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Query: UMLS:C0023241 (Legionella)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The risk of opportunistic infection in the renal transplant patient is due to an interaction between two major factors: the epidemiologic exposures (particularly within the hospital environment) and the net state of immunosuppression. The net state of immunosuppression is determined by the nature, dose, and duration of the immunosuppressive therapy being administered; the presence or absence of granulocytopenia and technical factors that could compromise the primary mucocutaneous barriers to infection; such metabolic factors as uremia, hyperglycemia, and the state of nutrition; and, finally, the immunomodulating effects of such viruses as CMV, the hepatitis viruses, and HIV. The major types of opportunistic infection to which the renal transplant patient is susceptible are the following: the viruses of the herpes group and papovaviruses; bacteria such as L monocytogenes, N asteroides, and Legionella; such fungi as Candida, Aspergillus, C neoformans, and the Mucoraceae; and protozoans such as P carinii, S stercoralis, and T gondii.
Transplant Proc 1988 Dec
PMID:Opportunistic infections in renal allograft recipients. 305 19

A patient is described who developed cavitary Legionella pneumonia 2 weeks after kidney transplantation. The initial pulmonary symptoms were followed by severe thrombocytopenia and acute renal failure. Although acute irreversible graft rejection was suspected, this was not supported by the pathology findings in the resected kidney, which were compatible with tubular damage. We presume that the extrapulmonary symptoms were caused by Legionellosis.
Transpl Int 1988 Dec
PMID:Legionella infection with acute renal failure and thrombocytopenia mimicking allograft rejection. A pitfall in post-transplantation diagnosis. 307 87

Mixed bacterial pneumonia caused by organisms other than anaerobes has been infrequently reported. We describe six cases and review the literature. Two patients had co-infection with S pneumoniae and L pneumophila. Two were infected with S pneumoniae and K pneumoniae and the others simultaneously harbored M tuberculosis and N asteroides. The first two sets of patients had bacteria isolated from usually sterile sites (blood and lung), while the latter harbored repeatedly isolated organisms not usually felt to be part of the normal respiratory flora. Mixed infection may help explain the substantial mortality still seen from pneumonia. This is especially true if Legionella, mycobacteria, or Nocardia species are encountered where routine smears and cultures may not aid in the diagnosis. Poor clinical response to specific antibacterial therapy in pneumonia should trigger further investigation for other potential pathogens.
Chest 1986 Dec
PMID:Community-acquired pneumonia caused by mixed aerobic bacteria. 309 44

Warm and cold water as well as water from wash basin drains and faucet aerators was examined to determine the number of viable and dead bacteria by culture and by staining and to establish the spectrum of species with special consideration of Legionella pneumophila. The relation between the number of Legionella pneumophila, the temperature, and the iron content of the water was determined in three separate warm water systems. High colony counts (up to 8.9 X 10(5) colony-forming units), were detected in both warm and cold water at certain sampling sites. The most prevalent genera were Pseudomonas, Bacillus, Flavobacterium, Acinetobacter, and Moraxella. Legionella pneumophila was found in every building in 35 of 150 warm samples and in 1 of 43 cold water samples. The highest water temperature of a sample containing Legionella pneumophila was 64 degrees C. The correlation between high colony counts and the occurrence of Legionella pneumophila in the samples was not significant. High iron concentrations, however, appear to have a positive effect on the growth of Legionella pneumophila.
Zentralbl Bakteriol Mikrobiol Hyg B 1986 Dec
PMID:Bacterial colonization and occurrence of Legionella pneumophila in warm and cold water, in faucet aerators, and in drains of hospitals. 310 60

42 dental units in 35 dentist practices were bacteriologically examined. Legionella of the species Legionella pneumophila--SG1 could be isolated from 4 dental units. Infection can occur during inhalation of finest aerosols, which are formed during the use of dental turbines and sprays.
Zentralbl Bakteriol Mikrobiol Hyg B 1986 Dec
PMID:[Demonstration of Legionella pneumophila in dental units]. 310 61

