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Nosocomial and Community Acquired Legionella Pneumophila Pneumonia.

Completed
Conditions
Legionnaires' Disease
Interventions
Other: Data extraction from medical files
Registration Number
NCT04106037
Lead Sponsor
Dr Philippe CLEVENBERGH
Brief Summary

Legionnaire's disease (LD) is a major cause of both community acquired and nosocomial pneumonia, with Legionella pneumophila serogroup A (Lp1) being the most virulent and the greatest cause of disease. Sample culture of low respiratory tract is considered the gold standard in the diagnosis of LD, however its sensitivity seems to be poor and its performance is technically demanding. The introduction of urinary antigen detection testing (LUA) brought a major advance in LD diagnosis, with upt to 95% of cases in Europe being diagnosed with this method. Despite the high sensitivity of LUA for Lp1, ranging from 80-90%, its negative predictive value is low in other serogroup than Lp1 and therefore, Legionella may be unrecognized as agent of pneumonia. Although underdiagnosed and underreported, LD represents the second most common cause of pneumonia requiring admission in intensive care unit (ICU). Average fatality rate of LD in Europe reaches 10%, but its mortality is considered to be even higher in nosocomial patients.

Despite the higher fatality rate in hospitalized LD patients, poor is the knowledge on the risk factors that could induce disease and that increase mortality in the hospitalized population affected by LD. In order to shed more light on this topic a cohort of patients diagnosed with LD in the last 3 years will be retrospectively examined.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
46
Inclusion Criteria

All confirmed human cases of Legionnaires' disease diagnosed within the CHU Brugmann hospital within the last 3 years, from 01/01/2016 till 31/12/2018. A similar approach will be followed for the St Pierre and the UZ Brussel Hospitals.

Exclusion Criteria

Pregnant women.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Legionnaires' diseaseData extraction from medical filesAll confirmed human cases of Legionnaires' disease diagnosed within the CHU Brugmann hospital within the last 3 years: from 01/01/2016 till 31/12/2018. A similar approach will be followed for the St Pierre Hospital and the UZ Brussel Hospital.
Primary Outcome Measures
NameTimeMethod
Severity respiratory failure3 years

Arterial pression of oxygen inferior to 600mmHg at diagnosis

All cause mortality3 years

All cause mortality

Secondary Outcome Measures
NameTimeMethod
CreatinineOne day

Creatinine level at diagnosis

UreaOne day

Urea level at diagnosis

Method of diagnosisOne day

Name of the method of diagnosis (urinary antigen, seroconversion, cultures).

AntibioticsOne day

Name of antibiotics given

AgeOne day

Age at diagnosis

SexOne day

Sex

Charlson comorbidity indexOne day

This is a health tool that assesses the comorbidity risk associated to a series of conditions in order to offer medical specialists an informed decision making process in terms of specific screenings or medical procedures.The index accounts for the patient age and 16 different conditions, and ranges from 0 till 37.

Nosocomial disease (yes/no)One day

Nosocomial cases of Legionnaires' disease are defined in this study as having an onset of symptoms more than 10 days after hospitalization.

Smoking statusOne day

Smoking (yes/no) at diagnosis

Chest X RayOne day

Descriptive analysis of Chest X Ray findings at diagnosis

C reactive proteinOne day

C reactive protein level at diagnosis

White blood cellsOne day

White blood cells level at diagnosis

Intensive care unit hospitalizationOne day

Intensive care unit hospitalization (yes/no)

Antibiotic treatment durationup to 40 days

Antibiotic treatment duration

Trial Locations

Locations (3)

CHU St Pierre Hospital

🇧🇪

Brussels, Belgium

Universitair Zienkenhuis Brussel

🇧🇪

Brussels, Belgium

CHU Brugmann

🇧🇪

Brussel, Belgium

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