台湾南部某医学中心发生军团病。

Legionnaires' disease at a medical center in southern Taiwan.

机构信息

Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan.

出版信息

J Microbiol Immunol Infect. 2018 Jun;51(3):352-358. doi: 10.1016/j.jmii.2016.08.006. Epub 2016 Dec 18.

DOI:10.1016/j.jmii.2016.08.006

PMID:28094205

Abstract

BACKGROUND/PURPOSE: Legionella pneumophila had been recognized as a pathogen for both healthcare-associated and community-acquired pneumonia. We aimed to evaluate clinical features and outcomes of patients with Legionnaires' disease at a tertiary medical center in southern Taiwan.

METHODS

From January 2005 to December 2013, a retrospective study of adult cases of Legionnaires' disease was conducted in a 1200-bed tertiary hospital. Their medical records were reviewed for further evaluation and analysis.

RESULTS

A total of 61 cases of Legionnaires' disease were identified during the study period. Their mean age was 61.1 years, with male predominance (43, 70.5%). Among them, 30 (49.2%) had healthcare-associated pneumonia (HCAP), 20 (32.8%) had community-acquired pneumonia, and notably 11 (18.0%) were caregivers. Patients with healthcare-associated pneumonia tend to have higher Charlson comorbidity scores than those with community-acquired pneumonia (3.6±2.4 vs. 1.9±1.9, p=0.008) and caregivers (0.5±0.5, p<0.001). Six patients died, resulting in an in-hospital mortality rate of 9.8%. Underlying cancer (66.7% vs. 20.0%, p=0.028) and a higher Charlson comorbidity score (4.7±2.6 vs. 2.2±2.2, p=0.013) were related to a fatal outcome.

CONCLUSION

L. pneumophila remains an important pathogen for pneumonia acquired from the community or associated with healthcare facility. Healthy caregivers may potentially be at risk for Legionella infection in certain clinical settings.

摘要

背景/目的：嗜肺军团菌已被认为是医院获得性和社区获得性肺炎的病原体。我们旨在评估台湾南部一家三级医学中心的军团病患者的临床特征和结局。

方法

从 2005 年 1 月至 2013 年 12 月，对一家 1200 张床位的三级医院的成人军团病病例进行了回顾性研究。对他们的病历进行了回顾性评估和分析。

结果

在研究期间共发现 61 例军团病病例。他们的平均年龄为 61.1 岁，男性居多（43 例，70.5%）。其中 30 例（49.2%）为医院获得性肺炎（HCAP），20 例（32.8%）为社区获得性肺炎，有 11 例（18.0%）是护理人员。与社区获得性肺炎患者相比，医院获得性肺炎患者的 Charlson 合并症评分更高（3.6±2.4 对 1.9±1.9，p=0.008），与护理人员相比评分更高（0.5±0.5，p<0.001）。6 例患者死亡，院内死亡率为 9.8%。基础癌症（66.7%对 20.0%，p=0.028）和更高的 Charlson 合并症评分（4.7±2.6 对 2.2±2.2，p=0.013）与致命结局相关。