1/9. An outbreak of legionella longbeachae infection in an intensive care unit?During a nine-day period, five patients in a 14-bed intensive care unit (ICU) were shown to have seroconverted with a four-fold or greater rise in serum antibody titre to legionella longbeachae serogroup 1. A further two patients were observed to have high titres consistent with previous exposure but earlier serum samples were not available for comparison. No patients had antibody responses to legionella pneumophila serogroups 1 and 2. L. longbeachae was not cultured from respiratory secretions from patients or from the environment within the unit. Legionella anisa was recovered from one cooling tower on the ninth floor of the tower block. The ICU is located on the first floor of the same tower and receives external air from two vents, one on the eastern and the other on the western aspect. All patients with serological evidence of L. longbeachae infection were concomitantly infected with multiresistant staphylococcus aureus, and were located in bays on the eastern side of the unit. A large pigeon nest was discovered within 1-2 m of the eastern vent. Following removal of the birds' nest, no further cases were seen on routine screening of all patients within the unit over the next eight weeks. Alternatively, seroconversion may have been related to demolition of the adjacent nine-storey nurses home. This was begun one month before the first case was diagnosed and was completed four months later. The periodic northerly winds could have carried legionellae from the demolition site directly over the block housing the ICU and may have concentrated them near the eastern air vent. All patients had pneumonia, which was probably multifactorial in origin. There is some uncertainty whether the serological responses seen were an epiphenomenon or were truly indicative of infection with L. longbeachae.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/9. legionellosis from legionella pneumophila serogroup 13.We describe 4 cases of legionella pneumophila serogroup 13-associated pneumonia. These cases originate from a broad geographic range that includes scotland, australia, and new zealand. L. pneumophila serogroup 13 pneumonia has a clinically diverse spectrum that ranges from relatively mild, community-acquired pneumonia to potentially fatal severe pneumonia with multisystem organ failure. All cases were confirmed by culture and direct fluorescent antibody staining or indirect immunofluorescent antibody tests. Proven or putative sources of L. pneumophila serogroup 13 infections in 2 patients included a contaminated whirlpool spa filter and river water. An environmental source was not found in the remaining 2 cases; environmental cultures yielded only other L. pneumophila serogroups or nonpneumophila Legionella species. We describe the clinical and laboratory features of L. pneumophila serogroup 13 infections. L. pneumophila serogroup 13 pneumonia is rarely reported, but it may be an underrecognized pathogenic serogroup of L. pneumophila.- - - - - - - - - - ranking = 2keywords = environment (Clic here for more details about this article) |
3/9. Characterization of a Legionella anisa strain isolated from a patient with pneumonia.Legionella anisa, previously found only in environmental specimens, was isolated from a bronchial lavage specimen of an immunocompromised patient with pneumonia. growth, physiologic, gas-liquid chromatographic, serologic, and dna characteristics were consistent with those of the type strain of L. anisa, WA-316-C3 (ATCC 35292).- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
4/9. legionella longbeachae pneumonia: report of two cases.legionella longbeachae serogroup 1 was isolated from the respiratory secretions of two patients with community-acquired pneumonia. One patient had a mild infection without evidence of the involvement of other organs and recovered, in spite of inappropriate antibiotic therapy. The other patient was severely-ill on presentation with multisystem failure and died soon after admission to hospital. The organisms were identified by the immunofluorescence technique and by quantitative dna-hybridization studies. The sources of the infection in these patients are unknown as the organism has never been isolated from the SA environment.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
5/9. First isolation of Legionella gormanii from human disease.Legionella gormanii, previously isolated only from the environment, was grown from the bronchial brush specimen of a patient with pneumonia. The organism was characterized by serologic, biochemical, and dna hybridization studies.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
6/9. Legionella jordanis isolated from a patient with fatal pneumonia.A Legionella-like organism was isolated from an open-lung biopsy of a patient with fatal pneumonia. The isolate was shown by growth, physiologic, serologic, and genetic characteristics to belong to the species Legionella jordanis, which had previously been isolated only from the environment.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
7/9. pneumonia and acute pancreatitis most probably caused by a legionella longbeachae infection.legionella longbeachae was first described and characterized in 1981. We report the first probable case of L. longbeachae infection in sweden. A previously healthy, 50-year-old greenhouse repairman fell ill with severe pneumonia and acute pancreatitis. The L. longbeachae type 1 IgG titer (indirect immunofluorescence) was 256 and decreased significantly with erythromycin treatment. Attempts to isolate the microorganism from the environment failed. Sera from the patient's colleagues and from blood donors all had antibody titers of less than 32.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
8/9. Positive serology to legionella longbeachae in patients with adult respiratory distress syndrome.In an observational study we measured the legionella longbeachae antibody titre rise in patients mechanically ventilated for more than eight days during a two-month period. The patients were divided into two groups on the basis of the presence or absence of the adult respiratory distress syndrome (ARDS). In nine patients with ARDS all showed an antibody rise consistent with recent infection with legionella longbeachae with a rise in titre (six patients) or a high titre after eight to ten days of ventilation (three patients). Three patients without ARDS did not show a rise in titre. culture of the environment, ventilator circuits, humidifiers and humidification water did not reveal an environmental source of legionella longbeachae in the intensive care Unit. legionella longbeachae may be implicated as a pathogenic organism in ARDS, or as a secondary nosocomial infection. Alternatively the antibody titre rise may represent an epiphenomenon and may not be related to legionella longbeachae infection.- - - - - - - - - - ranking = 2keywords = environment (Clic here for more details about this article) |
9/9. Relapse of legionella longbeachae infection in an immunocompromised patient.We describe the first known case of legionella longbeachae infection in the netherlands in a patient with myasthenia gravis. infection with L. longbeachae relapsed after prolonged therapy with erythromycin. No environmental source of L. longbeachae could be traced.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |