1887

Abstract

Here, we describe four cases of laboratory-confirmed infection. Case 1 was a culture-confirmed case of infection in a patient with liver cirrhosis. Following this, three other liver cirrhosis cases (cases 2–4) were diagnosed with infection as confirmed by quantitative real-time PCR. The cause of the pneumonia was determined as by positive direct fluorescence assay and isolation of the causative agent. The infections were successfully treated by administering appropriate antibiotics. These cases highlight the importance of considering as a cause of pneumonia in patients with liver disease and lung infections. The strain of isolated from Case 1 was characterized as being closely related to strain Philadelphila-1 (ATCC 33152), which is the type strain of the species, belonging to serogroup 1 and sequence type 36 (ST36), and is known to be distributed worldwide. To our knowledge, this is the first report of infection on the Chinese mainland for a decade and highlights the need to raise awareness of diagnostic methods for Legionnaires’ disease in China and the requirement for further epidemiological surveillance strategies to monitor this disease.

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2012-07-01
2019-10-13
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References

  1. Allegra S. , Berger F. , Berthelot P. , Grattard F. , Pozzetto B. , Riffard S. . ( 2008; ). Use of flow cytometry to monitor Legionella viability. . Appl Environ Microbiol 74:, 7813–7816. [CrossRef] [PubMed]
    [Google Scholar]
  2. Bej A. K. , Mahbubani M. H. , Atlas R. M. . ( 1991; ). Detection of viable Legionella pneumophila in water by polymerase chain reaction and gene probe methods. . Appl Environ Microbiol 57:, 597–600.[PubMed]
    [Google Scholar]
  3. Bernander S. , Jacobson K. , Helbig J. H. , Lück P. C. , Lundholm M. . ( 2003; ). A hospital-associated outbreak of Legionnaires’ disease caused by Legionella pneumophila serogroup 1 is characterized by stable genetic fingerprinting but variable monoclonal antibody patterns. . J Clin Microbiol 41:, 2503–2508. [CrossRef] [PubMed]
    [Google Scholar]
  4. Blatt S. P. , Parkinson M. D. , Pace E. , Hoffman P. , Dolan D. , Lauderdale P. , Zajac R. A. , Melcher G. P. . ( 1993; ). Nosocomial Legionnaires’ disease: aspiration as a primary mode of disease acquisition. . Am J Med 95:, 16–22. [CrossRef] [PubMed]
    [Google Scholar]
  5. Breiman R. F. , Cozen W. , Fields B. S. , Mastro T. D. , Carr S. J. , Spika J. S. , Mascola L. . ( 1990; ). Role of air sampling in investigation of an outbreak of Legionnaires’ disease associated with exposure to aerosols from an evaporative condenser. . J Infect Dis 161:, 1257–1261. [CrossRef] [PubMed]
    [Google Scholar]
  6. British Thoracic Society Standards of Care Committee ( 2001; ). BTS guidelines for the management of community acquired pneumonia in adults. . Thorax 56: (Suppl. 4), IV1–IV64.[PubMed] [CrossRef]
    [Google Scholar]
  7. Casini B. , Valentini P. , Baggiani A. , Torracca F. , Lorenzini C. , Frateschi S. , Matteoli B. , Privitera G. . ( 2008; ). Comparison of two molecular methods used for subtyping of Legionella pneumophila 1 strains isolated from a hospital water supply. . Water Sci Technol 58:, 683–688. [CrossRef] [PubMed]
    [Google Scholar]
  8. Centers for Disease Control and Prevention ( 2011; ). Legionellosis – United States, 2000–2009. . MMWR Morb Mortal Wkly Rep 60:, 1083–1086.[PubMed]
    [Google Scholar]
