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Prevalence of legionellosis among adults: A study of community-acquired pneumonia in France

Prävalenz der Legionellose bei Erwachsenen. Studie zur nosokomialen Pneumonie in Frankreich

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Summary

Over a 24-month period, 274 patients with community-acquired pneumonia were hospitalized in Departments of Medicine at hospitals in Bordeaux, Lyon, Marseille, and Toulouse. Etiology of the pneumonia was determined either by organism identification or by indirect immunofluorescence in only 139 cases (51%). The most frequently isolated etiological agents wereStreptococcus pneumoniae (34 cases),Legionella pneumophila (29 cases) andMycoplasma pneumoniae (24 cases). The majority of patients with legionellosis were male (79%), middle aged (mean age: 53 years), and living in urban areas (69%). Their clinical features were atypical and did not differ from those of other pneumonias. Four patients with legionellosis (13.8%) died.L. pneumophila was isolated directly in only three instances. The study confirms the high prevalence of legionellosis (20%) among pneumonias of identified etiology. The fact that these cases had an atypical clinical presentation and that isolation of the organism was difficult reinforce the need to apply the CDC criteria for the interpretation of positive serological titers.

Zusammenfassung

In einem Zeitraum von 24 Monaten wurden 274 Patienten mit nosokomialer Pneumonie in internen Abteilungen von Kliniken in Bordeaux, Lyon, Marseille und Toulouse stationär behandelt. Die ätiologische Diagnose der Pneumonie konnte durch Identifizierung des Erregers oder indirekte Immunfluoreszenz nur bei 139 Fällen (51%) gestellt werden. Die häufigsten Erreger warenStreptococcus pneumoniae (34 Fälle),Legionella pneumophila (29 Fälle) undMycoplasma pneumoniae (24 Fälle). Bei den Patienten mit Legionellose waren Männer in der Überzahl (79%), das mittlere Alter betrug 53 Jahre, 69% der Patienten lebten in Städten. Die klinischen Symptome waren uncharakteristisch und unterschieden sich nicht von denen anderer Pneumonien. Vier der an Legionella-Pneumonie erkrankten Patienten verstarben (13,8%).L. pneumophila wurde nur in drei Fällen direkt isoliert. Die vorliegende Untersuchung bestätigt die hohe Prävalenz der Legionellose bei Pneumonien definierter Ätiologie (20%). Die Tatsache, daß diese Fälle ein atypisches klinisches Bild aufwiesen und daß die Erregerisolation schwierig war, bestätigen die Notwendigkeit, positive serologische Befunde nach den CDC-Kriterien zu interpretieren.

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Authors and Affiliations

  1. Clinique Médicale et des Maladies Infectieuses, Hôpital Pellegrin, CHU de Bordeaux, F-33076, Bordeaux Cedex

    J. Aubertin M. D. & E. Brottier

  2. Département d'Epidémiologie et de Biostatistiques, Université Bordeaux II, F-33076, Bordeaux Cedex

    F. Dabis M.D. &  R. Salamon M.D.

  3. Laboratoire Central de Bactériologie et Centre National de Référence des Légionelloses, Hôpital de la Croix-Rousse, F-69317, Lyon Cedex 04

    J. Fleurette M.D. & N. Bornstein M.D.

  4. Service de Pneumologie, Hôpital Louis Pradel, F-69000, Lyon

    J. Brune M.D. & P. Vincent M.D.

  5. Service de Pneumologie, Hôspital Rangueil, F-31000, Toulouse

    J. Migueres M.D. &  A. Jover M.D.

  6. Service de Pneumologie, Hôpital Michel Levy, F-13000, Marseille

    C. Boutin M.D.

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  1. J. Aubertin M. D.
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  2. F. Dabis M.D.
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  3. J. Fleurette M.D.
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  4. N. Bornstein M.D.
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  5. R. Salamon M.D.
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  6. E. Brottier
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  7. J. Brune M.D.
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  8. P. Vincent M.D.
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  9. J. Migueres M.D.
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  10. A. Jover M.D.
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  11. C. Boutin M.D.
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Aubertin, J., Dabis, F., Fleurette, J. et al. Prevalence of legionellosis among adults: A study of community-acquired pneumonia in France. Infection 15, 328–331 (1987). https://doi.org/10.1007/BF01647732

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  • DOI: https://doi.org/10.1007/BF01647732

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