Legionnaires' disease in patients with cancer

Nunnink, Johannes C.; Gallagher, James; Yates, Jerome W.

doi:10.1002/mpo.2950140205

Cited by 15 publications

(8 citation statements)

References 22 publications

(14 reference statements)

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“…Other opportunistic infections included in our study were less frequent. The high incidence and risk of Legionella infections was unexpected although few cases have been reported in CLL patients 39‐42 . In most cases of Legionnaires’ disease, a source cannot be identified, although outbreaks have been linked to residential potable water, large building water systems, and car travel 43 .…”

Section: Discussionmentioning

confidence: 99%

A nationwide study on inpatient opportunistic infections in patients with chronic lymphocytic leukemia in the pre‐ibrutinib era

Steingrímsson

Gíslason

Þorsteinsdóttir

et al. 2020

European J of Haematology

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Objective Opportunistic infections in chronic lymphocytic leukemia (CLL) have been described in clinical trials, single‐center studies, and case reports. We performed a nationwide study to estimate the incidence and impact of inpatient opportunistic infections. Methods The incidence rate (IR) and incidence rate ratio (IRR) for Swedish CLL patients diagnosed 1994‐2013, and matched controls were calculated, as well as the case‐fatality ratio (CFR). Results Among 8989 CLL patients, a total of 829 opportunistic infections were registered (IR 16.6 per 1000 person‐years) compared with 252 opportunistic infections in 34 283 matched controls (IR 0.99). The highest incidence in the CLL cohort was for Pneumocystis pneumonia (200 infections, IR 4.03); Herpes zoster (146 infections, IR 2.94), and Pseudomonas (83 infections, IR 1.66) infections. The highest risk relative to matched controls was observed for Pneumocystis pneumonia (IRR 114, 95% confidence interval 58.7‐252). The 60‐day CFR for CLL patients with opportunistic infections was 23% (188/821), highest for progressive multifocal encephalopathy (5/7, 71%) and aspergillosis (25/60, 42%). Conclusion We have uniquely depicted the incidence of rare and serious infections in CLL patients and found a relatively high incidence of Pneumocystis pneumonia. Of the most common opportunistic infections, CLL patients with aspergillosis had the poorest prognosis.

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Section: Discussionmentioning

confidence: 99%

A nationwide study on inpatient opportunistic infections in patients with chronic lymphocytic leukemia in the pre‐ibrutinib era

Steingrímsson

Gíslason

Þorsteinsdóttir

et al. 2020

European J of Haematology

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“…Candida species have been isolated from patients with lower respiratory tract infection [7,20-22]. Haemophilus influenza [6,7,19-21], Staphylococcus epidermidis [6,7,17-19], Streptococcus species [6,7,17,19,25], Legionella pneymophila [23], as well as strains of Bacillus [7], Listeria [24] and Streptococcus [6,7,17,19,25] have been also identified in patients with different pulmonary diseases. Very similarly, the bacterium Chlamydia pneumoniae, a common cause of community-acquired pneumonia, has been implicated in lung carcinogenesis [11-16].…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have demonstrated the presence of colonies in respiratory tract in patients with cancer [19]; Haemophilus influenza [6,7,19-21] and Candida albicans [7,20-22] have been found in patients with lower respiratory tract malignancies. Legionella pneymophila has been diagnosed in patients with cancer [23], as well as strains of Bacillus [7], Listeria [24], and Streptococcus [6,7,17,19,25]. …”

Section: Introductionmentioning

confidence: 99%

Bacterial and fungal microflora in surgically removed lung cancer samples

Apostolou¹,

Tsantsaridou

Papasotiriou³

et al. 2011

J Cardiothorac Surg

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BackgroundClinical and experimental data suggest an association between the presence of bacterial and/or fungal infection and the development of different types of cancer, independently of chemotherapy-induced leukopenia. This has also been postulated for the development of lung cancer, however the prevalence and the exact species of the bacteria and fungi implicated, have not yet been described.AimTo determine the presence of bacterial and fungal microflora in surgically extracted samples of patients with lung cancer.Materials and methodsIn this single-center prospective, observational study, tissue samples were surgically extracted from 32 consecutive patients with lung cancer, and reverse-transcription polymerase chain reaction (RT-PCR) was used to identify the presence of bacteria and fungi strains.ResultsThe analysis of the electrophoresis data pointed out diversity between the samples and the strains that were identified. Mycoplasma strains were identified in all samples. Strains that appeared more often were Staphylococcus epidermidis, Streptococcus mitis and Bacillus strains, followed in descending frequency by Chlamydia, Candida, Listeria, and Haemophilus influenza. In individual patients Legionella pneumophila and Candida tropicalis were detected.ConclusionsA diversity of pathogens could be identified in surgically extracted tissue samples of patients with lung cancer, with mycoplasma strains being present in all samples. These results point to an etiologic role for chronic infection in lung carcinogenesis. Confirmation of these observations and additional studies are needed to further characterize the etiologic role of inflammation in lung carcinogenesis.

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“…42% had hematological malignancy and 22% had lung cancer. Neutropenic patients and patients on chronic steroids had higher risk of getting legionnaire's disease [18].…”

Section: Malignanciesmentioning

confidence: 97%

Legionnaires Disease in Immunocompromised Host

Rajasurya¹,

Surani²

2020

Hospital Acquired Infection and Legionnaires' Disease

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Legionella bacteria are aerobic, pleomorphic, gram negative bacilli found in fresh water environments and are usually transmitted through inhalation aerosols from contaminated water or soil. Legionnaire's disease is a severe form of pneumonia caused by legionella species and can be community acquired or hospital acquired. The reported incidence of Legionnaires' disease is approximately 1.4-1.8 cases per 100,000 persons and immunocompromised state is a very important risk factor. Some of the other important risk factors include old age, impaired cellular immunity, hematologic malignancies, solid organ transplantation, splenectomy, tumor necrosis factor-alpha inhibitors, chronic respiratory disease, diabetes and end stage renal disease. Legionella pneumophila serotype 1 is the most commonly reported cause of human Legionella infections. The pathogenesis of legionnaire's disease involves invasion of alveolar macrophages and cell mediated immunity is the primary means of immune control. The prevalence of Legionnaires disease has risen possibly from increased awareness and reporting. The symptoms of the disease are nonspecific requiring a high index of suspicion in vulnerable hosts, as effective treatment could be life-saving. Sensitivity of urinary antigen testing is lower in immunocompromised patients because of higher likelihood of infections caused non L. pneumophila species. Extrapulmonary manifestations and higher mortality are particularly more common in immunocompromised patients than in immunocompetent hosts.

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Legionnaires' disease in patients with cancer

Cited by 15 publications

References 22 publications

A nationwide study on inpatient opportunistic infections in patients with chronic lymphocytic leukemia in the pre‐ibrutinib era

A nationwide study on inpatient opportunistic infections in patients with chronic lymphocytic leukemia in the pre‐ibrutinib era

Bacterial and fungal microflora in surgically removed lung cancer samples

Legionnaires Disease in Immunocompromised Host

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