Abstract
Introduction: Legionella pneumophila causes severe pneumonia, with an increasing incidence and a high mortality rate. On November 2014 the second largest outbreak of Legionnaires' disease in the world was identified in Vila Franca de Xira, with 377 confirmed cases. Most of the patients were observed, admitted or re-evaluated at Hospital Vila Franca de Xira (HVFX).
Objectives: Descriptive analysis of the patients evaluated after the episode of pneumonia, in the context of a protocol created by the Pulmonary Unit of HVFX during the outbreak, as a means of supporting the emergency department and the wards by ensuring proper and timely follow-up.
Methods: Longitudinal retrospective study of a cohort of patients with confirmed and probable Legionella pneumonia. Amongst other information, we collected: epidemiological facts, comorbidities, smoking habits, symptoms, diagnostic methods, antibiotics prescribed, complications and follow-up data. The statistical analysis was performed using SPSS version 23.
Results: Out of the 225 evaluated patients, 140 confirmed and 22 probable cases were found. The mean age was 59 years and 60% were male. The most prevalent comorbidities were smoking (60%), hypertension (53%) and diabetes (26%). L. pneumophila antigenuria was positive in 80% of the cases, 6% had isolation of L. spp in sputum culture and 6% had seroconversion. Hospital admission was necessary in 87% of the patients, 25% were admitted to an Intensive Care Unit (ICU) and 8% needed invasive mechanical ventilation.
Conclusion: During an outbreak, the timely organization of a well-structured protocol may help an overloaded health system. It might also improve the course of action in similar future situations.
- Copyright ©the authors 2016