Legionnaires' disease in the renal transplant unit of "Hospital das Clinicas, FMUSP": during a five year period (1988-1993)

Abstract

Several reports have related Legionella pneumophila with pneumonia in renal transplant patients, however this association has not been systematically documented in Brazil. Therefore this paper reports the incidence, by serologycal assays, of Legionella pneumophila serogroup 1 in these patients during a five year period. For this purpose sera from blood samples of 70 hospitalized patients with pneumonia from the Renal Transplant Unit of Hospital das Clinicas, FMUSP collected at the acute and convalescent phase of infection were submitted to indirect immunofluorescence assay (IFA) to demonstrate anti-Legionella pneumophila serogroup 1 antibodies. Of these 70 patients studied during the period of 1988 to 1993,18 (25.71 %) had significant rises in specific antibody titers for Legionella pneumophila serogroup 1. Incidence was interrupted following Hospital water decontamination procedures, with recurrence of infections after treatment interruption. In this study, the high susceptibility (25.71%) of immunodepressed renal transplant patients to Legionella pneumophila serogroup 1 nosocomial infections is documented. The importance of the implementation and maintenance of water decontamination measures for prophylaxis of the infection is also clearly evident.

Assessment of Cytokine Release Afterin VitroStimulation of Whole Blood withLegionella Pneumophilain Immunocompromised Patients

“…Hemodialysis patients and patients after renal transplantation due to severe immune deficiencies are examined in terms of the risk of infection caused by viral and bacterial infections (Linarea et al, 2007;Minnaganti and Cunha, 2001). The contact of hemodialysis patients and patients after renal transplantation with L. pneumophila in the place of residence or hospital environmental was confirmed with positive results of antibodies IgM and/or IgG present in serum of these patients and also reported in literature as clinical cases of legionellosis (Mazieri et al, 1994;Shimzu et al, 1999).…”

“…The presence of anti-L. pneumophila antibodies in dialysis patients amounts to 5,16% and in patient after renal transplantation about 25% (Mazieri et al, 1994;Ongut et al, 2004).…”

“…There are number of reports in the literature concerning the cases of legionnaires' disease in hemodialysis patients and in patients after renal transplantation (Levin et al, 1991;Mazieri et al, 1994;Shimzu et al, 1999;Singh et al, 2002).…”

Absence of legionellosis in patients with community-acquired pneumonia requiring hospitalization

“… 2 Despite the scarce reports on legionellosis in Brazil, 3 , 4 very limited data are available from cohort studies. 5 In order to investigate the prevalence of legionellosis among patients with CAP, here we report the results of a prospective survey conducted in a 1200-bed tertiary Brazilian hospital, between October 2010 and July 2013.…”