Within a scope of an investigation concerning hygiene-problems in dental practice a longitudinal study was carried out in 20 dental offices with 53 units. In order to guarantee equal experimental conditions and to eliminate variations caused by changing water flow during the day, we took the samples before office hours alternating mondays, tuesdays and wednesdays. Those samples gathered from all handpieces (n = 530) and the drinking water faucets (n = 200) were examined according to the "Trinkwasser-Verordnung" (1986), diagnostics were supplemented concerning special groups of bacteria (see also Table 1). Analyses of copper, zinc and iron were done once during the study. Selecting certain sampling spots (see also Table 2) the surface contamination of the units and the surroundings was examined using the "Rodac"-method (n = 4800). The results of the study may be summarized as follows: The investigation concerning the surface contamination showed under qualitative and quantitative aspects (see also Fig. 10) constant contaminations on the patients' head- and armrests, the operating lamp, cuspidor-bowl and hand-wash-basin. In samples taken from the water system of dental units potentially pathogenic bacteria were isolated in 71%, in first place Ps. aeruginosa, followed by Ps. acidovorans and other species of this group. Legionella species occurred sporadically in the units and potable water of 8 offices. On the base of the total germ count (22 degrees C and 37 degrees C) the diagnosis "drinking-water quality" was possible only in 31%. The longitudinal investigation showed, that the contamination of the water system follows different progressive forms regarding extent and quality (see also Fig. 7). Relating to these results in the first step the development of a theoretical model concerning the different influencing factors (quality of water tubes and other devices, variation of temperature, quality of potable water and the effect of ionic exchangers, indirect contamination by patients and dental staff, nature of dental treatment, utilization frequency of the direct handpieces) appears to be necessary. Thus the contamination has to be understood as a developing process determined by specific promotors and catalyzers; in the second step the evaluation of adequate bactericidal and virucidal decontamination procedures fitting into the daily practical needs of dental offices should follow.
Zentralbl Bakteriol Mikrobiol Hyg B 1986 Dec
PMID:[Hygiene problems in dental practice with special attention to dental units]. 310 65

Cross-reactions of 17 members of the family Legionellaceae were studied by four different serological techniques: immunofluorescence (IF), slide agglutination (SA), microagglutination (MA) and immunodiffusion (ID), using antigens and rabbit antisera prepared in our laboratory. Results obtained corresponded closely with those described by other authors, especially for IF and SA. The 17 antigens were further tested by IF with a panel of sera previously diagnosed as positive for legionella. A high number of positive reactions with several of the antigens tested were found, half of them being positive for Legionella pneumophila serogroup 1, usually in combination with other serogroups or species. The remaining sera presented a great variety of patterns combining different antigens.
Epidemiol Infect 1987 Dec
PMID:Cross-reactivity among Legionella species and serogroups. 312 64

We examined the ability of two recombinant human cytokines, granulocyte-macrophage colony-stimulating factor (rHu-GM-CSF) and interferon-gamma (rHu-IFN-gamma) to activate antibacterial mechanisms in human pulmonary macrophages (PM) and peripheral blood monocytes (PBM). Growth of Legionella pneumophila (LP) was assessed in PM or PBM which had been exposed to either rHu-IFN-gamma (500-1000 u/ml) or rHu-GM-CSF (1 to 10,000 u/ml). In both PM and PBM exposed to 500 u/ml rHu-IFN-gamma, growth of LP was reduced compared to cells exposed to media alone. By comparison, exposure of these cell types to rHu-GM-CSF had no detectable effect on bacterial replication. In order to investigate potential mechanisms accounting for this observation, the effect of these cytokines on the hydrogen peroxide (H2O2)-releasing capacity of cells was studied. Exposure of PM and PBM to rHu-IFN-gamma (500 to 1000 u/ml) resulted in increased production of H2O2 triggered by phorbol myristate acetate; when subjected to the same experimental conditions, rHu-GM-CSF-exposed cells exhibited no increase in H2O2 production. To further clarify the role of rHu-IFN-gamma-induced augmentation of oxidative metabolism on cellular inhibition of bacterial growth, an amount of catalase capable of completely neutralizing extracellular H2O2 was added to cells before and during infection. This did not abrogate the antibacterial activity of rHu-IFN-gamma. These studies demonstrate that rHu-IFN-gamma but not rHu-GM-CSF is capable of augmenting the capacity of PM and PBM to restrict LP growth. These data suggest that the antibacterial activity of rHu-IFN-gamma in this system may involve oxidative as well as nonoxidative mechanisms.
Cell Immunol 1988 Dec
PMID:Cytokine activation of antibacterial activity in human pulmonary macrophages: comparison of recombinant interferon-gamma and granulocyte-macrophage colony-stimulating factor. 314 84

