Servicio de Medicina Interna, Hospital Universitario Lucus Augusti, Lugo, España.
Unidad de Enfermedades Infecciosas, Hospital Universitario Lucus Augusti, Lugo, España.
Med Clin (Barc). 2018 Oct 12;151(7):265-269. doi: 10.1016/j.medcli.2018.03.011. Epub 2018 Apr 26.
Most of the data on Legionella pneumonia in our country come from the Mediterranean area, and there are few studies from the Northwest area. This study tries to assess the situation of this infection in this area.
Retrospective study of all patients with positive Legionella antigenuria treated at the University Hospital Lucus Augusti in Lugo (Spain) from 2001, the year in which this test was introduced in our centre, until 2015. We analysed epidemiological data, risk factors, clinical, radiological and biochemical findings, and clinical outcome.
The sampled included 136 patients. When comparing the first five years of the study with the last five, the incidence increased from 10.9 to 64.5 cases/1,000,000; the number of antigenuria requests increased 3.4 times, and compared to other pneumonia aetiologies Legionella increased from 0.9% to 15%. The mean age was 64.1years and 84.6% were males; 74.3% had comorbidities. Males were significantly younger (62.7±16.6 vs 71.9±17.3) and consumed more alcohol (26.1% vs 0%) and tobacco (67.8% vs 14.3%). Diagnosis was established within the first 72hours in 88.9% of cases and most received levofloxacin (95.6%). Hospitalisation was needed in 85% of cases, 11.7% in ICU and 4.4% died.
After the introduction of antigenuria there was an increase in the incidence of Legionella pneumonia recorded in our health area. Its rate in recent years has been one of the highest in our country. Despite the fact that the patients had advanced age and comorbidities, mortality was low.
我国有关军团菌肺炎的数据大多来自地中海地区，来自西北地区的研究较少。本研究试图评估该地区的感染情况。
对 2001 年（本中心引入该检测方法的那一年）至 2015 年期间在卢戈大学医院卢克索·奥古斯蒂治疗的所有军团菌抗原尿阳性患者进行回顾性研究。我们分析了流行病学数据、危险因素、临床、放射学和生化表现以及临床结局。
纳入 136 例患者。与研究的前 5 年相比，后 5 年的发病率从 10.9 例/100 万增加到 64.5 例/100 万；抗原尿检测请求增加了 3.4 倍，与其他肺炎病因相比，军团菌从 0.9%增加到 15%。平均年龄为 64.1 岁，84.6%为男性；74.3%合并症。男性明显更年轻（62.7±16.6 岁比 71.9±17.3 岁），饮酒（26.1%比 0%）和吸烟（67.8%比 14.3%）的比例更高。88.9%的病例在 72 小时内确诊，大多数患者接受左氧氟沙星治疗（95.6%）。85%的病例需要住院治疗，11.7%的病例需要入住 ICU，4.4%的病例死亡。
在引入抗原尿检测方法后，我们卫生区域记录的军团菌肺炎发病率有所增加。近年来，其发病率在我国一直处于较高水平。尽管患者年龄较大且合并症较多，但死亡率较低。
