ABSTRACT
BACKGROUND AND OBJECTIVE: To describe an outbreak of Legionella pneumophila serogroup 1 in Mataró, Catalunya, Spain, in August 2002. The source of the microorganism was a cooling tower. PATIENTS AND METHOD: Prospective and observational study with analysis of epidemiological, clinical, and microbiological data. RESULTS: 151 patients were affected (62% male), with a mean age of 58.4 years old. Seven patients were classified as Pontiac Fever and 144 suffered from pneumonia. The diagnosis of pneumonia was confirmed in 79% of cases, was considered suspicious in 14% and probable in 7%. Forty per cent of patients were smokers and 53.5% had comorbidities, mainly diabetes mellitus (22%). Chief symptoms were fever (97%), chills and muscular pain (63% respectively), headache (54%) and cough (53%). Pulmonary condensation was the more frequent radiological feature (71%). Normal pulmonary exploration was observed in 38%. Forty-three per cent of cases were severely ill, and 16% of patients belonged to Fine's IV and V class. Antigenuria was the most important test for diagnosis, which confirmed 76% of cases. Legionella spp. was obtained in respiratory secretions of 10 patients. Molecular analysis confirmed clonality between respiratory microorganisms and that obtained in the cooling tower. CONCLUSION: The outbreak involved an important number of subjects in a short period of time. Antigenuria was the most useful test. However, the isolation of L. pneumophila from patients permitted the prompt identification of microorganism's source in a cooling tower. The low mortality observed probably relates to a rapid diagnosis and its target treatment.
Subject(s)
Legionnaires' Disease/diagnosis , Legionnaires' Disease/epidemiology , Disease Outbreaks , Female , Humans , Legionella pneumophila/isolation & purification , Male , Middle Aged , Spain/epidemiologyABSTRACT
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Subject(s)
Hypertension/drug therapy , Antihypertensive Agents/administration & dosage , Blood Pressure , 25631 , Time FactorsABSTRACT
Fundamento y objetivo: Describir un brote comunitario de neumonía por Legionella pneumophila serogrupo 1 ocurrido en la ciudad de Mataró en agosto de 2002, cuyo origen fue una torre de refrigeración. Pacientes y método: Estudio observacional y prospectivo. Se analizan aspectos epidemiológicos, factores de riesgo, hallazgos clínicos, radiológicos y microbiológicos. Resultados: El brote de infección afectó a 151 pacientes: un 62% eran varones y la edad media fue de 58,4 años. Se diagnosticó a 7 de fiebre de Pontiac y a 144 casos de neumonía (un 79% confirmadas, un 14% sospechosas y un 7% probables). Un 40% de los pacientes eran fumadores, un 53,5% tenía alguna enfermedad subyacente y un 22% eran diabéticos. Los síntomas predominantes fueron fiebre (97%), escalofríos y mialgias (ambos en el 63%), cefalea (54%) y tos (53%). La imagen radiológica más frecuente fue la condensación unilobular (71%). La semiología respiratoria fue normal en el 38%. Un 43% de los pacientes tenían criterios clínicos de gravedad. Un 16% se clasificó en los grupos IV-V de Fine. El diagnóstico se efectuó por antigenuria en el 76%; 10 pacientes tenían cultivo de muestras respiratorias positivo. El estudio molecular mostró coincidencia entre las cepas de las muestras clínicas y las de la torre de refrigeración. El tratamiento en el 95,6% de los casos fue con claritromicina. La mortalidad fue del 1,4%. Conclusiones: El brote de infección por L. pneumophila afectó a muchas personas en un período muy breve. La prueba diagnóstica más útil fue la antigenuria. El aislamiento de Legionella en muestras respiratorias fue fundamental para establecer la fuente de la infección. La baja mortalidad está relacionada probablemente con la rapidez del diagnóstico y el tratamiento adecuado
Background and objective: To describe an outbreak of Legionella pneumophila serogroup 1 in Mataró, Catalunya, Spain, in August 2002. The source of the microorganism was a cooling tower. Patients and method: Prospective and observational study with analysis of epidemiological, clinical, and microbiological data. Results: 151 patients were affected (62% male), with a mean age of 58.4 years old. Seven patients were classified as Pontiac Fever and 144 suffered from pneumonia. The diagnosis of pneumonia was confirmed in 79% of cases, was considered suspicious in 14% and probable in 7%. Forty per cent of patients were smokers and 53.5% had comorbidities, mainly diabetes mellitus (22%). Chief symptoms were fever (97%), chills and muscular pain (63% respectively), headache (54%) and cough (53%). Pulmonary condensation was the more frequent radiological feature (71%). Normal pulmonary exploration was observed in 38%. Forty-three per cent of cases were severely ill, and 16% of petients belonged to Fine's IV or V class. Antigenuria was the most important test for diagnosis, which confirmed 76% of cases. Legionella spp. was obtained in respiratory secretions of 10 patients. Molecular analysis confirmed clonality between respiratory microorganisms and that obtained in the cooling tower. Conclusion: The outbreak involved an important number of subjects in a short period of time. Antigenuria was the most useful test. However, the isolation of L. pneumophila from patients permitted the prompt identification of microorganism's source in a cooling tower. The low mortality observed probably relates to a rapid diagnosis and its target treatment
