1. [Active clinical surveillance for detection of Legionnaires' disease: implications for health care structures].
- Author
-
Marchesi I, Bargellini A, Cencetti S, Marchegiano P, Cauteruccio L, Casolari C, and Borella P
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Cross Infection economics, Cross Infection epidemiology, Cross Infection microbiology, Cross Infection prevention & control, Delivery of Health Care, Feasibility Studies, Female, Humans, Infection Control economics, Infection Control methods, Italy epidemiology, Legionnaires' Disease economics, Legionnaires' Disease epidemiology, Legionnaires' Disease microbiology, Legionnaires' Disease prevention & control, Male, Middle Aged, Pneumonia economics, Pneumonia epidemiology, Pneumonia microbiology, Pneumonia prevention & control, Retrospective Studies, Sanitary Engineering, Water Supply economics, Water Supply standards, Cross Infection diagnosis, Hospitals, University economics, Hospitals, University standards, Legionella pneumophila classification, Legionella pneumophila isolation & purification, Legionnaires' Disease diagnosis, Pneumonia diagnosis, Population Surveillance methods, Water Microbiology
- Abstract
In an university hospital of about 900 beds, a clinical surveillance was activated to detect cases of Legionnaires' disease in patients affected by community and/or nosocomial-acquired pneumonia. In the hospital Legionella spp was detected in the hot water distribution system and various disinfecting and control procedures were adopted to reduce contamination. Contemporary, the clinical surveillance began with the systematic detection of Legionella urinary antigen among recovered pneumonia, seroconversion as confirmation test and the collection of respiratory secretions or other biological materials to isolate the microorganism in patients positive to the urinary antigen. From September 2003 to May 2005, 486 pneumonia were followed, 98 of which considered of nosocomial origin. In total, 15 cases of community-acquired Legionnaires' disease were detected by the urinary test, whereas no cases of nosocomial origin were found. The characteristics of the detected cases are described in comparison with the other pneumonia and the surveillance cost was evaluated. The systematic clinical surveillance for Legionella infections is feasible with limit costs, allows to detect community-acquired cases otherwise unknown and to ascertain the absence/presence of nosocomial-acquired pneumonia, irrespective of the environment contamination.
- Published
- 2007