A Survey of Methods Used to Detect Nosocomial Legionellosis Among Participants in the National Nosocomial Infections Surveillance System

Ae, Fiore; Jc, Butler; Tg, Emori; Rp, Gaynes

doi:10.1086/501642

Cited by 45 publications

(25 citation statements)

References 23 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This incidence of disease is comparable to previous estimates. 17 However, any response bias would have led to nondifferential misclassification, reducing our power to detect an association of residual disinfection of drinking water and hospitalacquired legionnaires' disease, leading to an underestimation of the protective effect of monochloramine. Because this was an observational study, there may have been variation in the assessment of the status of hospitalacquired legionnaires' disease because of differences in detecting or reporting cases or outbreaks of disease, and this may also have resulted in nondifferential misclassification and a bias toward the null.…”

Section: Discussionmentioning

confidence: 99%

“…15 Efforts to prevent hospital-acquired legionnaires' disease have focused on increasing the temperature of hot water and the supplemental chlorination of drinking water. [16][17][18] Although these measures may be effective in controlling the growth of Legionella species in drinking water systems, high water temperatures may result in scalding injuries and supplemental chlorination may hasten the development of corrosion and leaks in plumbing systems. 19 The long-term efficacy of alternative methods for controlling and eradicating legionellae in hospital water systems (eg, ozone, ultraviolet light, and copper-silver ionization) has not been determined.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Risk of Hospital-Acquired Legionnaires' Disease in Cities Using Monochloramine Versus Other Water Disinfectants

Heffelfinger

Kool²,

Fridkin³

et al. 2003

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

Objective:To measure the association between the disinfection of municipal drinking water with monochloramine and the occurrence of hospital-acquired legionnaires' disease (LD).Setting:One hundred sixty-six U.S. hospitals.Design:Survey of 459 members of the Society for Healthcare Epidemiology of America (SHEA) for hospital features; endemic- and outbreak-related, hospital-acquired LD; the source of the hospital water supply; and the methods of disinfection used by the hospitals and municipal water treatment plants.Results:SHEA members representing 166 (36%) of 459 hospitals responded; 33 (20%) reported one or more episodes of hospital-acquired LD during the period from 1994 to 1998 and 23 (14%) reported an outbreak of hospital-acquired LD during the period from 1989 to 1998. Hospitals with an occurrence of hospital-acquired LD had a higher census (median, 319 vs 221;P= .03), more acute care beds (median, 500 vs 376;P= .04), and more intensive care unit beds (median, 42 vs 24;P= .009) than did other hospitals. They were also more likely to have a transplant service (74% vs 42%;P= .001) and to perform surveillance for hospital-acquired disease (92% vs 61%;P= .001). After adjustment for the presence of a transplant program and surveillance for legionnaires' disease, hospitals supplied with drinking water disinfected with monochloramine by municipal plants were less likely to have sporadic cases or outbreaks of hospital-acquired LD (odds ratio, 0.20; 95% confidence interval, 0.07 to 0.56) than were other hospitals.Conclusion:Water disinfection with monochloramine by municipal water treatment plants significantly reduces the risk of hospital-acquired LD.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Risk of Hospital-Acquired Legionnaires' Disease in Cities Using Monochloramine Versus Other Water Disinfectants

Heffelfinger

Kool²,

Fridkin³

et al. 2003

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

show abstract

“…Currently, a minority of institutions in the United States perform universal Legionella testing of at-risk patients with nosocomial pneumonia (95). Infection control personnel should educate medical staff to heighten suspicion for health careassociated Legionnaires' disease, especially in high-risk patients, and to implement routine testing policies.…”

Section: Nosocomial Outbreaks and Preventionmentioning

confidence: 99%

Legionella and Legionnaires' Disease: 25 Years of Investigation

2002

View full text Add to dashboard Cite

There is still a low level of clinical awareness regarding Legionnaires' disease 25 years after it was first detected. The causative agents, legionellae, are freshwater bacteria with a fascinating ecology. These bacteria are intracellular pathogens of freshwater protozoa and utilize a similar mechanism to infect human phagocytic cells. There have been major advances in delineating the pathogenesis of legionellae through the identification of genes which allow the organism to bypass the endocytic pathways of both protozoan and human cells. Other bacteria that may share this novel infectious process are Coxiella burnetti and Brucella spp. More than 40 species and numerous serogroups of legionellae have been identified. Most diagnostic tests are directed at the species that causes most of the reported human cases of legionellosis, L. pneumophila serogroup 1. For this reason, information on the incidence of human respiratory disease attributable to other species and serogroups of legionellae is lacking. Improvements in diagnostic tests such as the urine antigen assay have inadvertently caused a decrease in the use of culture to detect infection, resulting in incomplete surveillance for legionellosis. Large, focal outbreaks of Legionnaires' disease continue to occur worldwide, and there is a critical need for surveillance for travel-related legionellosis in the United States. There is optimism that newly developed guidelines and water treatment practices can greatly reduce the incidence of this preventable illness

show abstract

“…Az operációt követő hónapban a bakteriális infekciók domináltak. A bacteriaemia leggyakoribb locusai a hasi és intravascularis katéterek, de nem ritka, hogy nem sikerül a forrást azonosítani [42]. Kirby és mtsai szoros összefüggést találtak a korai poszttranszplantációs időszakban bekövetkező halálozás és a bacteriaemia előfordulása között [43].…”

