title: Nosocomial Legionnaires' disease uncovered in a prospective pneumonia study.
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.
mesh_terms: D000328:Adult; D000368:Aged; D003428:Cross Infection / Q000175:diagnosis* / Q000635:transmission; D005260:Female; D006784:Hospitals, Teaching; D006787:Hospitals, Veterans; D006801:Humans; D007875:Legionella / Q000302:isolation & purification; D007877:Legionnaires' Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000635:transmission; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania; D011014:Pneumonia / Q000209:etiology*; D011446:Prospective Studies; D014871:Water Microbiology