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Volume 26, Number 10—October 2020

CME ACTIVITY - Synopsis

Healthcare-Associated Legionnaires’ Disease, Europe, 2008−2017

Julien BeautéComments to Author , Diamantis Plachouras, Sven Sandin, Johan Giesecke, and Pär Sparén
Author affiliations: European Centre for Disease Prevention and Control, Stockholm, Sweden (J. Beauté, D. Plachouras); Karolinska Institutet, Stockholm (J. Beauté, S. Sandin, J. Giesecke, P. Sparén); Icahn School of Medicine at Mount Sinai, New York, New York, USA (S. Sandin); Seaver Autism Center for Research and Treatment at Mount Sinai, New York (S. Sandin)

Main Article

Table 4

Monoclonal subtype for L. pneumophila serogroup 1 isolates, European Union–European Economic Area, 2008−2017

Monoclonal subtype Community-acquired cases, no. (%) Healthcare-associated cases, no. (%)
Monoclonal antibody 3/1–positive*
Allentown 4 (0.5) 1 (1.1)
Allentown/France 198 (25.8) 8 (8.9)
Benidorm 105 (13.7) 9 (10.0)
France 1 (0.1) 0
Knoxville 197 (25.7) 5 (5.6)
Philadelphia 135 (17.6) 16 (17.8)
Subtotal
640 (83.6)
 39 (43.3)
Monoclonal antibody 3/1–negative
Bellingham 38 (5.0) 11 (12.2)
Camperdown 4 (0.5) 0
Heysham 0 1 (1.1)
OLDA 26 (3.4) 15 (16.7)
Oxford 3 (0.4) 1 (1.1)
Oxford/OLDA 55 (7.2) 23 (25.6)
Subtotal
126 (16.4)
 51 (56.7)
Total 766 (100.0) 90 (100.0)

*Monoclonal types are grouped by the presence (or lack) of the virulence-associated epitope recognized by the monoclonal antibody 3/1 (Dresden Panel) (10).