Section: Posztoperatív Időszak éS Fertőzésekunclassified

Bakteriális infekciók májátültetés után

et al. 2015

View full text Add to dashboard Cite

Bevezetés: A szerzők a májátültetést követően kialakult mikrobás fertőzéseket, a mintavételek eredményeit, a multidrug-rezisztencia incidenciáját vizsgálták a hazai betegek körében. Célkitűzés: Tanulmányozták a bakteriális fertőzés kialakulásának kockázati tényezőit, az infekciókhoz kapcsolódó szövődmények előfordulását, lefolyását, és részletes kórokozó-spektrumelemzést végeztek. Módszer: 2003-2012 között májátültetett 408 beteg adatait (281 bakterioló-giai tenyésztést) vizsgálták. Eredmények: A 408 beteg közül 70 betegnél (17%) észleltek klinikai tünetekkel járó fertőzést. A tenyésztési lelet 58 betegnél (14,2%) pozitív, 12 betegnél (2,9%) negatív volt. Hét esetben (12,1%) alakult ki cholangitis, 17 esetben (29,3%) fordult elő hasűri és 28 esetben (48,3%) pulmonalis eredetű fertőzés. Posztoperatív fertőzés gyakrabban lépett fel kezdeti csökkent graftműködés, akut veseelégtelenség, epeúti szövődmény és hasű-ri vérzés mellett. Infekció kialakulása esetén az 1, 3 és 5 éves betegtúlélés 70%, 56% és 56% volt, míg infekció nélkül ez 94%, 87%, 85% volt (p<0,001). A kitenyészett baktériumok 56%-ánál találtak multidrug-rezisztenciát, viszont nem volt szignifi káns különbség a multidrug-rezisztencia pozitív és negatív baktériummal fertőzött csoportok egyéves betegtúlélése között (70,2% mindkettő). Következtetések: Az infekciókontroll, a multidrug-rezisztens kórokozók menedzselése a preventív, higiéniai, izolációs elvek kialakítását, betartását, valamint műtéttechnikai, transzfúziós, antibiotikus stratégiák, folyamatok fejlesztését kell, hogy megcélozza, szakmai csapatmunka keretén belül. Orv. Hetil., 2015, 156(34), 1366-1382. Kulcsszavak: májátültetés, posztoperatív fertőzés, multidrug-rezisztencia, túlélés, szepszis Bacterial infection after orthotopic liver transplantationIntroduction: The authors reviewed the prevalence of postoperative infections, the results of bacterium cultures, and the incidence of multidrug resistance in their liver transplanted patients during a period between 2003 and 2012. Aim: The aim of this study was to analyse risk factors and colonisations of bacterial infections. Method: The fi les of 408 patients (281 bacterium cultures) were reviewed. Results: Of the 408 patients 70 had a postoperative infection (17%); 58 patients (14.2%) had positive and 12 patients (2.9%) negative bacterial culture results. Cholangitis was found in 7 cases (12.1%), abdominal infection in 17 cases (29.3%), and pulmonal infection in 28 cases (48.3%). Postoperative infection was more frequent in patients with initial poor graft function, acute renal insuffi ciency, biliary complication, and in those with intraabdominal bleeding. The 1-, 3-and 5-year cumulative survival of patients who had infection was 70%, 56% and 56%, respectively, whereas the cumulative survival data of patients without infection was 94%, 87% and 85%, respectively (p<0.001). Multidrug resistance was found in 56% of the positive cultures, however, the one-year survival was not different in patients who had multidrug resistance positive and negative...

show abstract

A Survey of Methods Used to Detect Nosocomial Legionellosis Among Participants in the National Nosocomial Infections Surveillance System

Cited by 45 publications

References 23 publications

Risk of Hospital-Acquired Legionnaires' Disease in Cities Using Monochloramine Versus Other Water Disinfectants

Risk of Hospital-Acquired Legionnaires' Disease in Cities Using Monochloramine Versus Other Water Disinfectants

Legionella and Legionnaires' Disease: 25 Years of Investigation

Bakteriális infekciók májátültetés után

Contact Info

Product

Resources

About