Nosocomial Legionnaires' Disease Uncovered in a Prospective Pneumonia Study
Implications for Underdiagnosis
- Robert R. Muder, MD;
- Victor L. Yu, MD;
- Jonathan K. McClure, MD;
- Frank J. Kroboth, MD;
- Spryos D. Kominos, ScD;
- Robert M. Lumish, MD
Abstract
Most hospitals have yet to record a case of nosocomial legionnaires' disease; the importance of isolation of Legionella pneumophila in the water system of such an institution is unclear. We undertook a prospective pneumonia study in tandem at a veterans hospital where legionnaires' disease was known to be endemic and a community teaching hospital where legionnaires' disease had never been documented. Legionella serological tests were performed on all patients with pneumonia; selective culture media and direct fluorescent antibody testing for Legionella were made readily available. Simultaneous environmental surveys for Legionella were performed. At the community hospital, we discovered that 64% of sites in the water distribution system yielded L pneumophila and that 14.3% of nosocomial pneumonias were legionnaires' disease. The epidemiologic implications of these findings are discussed. Options concerning case detection and eradication measures in the face of hospital water contamination with L pneumophila are presented.
(JAMA 1983;249:3184-3188)
Footnotes
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Reprint requests to Infectious Disease Section, Veterans Administration Medical Center, University Drive C, Pittsburgh, PA 15240 (Dr Yu).
