Community acquired pneumonia due to Legionella pneumophila in a tertiary care hospital

Abstract

Introduction: Legionella pneumophila can cause severe community acquired pneumonia which may be life threatening. This organism is found in aquatic environments and infection is acquired through inhalation of aerosols. Few studies conducted in Sri Lanka have confirmed the presence of this organism in cooling tower water in Sri Lanka. Published data regarding human cases of legionellosis in Sri Lanka is not available. Objective: To determine the prevalence of community acquired pneumonia due to L. pneumophila among patients who required hospital admission and assess the risk factors associated with this infection. Methods: The study was carried out from July 2014 to June 2015 at the Teaching Hospital, Peradeniya. Expectorated sputum or endotracheal secretions and urine specimen were collected within 24 hours of admission after obtaining consent from all adult patients admitted during the study period with community acquired pneumonia. Respiratory specimens, if obtained, were inoculated onto Buffered Charcoal Yeast Extract (BCYE) agar and were inoculated at 35 º C-37 º C for 7 days and observed for typical colonies. Urine specimens were stored at-20 º C and ELISA test was performed for the detection of L. pneumophila serogroup 1a antigen. Results: Eighty urine specimens and 27 respiratory specimens were obtained form 80 patients. None of the respiratory specimens grew suspected colonies of L. pneumophila and all urine specimens were negative for L. pneumophila serogroup 1a antigen. Conclusion: L. pneumophila serogroup 1a was not identified as the pathogen responsible for community acquired pneumonia in this study sample.

Legionella pneumonia as a cause of atypical pneumonia in a tertiary care hospital in Sri Lanka

“…An Indian study revealed 17.69% antigenuria, 27.43% seropositivity and no culture positivity (Javed et al 2010). A recent Sri Lankan research too did not yield legionella from culture or urinary antigen (Dissanayake et al 2016). Similarly, the current study did not find positive results in spite of combining culture with urinary antigen detection.…”

“…First isolation of Legionella pneumophila in Sri Lanka was from environmental water samples and revealed positive from 57.4% of selected hotels and 38.4% of selected cooling towers (Wahala & Wickramasinghe 2000). Further, a study enrolling 80 patients with CAP in a tertiary care hospital in the country did not reveal any case of legionella (Dissanayake et al 2016). Similarly, the current study did not find a single case of legionella infection in the study group.…”

Molecular evidence of <em>Legionella pneumophila</em> associated lower respiratory tract infection in a COVID-19 suspected patient in Sri Lanka - A Case Report

“…L. pneumophila was not identified in their study population. 8 A study done by Kottahachchi et al in the Western Province of Sri Lanka also did not identify L. pneumophila in a sample of patients with atypical pneumonia. 9 According to the results of these studies L. pneumophila has been reported from the environment and humans.…”