title: Legionnaires' disease at a Dutch flower show: prognostic factors and impact of therapy.
abstract: After a large outbreak of Legionnaires' disease in the Netherlands, we determined risk factors for intensive care unit (ICU) admission and death and the impact of adequate therapy on ICU-free survival among 141 hospitalized patients. Overall mortality rate was 13%, and ICU mortality rate was 36%. Smoking, temperature >38.5 degrees C, and bilateral infiltrates shown on chest x-ray were independent risk factors for ICU admission or death (all p<0.05). Starting adequate therapy within 24 hours after admission resulted in a higher ICU-free survival rate compared to therapy initiation after 24 hours: 78% versus 54%, respectively (p=0.005). However, delay in providing therapy to patients with urinary antigen tests with negative results did not influence outcome. These data suggest that by using the urinary antigen test on admission a more tailored approach to patients with community-acquired pneumonia may be applied.
authors.affiliation: Academic Medical Center, Amsterdam, the Netherlands. K.D.Lettinga@amc.uva.nl
authors.forename: Kamilla D
authors.initials: KD
authors.lastname: Lettinga
authors.forename: Annelies
authors.initials: A
authors.lastname: Verbon
authors.forename: Gerrit-Jan
authors.initials: GJ
authors.lastname: Weverling
authors.forename: Joop F P
authors.initials: JF
authors.lastname: Schellekens
authors.forename: Jeroen W
authors.initials: JW
authors.lastname: Den Boer
authors.forename: Ed P F
authors.initials: EP
authors.lastname: Yzerman
authors.forename: Jacobus
authors.initials: J
authors.lastname: Prins
authors.forename: Wim G
authors.initials: WG
authors.lastname: Boersma
authors.forename: Ruud J
authors.initials: RJ
authors.lastname: van Ketel
authors.forename: Jan M
authors.initials: JM
authors.lastname: Prins
authors.forename: Peter
authors.initials: P
authors.lastname: Speelman
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007877:Legionnaires' Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D016015:Logistic Models; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents