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Legionnaires' Disease in Pediatric Patients, Control Measures and 5-Year Follow-up.
Fulová, Miriam; Kotrbancová, Martina; Brazinová, Alexandra; Boledovicová, Jana; Trnková, Katarína; Spaleková, Margita.
Affiliation
  • Fulová M; Institute of Epidemiology, Faculty of Medicine, Comenius University Bratislava, Spitálska 24, 813 72 Bratislava, Slovakia.
  • Kotrbancová M; Institute of Epidemiology, Faculty of Medicine, Comenius University Bratislava, Spitálska 24, 813 72 Bratislava, Slovakia.
  • Brazinová A; Institute of Epidemiology, Faculty of Medicine, Comenius University Bratislava, Spitálska 24, 813 72 Bratislava, Slovakia.
  • Boledovicová J; National Institute of Children´s Diseases, Limbová 1, 833 40, Bratislava, Slovakia.
  • Trnková K; Department of the Environment, Faculty of Natural Sciences, Matej Bel University Banská Bystrica, Tajovského 55, 974 01 Banská Bystrica, Slovakia.
  • Spaleková M; Institute of Epidemiology, Faculty of Medicine, Comenius University Bratislava, Spitálska 24, 813 72 Bratislava, Slovakia.
Pediatr Infect Dis J ; 39(11): 990-994, 2020 11.
Article in En | MEDLINE | ID: mdl-32472821
BACKGROUND: Legionnaires' disease (LD) occurs predominantly in adults and elderly people. Its incidence in Europe has been increasing in recent years. It is rare in younger age groups and prone to be reported as healthcare-associated infection with a higher risk of fatal outcome. Hospital-acquired LD is mostly associated with a colonized hospital water system. We describe 5 LD cases in a children's hospital in Slovakia, subsequent environmental investigation, control measures, and 5-year monitoring of Legionella colonization in hospital's water system. METHODS: In 2014-2019, we tested clinical specimens from 75 hospitalized patients. Respiratory samples were cultured for Legionella, patient's urine was tested for Legionella urinary antigens, and the microagglutination test was used for serologic testing. Samples of water were collected in 2015-2019 and processed according ISO11731. RESULTS: We identified 5 Legionella infections in 2014-2015. Median age of patients was 15 years. All were high-risk patients hospitalized for their underlying diseases. All patients required admission to intensive care unit, and artificial ventilation due to general deterioration and respiratory failure. Legionella pneumophila was isolated from 72% of water samples. Chlorine dioxide dosing into water system above 0.3 ppm caused significant decrease of Legionella concentration in water samples. Samples taken from outlets with antimicrobial filter installed were legionellae-negative. CONCLUSIONS: Control measures led to decreased risk of infection, but not to eradication of Legionellae. It is necessary to extend the diagnostics for Legionella infection in hospitalized children with pneumonia, especially in hospitals with colonized water system.
Subject(s)

Full text: 1 Collection: 01-internacional Health context: 12_ODS3_hazardous_contamination / 1_ASSA2030 / 2_ODS3 Database: MEDLINE Main subject: Legionnaires' Disease Type of study: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspects: Patient_preference Limits: Adolescent / Child / Female / Humans / Infant / Male Country/Region as subject: Europa Language: En Journal: Pediatr Infect Dis J Year: 2020 Document type: Article

Full text: 1 Collection: 01-internacional Health context: 12_ODS3_hazardous_contamination / 1_ASSA2030 / 2_ODS3 Database: MEDLINE Main subject: Legionnaires' Disease Type of study: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspects: Patient_preference Limits: Adolescent / Child / Female / Humans / Infant / Male Country/Region as subject: Europa Language: En Journal: Pediatr Infect Dis J Year: 2020 Document type: Article