1887

Abstract

The reported incidence of Legionnaires' disease caused by Legionella longbeachae has increased since 2008 in Scotland. While microbiological and epidemiological studies have identified exposure to growing media as a risk factor for infection, little is known about the differences regarding disease risk factors, clinical features and outcomes of infection with L. longbeachae when compared with L. pneumophila. A nested case–case study was performed comparing 12 L. longbeachae cases with 25 confirmed L. pneumophila cases. Fewer L. longbeachae infected patients reported being smokers [27 % (95 % CI 2–52 %) vs. 68 % (95 % CI 50–86 %), P = 0.034] but more L. longbeachae patients experienced breathlessness [67 % (95 % CI 40–94 %) vs. 28 % (95 % CI 10–46 %), P = 0.036]. Significantly more L. longbeachae-infected patients received treatment in intensive care [50 % (95 % CI 22–78 %) vs. 12 % (95 % CI 0–25 %), P = 0.036]. However, the differences in diagnostic methods between the two groups may have led to only the most severe cases of L. longbeachae being captured by the surveillance system. No differences were observed in any of the other pre-hospital symptoms assessed. Our results highlight the similarity of Legionnaires' disease caused by L. pneumophila and L. longbeachae, and reinforce the importance of diagnostic tools other than the urinary antigen assays for the detection of non-L. pneumophila species. Unfortunately, cases of community-acquired pneumonia caused by Legionella species will continue to be underdiagnosed unless routine testing criteria changes.

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2016-02-01
2019-10-23
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References

  1. Amodeo M. R., Murdoch D. R., Pithie A. D.. ( 2010;). Legionnaires' disease caused by Legionella longbeachae and Legionella pneumophila: comparison of clinical features, host-related risk factors, and outcomes. Clin Microbiol Infect 16: 1405–1407 [CrossRef] [PubMed].
    [Google Scholar]
  2. Burdet C., Lepeule R., Duval X., Caseris M., Rioux C., Lucet J.-C., Yazdanpanah Y.. ( 2014;). Quinolones versus macrolides in the treatment of legionellosis: a systematic review and meta-analysis. J Antimicrob Chemother 69: 2354–2360 [CrossRef] [PubMed].
    [Google Scholar]
  3. Cameron S., Roder D., Walker C., Feldheim J.. ( 1991;). Epidemiological characteristics of Legionella infection in South Australia: implications for disease control. Aust N Z J Med 21: 65–70 [CrossRef] [PubMed].
    [Google Scholar]
  4. Currie S. L., Beattie T. K., Knapp C. W., Lindsay D. S. J.. ( 2014;). Legionella spp. in UK composts–a potential public health issue?. Clin Microbiol Infect 20: O224–O229 [CrossRef] [PubMed].
    [Google Scholar]
  5. European Centre for Disease Prevention and Control (ECDC) ( 2012;). European Legionnaires' disease surveillance network (ELDSNet): Operating procedure Available: http://ecdc.europa.eu/en/healthtopics/legionnaires_disease/ELDSNet/Pages/index.aspx Accessed: 14th September 2015.
    [Google Scholar]
  6. European Centre for Disease Prevention and Control (ECDC) ( 2014;). Legionnaires' disease in Europe 2013 Available: http://ecdc.europa.eu/en/healthtopics/legionnaires_disease/Pages/Publications.aspx. Accessed: 7th October 2015.
    [Google Scholar]
  7. Fields B. S., Benson R. F., Besser R. E.. ( 2002;). Legionella and Legionnaires' disease: 25 years of investigation. Clin Microbiol Rev 15: 506–526 [CrossRef] [PubMed].
    [Google Scholar]
  8. Graham F. F., White P. S., Harte D. J. G., Kingham S. P.. ( 2012;). Changing epidemiological trends of legionellosis in New Zealand, 1979-2009. Epidemiol Infect 140: 1481–1496 [CrossRef] [PubMed].
    [Google Scholar]
  9. Health Protection Scotland (HPS) ( 2014;). Cluster of Legionella longbeachae cases in Scotland in September/October 2013 Available: http://www.hps.scot.nhs.uk/resp/publicationsdetail.aspx?id = 58958&subjectid = 185,97. Accessed: 8th October 2015.
    [Google Scholar]
  10. Lim W. S., Baudouin S. V., George R. C., Hill A. T., Jamieson C., Le Jeune I., Macfarlane J. T., Read R. C., Roberts H. J., other authors. ( 2009;). BTS guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax 64: (Suppl 3), iii1–iii55 [CrossRef] [PubMed].
    [Google Scholar]
  11. Murdoch D. R., Podmore R. G., Anderson T. P., Barratt K., Maze M. J., French K. E., Young S. A., Chambers S. T., Werno A. M.. ( 2013;). Impact of routine systematic polymerase chain reaction testing on case finding for Legionnaires' disease: a pre-post comparison study. Clin Infect Dis 57: 1275–1281 [CrossRef] [PubMed].
    [Google Scholar]
  12. O'Connor B. A., Carman J., Eckert K., Tucker G., Givney R., Cameron S.. ( 2007;). Does using potting mix make you sick? Results from a Legionella longbeachae case-control study in South Australia. Epidemiol Infect 135: 34–39 [CrossRef] [PubMed].
    [Google Scholar]
  13. Pedro-Botet L., Yu V. L.. ( 2006;). Legionella: macrolides or quinolones?. Clin Microbiol Infect 12: (Suppl 3), 25–30 [CrossRef] [PubMed].
    [Google Scholar]
  14. Potts A., Donaghy M., Marley M., Othieno R., Stevenson J., Hyland J., Pollock K. G., Lindsay D., Edwards G., other authors. ( 2013;). Cluster of Legionnaires disease cases caused by Legionella longbeachae serogroup 1, Scotland, August to September 2013. Euro Surveill 18: 20656 [CrossRef] [PubMed].
    [Google Scholar]
  15. Pravinkumar S. J., Edwards G., Lindsay D., Redmond S., Stirling J., House R., Kerr J., Anderson E., Breen D., other authors. ( 2010;). A cluster of Legionnaires' disease caused by Legionella longbeachae linked to potting compost in Scotland, 2008-2009. Euro Surveill 15: 19496 [PubMed].
    [Google Scholar]
  16. Public Health England (PHE) ( 2015;). Legionnaires' disease in England and Wales Available: https://www.gov.uk/government/collections/legionnaires-disease-guidance-data-and-analysis#epidemiology. Accessed: 7th October 2015.
    [Google Scholar]
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