Main Article

References
  1. Fields  BS, Benson  RF, Besser  RE. Legionella and Legionnaires’ disease: 25 years of investigation. Clin Microbiol Rev. 2002;15:506–26. DOIPubMedGoogle Scholar
  2. Beauté  J; The European Legionnaires’ Disease Surveillance Network. Legionnaires’ disease in Europe, 2011 to 2015. Euro Surveill. 2017;22. DOIPubMedGoogle Scholar
  3. Soda  EA, Barskey  AE, Shah  PP, Schrag  S, Whitney  CG, Arduino  MJ, et al. Vital signs: health care-associated Legionnaires’ disease surveillance data from 20 states and a large metropolitan area - United States, 2015. MMWR Morb Mortal Wkly Rep. 2017;66:584–9. DOIPubMedGoogle Scholar
  4. European Centre for Disease Prevention and Control. Annual epidemiological report for 2017—Legionnaires' disease. Stockholm: The Centre; 2019.
  5. European Centre for Disease Prevention and Control. Legionnaires’ disease in Europe, 2015. ECDC surveillance report. Stockholm: The Centre; 2017.
  6. Hamilton  KA, Prussin  AJ II, Ahmed  W, Haas  CN. Outbreaks of Legionnaires’ disease and Pontiac fever 2006-2017. Curr Environ Health Rep. 2018;5:263–71. DOIPubMedGoogle Scholar
  7. Sabria  M, Yu  VL. Hospital-acquired legionellosis: solutions for a preventable infection. Lancet Infect Dis. 2002;2:368–73. DOIPubMedGoogle Scholar
  8. Chalmers  JD, Taylor  JK, Singanayagam  A, Fleming  GB, Akram  AR, Mandal  P, et al. Epidemiology, antibiotic therapy, and clinical outcomes in health care-associated pneumonia: a UK cohort study. Clin Infect Dis. 2011;53:107–13. DOIPubMedGoogle Scholar
  9. Polverino  E, Torres  A, Menendez  R, Cillóniz  C, Valles  JM, Capelastegui  A, et al.; HCAP Study investigators. Microbial aetiology of healthcare associated pneumonia in Spain: a prospective, multicentre, case-control study. Thorax. 2013;68:1007–14. DOIPubMedGoogle Scholar
  10. Helbig  JH, Bernander  S, Castellani Pastoris  M, Etienne  J, Gaia  V, Lauwers  S, et al. Pan-European study on culture-proven Legionnaires’ disease: distribution of Legionella pneumophila serogroups and monoclonal subgroups. Eur J Clin Microbiol Infect Dis. 2002;21:710–6. DOIPubMedGoogle Scholar
  11. Blatt  SP, Parkinson  MD, Pace  E, Hoffman  P, Dolan  D, Lauderdale  P, et al. Nosocomial Legionnaires’ disease: aspiration as a primary mode of disease acquisition. Am J Med. 1993;95:16–22. DOIPubMedGoogle Scholar
  12. Decker  BK, Palmore  TN. The role of water in healthcare-associated infections. Curr Opin Infect Dis. 2013;26:345–51. DOIPubMedGoogle Scholar
  13. Stephens  JH, Shaw  DD, Koehler  AP. Legionella pneumophila: probable transmission from a contaminated respiratory device. Commun Dis Intell Q Rep. 2015;39:E201–3.PubMedGoogle Scholar
  14. Collins  SL, Afshar  B, Walker  JT, Aird  H, Naik  F, Parry-Ford  F, et al. Heated birthing pools as a source of Legionnaires’ disease. Epidemiol Infect. 2016;144:796–802. DOIPubMedGoogle Scholar
  15. Almeida  D, Cristovam  E, Caldeira  D, Ferreira  JJ, Marques  T. Are there effective interventions to prevent hospital-acquired Legionnaires’ disease or to reduce environmental reservoirs of Legionella in hospitals? A systematic review. Am J Infect Control. 2016;44:e183–8. DOIPubMedGoogle Scholar
  16. Santé Publique France. Legionellosis notification form [updated 2017 Feb 6] [cited 2020 Jul 16]. https://demarchesadministratives.fr/formulaires/cerfa-12202-02-maladie-a-declaration-obligatoire-legionellose
  17. Istituto Superiore di Sanità. Linee guida per la prevenzione ed il controllo della legionellosi. 2015 May 13 [cited 2020 Jul 16]. http://old.iss.it/binary/iss4/cont/C_17_pubblicazioni_2362.pdf
  18. Public Health England. Legionnaires’ disease: case definitions. [updated 2017 Feb 6] [cited 2020 Jul 16]. https://www.gov.uk/government/publications/legionnaires-disease-clinical-case-definitions
  19. European Commission. Commission Implementing Decision 2012/506/EU of 8 August 2012 amending Decision 2002/253/EC laying down case definitions for reporting communicable diseases to the community network under decision no 2119/98/EC of the European Parliament and of the Council [cited 2020 Jul 16]. https://op.europa.eu/en/publication-detail/-/publication/10ed460f-0711-11e2-8e28-01aa75ed71a1/language-en
  20. Beauté  J, Zucs  P, de Jong  B, on behalf of the European Legionnai  C; European Legionnaires’ Disease Surveillance Network. Legionnaires disease in Europe, 2009-2010. Euro Surveill. 2013;18:20417. DOIPubMedGoogle Scholar
  21. Farnham  A, Alleyne  L, Cimini  D, Balter  S. Legionnaires’ disease incidence and risk factors, New York, New York, USA, 2002-2011. Emerg Infect Dis. 2014;20:1795–802. DOIPubMedGoogle Scholar
  22. Straus  WL, Plouffe  JF, File  TM Jr, Lipman  HB, Hackman  BH, Salstrom  SJ, et al.; Ohio Legionnaires Disease Group. Risk factors for domestic acquisition of legionnaires disease. Ohio legionnaires Disease Group. Arch Intern Med. 1996;156:1685–92. DOIPubMedGoogle Scholar
  23. Goetz  AM, Stout  JE, Jacobs  SL, Fisher  MA, Ponzer  RE, Drenning  S, et al. Nosocomial legionnaires’ disease discovered in community hospitals following cultures of the water system: seek and ye shall find. Am J Infect Control. 1998;26:8–11. DOIPubMedGoogle Scholar
  24. Katz  SM, Hammel  JM. The effect of drying, heat, and pH on the survival of Legionella pneumophila. Ann Clin Lab Sci. 1987;17:150–6.PubMedGoogle Scholar
  25. Phin  N, Parry-Ford  F, Harrison  T, Stagg  HR, Zhang  N, Kumar  K, et al. Epidemiology and clinical management of Legionnaires’ disease. Lancet Infect Dis. 2014;14:1011–21. DOIPubMedGoogle Scholar
  26. Currie  SL, Beattie  TK. Compost and Legionella longbeachae: an emerging infection? Perspect Public Health. 2015;135:309–15. DOIPubMedGoogle Scholar
  27. Muder  RR, Yu  VL. Infection due to Legionella species other than L. pneumophila. Clin Infect Dis. 2002;35:990–8. DOIPubMedGoogle Scholar
  28. Seenivasan  MH, Yu  VL, Muder  RR. Legionnaires’ disease in long-term care facilities: overview and proposed solutions. J Am Geriatr Soc. 2005;53:875–80. DOIPubMedGoogle Scholar
  29. Bargellini  A, Marchesi  I, Marchegiano  P, Richeldi  L, Cagarelli  R, Ferranti  G, et al. A culture-proven case of community-acquired legionella pneumonia apparently classified as nosocomial: diagnostic and public health implications. Case Rep Med. 2013;2013:303712. DOIPubMedGoogle Scholar
  30. Lessler  J, Brookmeyer  R, Perl  TM. An evaluation of classification rules based on date of symptom onset to identify health-care associated infections. Am J Epidemiol. 2007;166:1220–9. DOIPubMedGoogle Scholar

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Page updated: September 17, 2020
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