A prospective evaluation of a DNA probe assay for detection of Legionella species was performed on 427 consecutive respiratory specimens submitted over an 18-month period. The Gen-Probe assay utilizing both low (greater than or equal to 4.0) and high (greater than 7.0) ratio threshold values was compared to direct fluorescent antibody staining (DFA) as a predictor of isolation of Legionella on culture. The highest sensitivity (63%) was obtained with the lower threshold ratio, but was not significantly different from the result obtained with a threshold ratio of greater than 7.0 (50%, p = 0.722) or DFA results (44%, p = 0.479). The specificity of the DNA probe assay was improved with the high threshold (99%) compared either to the low threshold ratio (95%, p = 0.002) or DFA (97%, p = 0.055). When the DNA probe was compared to DFA and/or Legionella isolation on culture, a significantly lower specificity (97% versus 99%, p = 0.0006) and higher sensitivity (74% versus 37%, p = 0.013) was obtained with a threshold value of greater than or equal to 4.0 than greater than 7.0. Ten of 20 specimens with a DNA probe ratio between 4.0 and 7.0 were DFA positive, although only two were isolated on culture. The DFA assay and both probe threshold ratios have a high negative predictive value when compared to culture. However, only the threshold ratio of greater than 7.0 has a sufficiently high positive predictive value to be useful alone.(ABSTRACT TRUNCATED AT 250 WORDS)
Eur J Clin Microbiol Infect Dis 1988 Dec
PMID:Prospective evaluation of the Gen-Probe assay for detection of legionellae in respiratory specimens. 314 56

The presumed route of human infection by Legionella pneumophila is inhalation. We investigated possible oral transmission of legionellosis in guinea pigs. Fifty-six guinea pigs (group 1) were given virulent L. pneumophila, serogroup 1, in drinking water. Fifty-nine guinea pigs (group 2) were inoculated with L. pneumophila via gastric intubation. Nineteen guinea pigs (group 3) were given heat-killed L. pneumophila in drinking water. Twenty-four guinea pigs (group 4, positive control) were inoculated intraperitoneally with L. pneumophila. Twenty-seven guinea pigs (group 5, negative control) were either intubated gastrically with phosphate-buffered saline or given drinking water without L. pneumophila. Sixty-six of 115 (57%) of the guinea pigs orally inoculated with viable L. pneumophila (groups 1 and 2) had a temperature greater than or equal to 103 degrees F and 8 of 115 (7%) had diarrhea, compared with 0 of 19 (0%) and 0 of 19 (0%), respectively, in group 3 and 1 of 27 (4%) and 0 of 27 (0%), respectively, in group 5. There were no fatalities in groups 1, 2, 3, and 5 compared with 15 of 24 (63%) in group 4. Groups 1, 2, and 4 consistently showed pneumonitis and splenitis. The pneumonitis of groups 1 and 2 was mild, predominantly interstitial, and mainly composed of macrophages; neither gross nor microscopic evidence of aspiration was seen. In group 1, 4 of 29 (14%) guinea pigs tested seroconverted to L. pneumophila compared with 0 of 7 (0%) in group 3 and 0 of 10 (0%) in group 5. In groups 1 and 2 combined, L. pneumophila was isolated from the lung of 5 of 57 (11%) guinea pigs and spleen of 5 of 47 (11%) guinea pigs compared with 0 of 14 guinea pigs in group 5. We conclude that viable L. pneumophila administered orally produces a self-limited febrile illness in guinea pigs.
Gastroenterology 1988 Dec
PMID:A self-limited febrile illness produced in guinea pigs associated with oral administration of Legionella pneumophila. 318 81


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