Ghost in opera: Are Legionella bacteria really rare pathogens for hospital plumbing?

Abstract

Objectives: The aim of this study was to evaluate the presence of Legionella species (spp.) in our hospital and to identify patients who were possibly affected by the current plumping system. Materials and methods: Legionella spp. swap antigen test showed positivity from plumbing in two patients’ room between June 2016 and December 2016. All patients were retrospectively checked whether they were infected or not. The symptoms of Legionnaires' disease (LD) were asked and urine antigen test was performed. Possible transmission pathways were investigated and discussed. The main source of bacteria and possible routes of transmission were identified. Results: A total of 40 patients were suspected of being infected with LD. A total of 34 (34/40, 85%) patients were reached. During the evaluation, five (5/34, 14%) patients (3 males, 2 females; mean age: 68±2.6 years; range, 58 to 64 years) showed a clinical picture resembling LD. Chronic obstructive pulmonary disease and chronic renal failure were the most common comorbid diseases. Urinary antigen positivity was demonstrated in only two (2/5, 40%) patients. Antibiotic treatment was started after clinical presentation of fever in all patients. Two patients with a positive antigen test had a history of severe respiratory failure requiring hospitalization. Mortality was seen in none of the patients. Legionella spp. was detected in the hospital water storage tank. Conclusion: On-site analysis is important for every facility, as bacterial contamination of hospital plumbing by Legionella spp. is a rare condition.