The impact of legionellosis into fatal outcomes of pneumonia in Irkutsk

A D Botvinkin,N A Kravchenko,V V Svistunov,O S Gibteva,E A Sidorova,T P Balandina,L A Stepanenko,A E Makarova,M V Lemeshevskaya,S V Balakhonov,E I Andaev,T A Bayanova

doi:10.23946/2500-0764-2021-6-4-82-89

Abstract

Aim. To study the diagnosis of legionellosis in patients who died because of pneumonia in Irkutsk (2016-2018).Materials and Methods. We performed 65 autopsies of patients who died from pneumonia in Irkutsk (2016-2018), studied their case histories, and interrogated 510 tap water samples for Legionella pneumophila by means of inoculation and polymerase chain reaction.Results. Among 65 fatal pneumonia outcomes registered in Irkutsk during 2016-2018, legionellosis has been confirmed in three cases (4.6%). Two of these patients were at the late stages of HIV infection while the third, 74-yearold, patient had multiple comorbid conditions. Nosocomial infection was suspected in one of these cases. None of these three patients left Irkutsk during the last month of their life. The assumed transmission factor was tap water, as Legionella pneumophila was found in tap water samples collected in 2013 and 2015.Conclusion. Patients with severe pneumonia need screening for legionellosis to perform the correct treatment, particularly during COVID-19 pandemic.

Highlights

Among 65 fatal pneumonia outcomes registered in Irkutsk during 2016-2018, legionellosis has been confirmed in three cases (4.6%)
The assumed transmission factor was tap water, as Legionella pneumophila was found in tap water samples collected in 2013 and 2015
Patients with severe pneumonia need screening for legionellosis to perform the correct treatment, during COVID-19 pandemic

Summary

Introduction

До начала пандемии новой коронавирусной инфекции Legionella pneumophila занимала второе место после Streptococcus pneumoniae в структуре возбудителей тяжелой и жизнеугрожающей внебольничной пневмонии. Пробы легочной ткани из очага поражения для молекулярно-генетического исследования фиксировали в растворе 1% СТАВ (гексадецилтриметиламмонийбромид) в 50% изопропиловом спирте и хранили до начала исследования при температуре - 65±5°C. В группе из 65 умерших с проявлениями пневмонии у 44 в качестве основного клинического диагноза в историях болезней была указана внебольничная или госпитальная пневмония (J12-J18), у 11 − новообразования (С15-С39) и у 10 – ВИЧ-инфекция (В20-В24). ДНК Legionella pneumophila (серогруппа 1) обнаружена в трех пробах легочной ткани из 65 (4,6±2,6%). В анамнезе − выявленная 5 лет назад ВИЧ-инфекция и туберкулез легких.

Results

Conclusion