Nosocomial Legionnaire's disease in a children's hospital

Citation
M. Campins et al., Nosocomial Legionnaire's disease in a children's hospital, PEDIAT INF, 19(3), 2000, pp. 228-234
Citations number
49
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Clinical Immunolgy & Infectious Disease
Journal title
PEDIATRIC INFECTIOUS DISEASE JOURNAL
ISSN journal
0891-3668 → ACNP
Volume
19
Issue
3
Year of publication
2000
Pages
228 - 234
Database
ISI
SICI code
0891-3668(200003)19:3<228:NLDIAC>2.0.ZU;2-6
Abstract
Background. Only a few cases of nosocomial Legionella sp, infection have be en reported in children. We report the clinical and epidemiologic data of f ive nosocomial legionellosis cases that occurred in the Pediatric Nephrolog y Service between August, 1994, and December, 1998, and the control measure s adopted, Methods. The Hospital Materno-Infantil Vall d'Hebron, Barcelona, is a 407-b ed tertiary care hospital. The pediatric kidney transplant unit has three i solated beds in the same ward within the Pediatric Nephrology Service. Diag nostic workup to establish Legionella pneumophila infection included cultur e, fluorescent antibody and serologic studies. Macrorestriction analysis of genomic DNA was used as epidemiologic markers of the isolated strains. Results, In May, 1996, a case of L. pneumophila serogroup 6 pneumonia was i dentified in a 19-year-old youth who had received a kidney transplant 16 da ys earlier. Retrospective and prospective analysis of legionellosis cases d iagnosed at our center up to August, 1994, yielded four additional cases. F our patients had had a kidney transplant and were receiving immunosuppressi ve therapy, and the fifth had been diagnosed with systemic lupus erythemato sus with renal involvement. L, pneumophila serogroup 6 was isolated in bron chial secretions in four cases; in the fifth patient the diagnosis was made by serology. L, pneumophila serogroup 6 was isolated from potable water of the hospital, Molecular epidemiologic methods revealed the identity of the environmental and clinical isolates. Shower-was implicated as the most fea sible means of exposure to contaminated water. Conclusions. Nosocomial legionellosis, albeit rare in children, should be c onsidered in the differential diagnosis of pneumonias, particularly in immu nosuppressed children, because the fatality rate may be high without early diagnosis and treatment.