

AU - Ko, Wen-Chien

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Background/purpose: Legionella pneumophila had been recognized as a pathogen for both healthcare-associated and community-acquired pneumonia. We aimed to evaluate clinical features and outcomes of patients with Legionnaires’ disease at a tertiary medical center in southern Taiwan. Methods: From January 2005 to December 2013, a retrospective study of adult cases of Legionnaires’ disease was conducted in a 1200-bed tertiary hospital. Their medical records were reviewed for further evaluation and analysis. Results: A total of 61 cases of Legionnaires’ disease were identified during the study period. Their mean age was 61.1 years, with male predominance (43, 70.5%). Among them, 30 (49.2%) had healthcare-associated pneumonia (HCAP), 20 (32.8%) had community-acquired pneumonia, and notably 11 (18.0%) were caregivers. Patients with healthcare-associated pneumonia tend to have higher Charlson comorbidity scores than those with community-acquired pneumonia (3.6 ± 2.4 vs. 1.9 ± 1.9, p = 0.008) and caregivers (0.5 ± 0.5, p < 0.001). Six patients died, resulting in an in-hospital mortality rate of 9.8%. Underlying cancer (66.7% vs. 20.0%, p = 0.028) and a higher Charlson comorbidity score (4.7 ± 2.6 vs. 2.2 ± 2.2, p = 0.013) were related to a fatal outcome. Conclusion: L. pneumophila remains an important pathogen for pneumonia acquired from the community or associated with healthcare facility. Healthy caregivers may potentially be at risk for Legionella infection in certain clinical settings.

AB - Background/purpose: Legionella pneumophila had been recognized as a pathogen for both healthcare-associated and community-acquired pneumonia. We aimed to evaluate clinical features and outcomes of patients with Legionnaires’ disease at a tertiary medical center in southern Taiwan. Methods: From January 2005 to December 2013, a retrospective study of adult cases of Legionnaires’ disease was conducted in a 1200-bed tertiary hospital. Their medical records were reviewed for further evaluation and analysis. Results: A total of 61 cases of Legionnaires’ disease were identified during the study period. Their mean age was 61.1 years, with male predominance (43, 70.5%). Among them, 30 (49.2%) had healthcare-associated pneumonia (HCAP), 20 (32.8%) had community-acquired pneumonia, and notably 11 (18.0%) were caregivers. Patients with healthcare-associated pneumonia tend to have higher Charlson comorbidity scores than those with community-acquired pneumonia (3.6 ± 2.4 vs. 1.9 ± 1.9, p = 0.008) and caregivers (0.5 ± 0.5, p < 0.001). Six patients died, resulting in an in-hospital mortality rate of 9.8%. Underlying cancer (66.7% vs. 20.0%, p = 0.028) and a higher Charlson comorbidity score (4.7 ± 2.6 vs. 2.2 ± 2.2, p = 0.013) were related to a fatal outcome. Conclusion: L. pneumophila remains an important pathogen for pneumonia acquired from the community or associated with healthcare facility. Healthy caregivers may potentially be at risk for Legionella infection in certain clinical settings.

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U2 - 10.1016/j.jmii.2016.08.006

DO - 10.1016/j.jmii.2016.08.006

M3 - Article

VL - 51

SP - 352

EP - 358

JO - Journal of Microbiology, Immunology and Infection

JF - Journal of Microbiology, Immunology and Infection

SN - 1684-1182

IS - 3

ER -