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Volume 51, Number 3, June 2018

Legionnaires\' disease at a medical center in southern Taiwan 


Tzu-Lun Hung, Ming-Chi Li, Li-Rong Wang, Ching-Chuan Liu, Chia-Wen Li, Po-Lin Chen, Ling-Shan Syue, Nan-Yao Lee, Wen-Chien Ko


 

Corresponding author:

Affiliations
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
Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Correspondence
Corresponding authors. Department of Internal Medicine, National Cheng Kung University Hospital, Number 138, Sheng Li Road, Tainan 704, Taiwan. 



 

Background and 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. 



 

Key words:

caregiver, Legionnaires' disease, pneumonia, Taiwan