Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023241 (Legionella)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Legionella bacteria colonize drinking water systems and can cause severe pneumonia in humans (Legionnaires' disease (LD)). The German network for community-acquired pneumonia (CAPNETZ) estimates 15,000-30,000 new cases of LD per year in Germany. LD cases are divided into those that were acquired in the context of a stay in a hospital or nursing home (healthcare-associated; HCA), in the community (community-acquired (CA)) or during travel (travelassociated (TA)). According to the recommendations of the Communicable Disease Surveillance Centre (CDSC; UK) and the Healthcare Infection Control Practices Advisory Committee (HICPAC; USA) a single case of nosocomial LD should prompt an epidemiologic and, depending on its results, also technical investigation of the institution. In this study we present data from nosocomial cases of LD in the context of all cases of LD that were reported to the Robert Koch Institute (RKI) within the mandatory surveillance system from 2004 through 2006. We calculated the number of cases per population (incidence), the number of cases per person-days at risk (incidence rate) and case fatality. The analysis comprised 1,339 cases of LD. Among the 942 cases with one of the three categories of exposure CALD was reported in 58 % (547 cases), TALD in 29 % (270 cases) and HCA-LD in 13 % (125 cases). The incidence rate of TALD was 9-fold, but that of HCA-LD 15-fold higher than that of CALD. Case fatality of HCA-LD was 13 % and thus higher than that of CALD (9 %) and TALD (5 %). HCA-LD cases were reported from all states and included 77 different counties. Reporting counties represent the place of residence of the LD case-patients. German notification data show that cases of LD, and likely also HCALD, are underreported. Incidence rate and case fatality are highest in HCA-LD. HCA-LD occurs widespread. These results and the preventability of HCA-LD support the recommendation to thoroughly investigate single cases of HCA-LD in hospitals and nursing homes.
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PMID:[Nosocomial Legionnaires' disease--results from the analysis of Germany's surveillance data; 2004-2006]. 1921 58

Healthcare-associated Legionnaires' disease (HCA LD) causes significant morbidity and mortality, with varying guidance on prevention. We describe the evaluation of a case of possible HCA LD and note the pitfalls of relying solely on an epidemiologic definition for association of a case with a facility. Our detailed investigation led to the identification of a new Legionella pneumophila serogroup 1 sequence type, confirmed a healthcare association and helped build the framework for our ongoing preventive efforts. Our experience highlights the role of routine environmental cultures in the assessment of risk for a given facility. As clinicians increasingly rely on urinary antigen testing for the detection of L. pneumophila, our investigation emphasises the importance of clinical cultures in an epidemiologic investigation.
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PMID:Healthcare-associated Legionnaires' disease: Limitations of surveillance definitions and importance of epidemiologic investigation. 2934 93

Healthcare-associated Legionnaires' disease (HCA LD) can cause nosocomial outbreaks with high death rates. We compared community-acquired LD cases with HCA LD cases in Europe during 2008-2017 using data from The European Surveillance System. A total of 29 countries reported 40,411 community-acquired and 4,315 HCA LD cases. Of the HCA LD cases, 2,937 (68.1%) were hospital-acquired and 1,378 (31.9%) were linked to other healthcare facilities. The odds of having HCA LD were higher for women, children and persons <20 years of age, and persons >60 years of age. Out of the cases caused by Legionella pneumophila with a known serotype, community-acquired LD was more likely to be caused by L. pneumophila serogroup 1 (92.3%) than was HCA LD (85.1%). HCA LD patients were more likely to die. HCA LD is associated with specific patient demographics, causative strains, and outcomes. Healthcare facilities should consider these characteristics when designing HCA LD prevention strategies.
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PMID:Healthcare-Associated Legionnaires' Disease, Europe, 2008-2017. 3294 66