Community-acquired Legionnaires' disease caused by Legionella pneumophila serogroup 10 linked to the private home.
We describe the case of a 66-year-old man with a culture-proven Legionella pneumonia after kidney transplantation. The patient developed the infection 15 days after discharge from a university hospital. Legionella pneumonia caused by Legionella pneumophila serogroup 5/10 was established by positive direct fluorescence assay, positive urinary-antigen detection and isolation of the causative agent. The infection was successfully treated by giving appropriate antibiotics, but the further course was complicated by invasive aspergillosis, cytomegalovirus pneumonia, failure of the transplanted kidney and development of septic anaemia. Four months after the diagnosis of Legionella pneumonia the patient died of multi-organ failure. The microbiological and epidemiological investigation revealed that strains from the water supply of the patient's private home were indistinguishable from the patient's isolate by amplified fragment length polymorphism analysis and sequence-based typing (SBT). Unrelated strains of serogroups 4, 5, 8 and 10 from the Dresden strain collection were of different SBT types. Thus, SBT is a very useful tool for epidemiological investigation of infections by L. pneumophila serogroups other than serogroup 1.
Lück
Paul Christian
PC
Institut für Medizinische Mikrobiologie und Hygiene, TU Dresden, Fiedlerstrasse 42, D-01307 Dresden, Germany.
Schneider
Thomas
T
Medizinische Klinik I (Gastroenterologie, Rheumatologie und Infektiologie), Charité -Universitätsmedizin Berlin Hindenburgdamm 30, 12203 Berlin, Germany.
Wagner
Jutta
J
Institut für Mikrobiologie und Hygiene, Charité - Universitätsmedizin Berlin Hindenburgdamm 27, 12203 Berlin, Germany.
Walther
Ilona
I
Gesundheitsamt der Stadt Hoyerswerda. 02977 Hoyerswerda, Germany.
Reif
Ursula
U
Landesuntersuchungsanstalt für das Gesundheits- und Veterinärwesen Sachsen, Jägerstrasse 8-10, 01099 Dresden, Germany.
Weber
Stefan
S
Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Hoyerswerda, Maria Grollmuß-Strasse 10, 02977 Hoyerswerda, Germany.
Weist
Klaus
K
Institut für Hygiene und Umweltmedizin, Charité - Universitätsmedizin Berlin Hindenburgdamm 27, 12203 Berlin, Germany.
D000368:Aged; D054458:Amplified Fragment Length Polymorphism Analysis; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000150:complications; D017714:Community-Acquired Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D003586:Cytomegalovirus Infections / Q000150:complications; D017809:Fatal Outcome; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D016030:Kidney Transplantation; D016952:Legionella pneumophila / Q000145:classification / Q000302:isolation & purification*; D007877:Legionnaires' Disease / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D008297:Male; D017720:Molecular Epidemiology; D011024:Pneumonia, Viral; D051437:Renal Insufficiency / Q000150:complications; D018805:Sepsis / Q000150:complications; D012703:Serotyping; D014556:Urine / Q000382:microbiology; D014871:Water Microbiology
D000900:Anti-Bacterial Agents