title: Liver cirrhosis as a predisposing condition for Legionnaires' disease: a report of four laboratory-confirmed cases from China.
abstract: Here, we describe four cases of laboratory-confirmed Legionella infection. Case 1 was a culture-confirmed case of Legionella infection in a patient with liver cirrhosis. Following this, three other liver cirrhosis cases (cases 2-4) were diagnosed with Legionella infection as confirmed by quantitative real-time PCR. The cause of the pneumonia was determined as Legionella pneumophila by positive direct fluorescence assay and isolation of the causative agent. The infections were successfully treated by administering appropriate antibiotics. These cases highlight the importance of considering Legionella as a cause of pneumonia in patients with liver disease and lung infections. The strain of L. pneumophila isolated from Case 1 was characterized as being closely related to strain Philadelphila-1 (ATCC 33152(T)), which is the type strain of the species, belonging to serogroup 1 and sequence type 36 (ST36), and is known to be distributed worldwide. To our knowledge, this is the first report of Legionella infection on the Chinese mainland for a decade and highlights the need to raise awareness of diagnostic methods for Legionnaires' disease in China and the requirement for further epidemiological surveillance strategies to monitor this disease.
authors.affiliation: State Key Laboratory for Infectious Disease Prevention and Control and the National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping, Beijing 102206, PR China.
authors.forename: Tian
authors.initials: T
authors.lastname: Qin
authors.affiliation: 302 Military Hospital, 100 Xisihuan Middle Road, Fengtai, Beijing 100039, PR China.
authors.forename: Jie
authors.initials: J
authors.lastname: Xia
authors.affiliation: State Key Laboratory for Infectious Disease Prevention and Control and the National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping, Beijing 102206, PR China.
authors.forename: Hongyu
authors.initials: H
authors.lastname: Ren
authors.affiliation: State Key Laboratory for Infectious Disease Prevention and Control and the National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping, Beijing 102206, PR China.
authors.forename: Haijian
authors.initials: H
authors.lastname: Zhou
authors.affiliation: 302 Military Hospital, 100 Xisihuan Middle Road, Fengtai, Beijing 100039, PR China.
authors.forename: Bo
authors.initials: B
authors.lastname: Tang
authors.affiliation: State Key Laboratory for Infectious Disease Prevention and Control and the National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping, Beijing 102206, PR China.
authors.forename: Zhujun
authors.initials: Z
authors.lastname: Shao
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001431:Bacteriological Techniques; D002681:China; D019085:Fluorescent Antibody Technique, Direct; D005838:Genotype; D006801:Humans; D016952:Legionella pneumophila / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D007877:Legionnaires' Disease / Q000175:diagnosis* / Q000188:drug therapy; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D058889:Molecular Typing; D060888:Real-Time Polymerase Chain Reaction; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents