Legionnaires' disease at a Dutch flower show: prognostic factors and impact of therapy.
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.
Lettinga
Kamilla D
KD
Academic Medical Center, Amsterdam, the Netherlands. K.D.Lettinga@amc.uva.nl
Verbon
Annelies
A
Weverling
Gerrit-Jan
GJ
Schellekens
Joop F P
JF
Den Boer
Jeroen W
JW
Yzerman
Ed P F
EP
Prins
Jacobus
J
Boersma
Wim G
WG
van Ketel
Ruud J
RJ
Prins
Jan M
JM
Speelman
Peter
P
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
D000900:Anti-Bacterial Agents