  9. Che D. , Campese C. , Santa-Olalla P. , Jacquier G. , Bitar D. , Bernillon P. , Desenclos J. C. . ( 2008; ). Sporadic community-acquired Legionnaires’ disease in France: a 2-year national matched case-control study. . Epidemiol Infect 136:, 1684–1690. [CrossRef] [PubMed]
    [Google Scholar]
  10. Diederen B. M. W. , de Jong C. M. A. , Kluytmans J. A. J. W. , van der Zee A. , Peeters M. F. . ( 2006; ). Detection and quantification of Legionella pneumophila DNA in serum: case reports and review of the literature. . J Med Microbiol 55:, 639–642. [CrossRef] [PubMed]
    [Google Scholar]
  11. 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]
  12. Fry N. K. , Bangsborg J. M. , Bergmans A. , Bernander S. , Etienne J. , Franzin L. , Gaia V. , Hasenberger P. , Baladrón Jiménez B. . & other authors ( 2002; ). Designation of the European Working Group on Legionella Infection (EWGLI) amplified fragment length polymorphism types of Legionella pneumophila serogroup 1 and results of intercentre proficiency testing using a standard protocol. . Eur J Clin Microbiol Infect Dis 21:, 722–728. [CrossRef] [PubMed]
    [Google Scholar]
  13. Gaia V. , Fry N. K. , Afshar B. , Lück P. C. , Meugnier H. , Etienne J. , Peduzzi R. , Harrison T. G. . ( 2005; ). Consensus sequence-based scheme for epidemiological typing of clinical and environmental isolates of Legionella pneumophila . . J Clin Microbiol 43:, 2047–2052. [CrossRef] [PubMed]
    [Google Scholar]
  14. Ginevra C. , Lopez M. , Forey F. , Reyrolle M. , Meugnier H. , Vandenesch F. , Etienne J. , Jarraud S. , Molmeret M. . ( 2009; ). Evaluation of a nested-PCR-derived sequence-based typing method applied directly to respiratory samples from patients with Legionnaires’ disease. . J Clin Microbiol 47:, 981–987. [CrossRef] [PubMed]
    [Google Scholar]
  15. Jaeger T. M. , Atkinson P. P. , Adams B. A. , Wright A. J. , Hurt R. D. . ( 1988; ). Legionella bozemanii pneumonia in an immunocompromised patient. . Mayo Clin Proc 63:, 72–76.[PubMed] [CrossRef]
    [Google Scholar]
  16. Jernigan D. B. , Sanders L. I. , Waites K. B. , Brookings E. S. , Benson R. F. , Pappas P. G. . ( 1994; ). Pulmonary infection due to Legionella cincinnatiensis in renal transplant recipients: two cases and implications for laboratory diagnosis. . Clin Infect Dis 18:, 385–389. [CrossRef] [PubMed]
    [Google Scholar]
  17. Joly J. R. , McKinney R. M. , Tobin J. O. , Bibb W. F. , Watkins I. D. , Ramsay D. . ( 1986; ). Development of a standardized subgrouping scheme for Legionella pneumophila serogroup 1 using monoclonal antibodies. . J Clin Microbiol 23:, 768–771.[PubMed]
    [Google Scholar]
  18. Joseph C. A. , Ricketts K. D. . on behalf of the European Working Group for Legionella Infections ( 2010; ). Legionnaires’ disease in Europe 2007–2008. . Euro Surveill 15:, 19493.[PubMed]
    [Google Scholar]
  19. Kümpers P. , Tiede A. , Kirschner P. , Girke J. , Ganser A. , Peest D. . ( 2008; ). Legionnaires’ disease in immunocompromised patients: a case report of Legionella longbeachae pneumonia and review of the literature. . J Med Microbiol 57:, 384–387. [CrossRef] [PubMed]
    [Google Scholar]
  20. Lück P. C. , Schneider T. , Wagner J. , Walther I. , Reif U. , Weber S. , Weist K. . ( 2008; ). Community-acquired Legionnaires’ disease caused by Legionella pneumophila serogroup 10 linked to the private home. . J Med Microbiol 57:, 240–243. [CrossRef] [PubMed]
    [Google Scholar]
  21. Mahbubani M. H. , Bej A. K. , Miller R. , Haff L. , DiCesare J. , Atlas R. M. . ( 1990; ). Detection of Legionella with polymerase chain reaction and gene probe methods. . Mol Cell Probes 4:, 175–187. [CrossRef] [PubMed]
    [Google Scholar]
  22. Mandell L. A. , Wunderink R. G. , Anzueto A. , Bartlett J. G. , Campbell G. D. , Dean N. C. , Dowell S. F. , File T. M. Jr , Musher D. M. . & other authors ( 2007; ). Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. . Clin Infect Dis 44: (Suppl. 2), S27–S72. [CrossRef] [PubMed]
    [Google Scholar]
  23. McClelland M. R. , Vaszar L. T. , Kagawa F. T. . ( 2004; ). Pneumonia and osteomyelitis due to Legionella longbeachae in a woman with systemic lupus erythematosus. . Clin Infect Dis 38:, e102–e106. [CrossRef] [PubMed]
    [Google Scholar]
  24. McDade J. E. , Shepard C. C. , Fraser D. W. , Tsai T. R. , Redus M. A. , Dowdle W. R. . Laboratory Investigation Team ( 1977; ). Legionnaires’ disease: isolation of a bacterium and demonstration of its role in other respiratory disease. . N Engl J Med 297:, 1197–1203. [CrossRef] [PubMed]
    [Google Scholar]
  25. Miyashita N. , Matsushima T. , Oka M. . Japanese Respiratory Society ( 2006; ). The JRS guidelines for the management of community-acquired pneumonia in adults: an update and new recommendations. . Intern Med 45:, 419–428. [CrossRef] [PubMed]
    [Google Scholar]
  26. Ratzow S. , Gaia V. , Helbig J. H. , Fry N. K. , Lück P. C. . ( 2007; ). Addition of neuA, the gene encoding N-acylneuraminate cytidylyl transferase, increases the discriminatory ability of the consensus sequence-based scheme for typing Legionella pneumophila serogroup 1 strains. . J Clin Microbiol 45:, 1965–1968. [CrossRef] [PubMed]
    [Google Scholar]
  27. Singh N. , Stout J. E. , Yu V. L. . ( 2002; ). Legionnaires’ disease in a transplant recipient acquired from the patient’s home: implications for management. . Transplantation 74:, 755–756. [CrossRef] [PubMed]
    [Google Scholar]
  28. Sopena N. , Sabrià-Leal M. , Pedro-Botet M. L. , Padilla E. , Dominguez J. , Morera J. , Tudela P. . ( 1998; ). Comparative study of the clinical presentation of Legionella pneumonia and other community-acquired pneumonias. . Chest 113:, 1195–1200. [CrossRef] [PubMed]
    [Google Scholar]
  29. Yagyu H. , Nakamura H. , Tsuchida F. , Sudou A. , Kishi K. , Oh-ishi S. , Matsuoka T. . ( 2003; ). Chest CT findings and clinical features in mild Legionella pneumonia. . Intern Med 42:, 477–482. [CrossRef] [PubMed]
    [Google Scholar]
  30. Yamamoto H. , Hashimoto Y. , Ezaki T. . ( 1993; ). Comparison of detection methods for Legionella species in environmental water by colony isolation, fluorescent antibody staining, and polymerase chain reaction. . Microbiol Immunol 37:, 617–622.[PubMed] [CrossRef]
    [Google Scholar]
  31. Yu V. L. , Plouffe J. F. , Pastoris M. C. , Stout J. E. , Schousboe M. , Widmer A. , Summersgill J. , File T. , Heath C. M. . & other authors ( 2002; ). Distribution of Legionella species and serogroups isolated by culture in patients with sporadic community-acquired legionellosis: an international collaborative survey. . J Infect Dis 186:, 127–128. [CrossRef] [PubMed]
    [Google Scholar]
  32. Zhou H. , Ren H. , Zhu B. , Kan B. , Xu J. , Shao Z. . ( 2010; ). Optimization of pulsed-field gel electrophoresis for Legionella pneumophila subtyping. . Appl Environ Microbiol 76:, 1334–1340. [CrossRef] [PubMed]
    [Google Scholar]
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