Infections Caused by Legionella micdadei and Legionella pneumophila among Renal Transplant Recipients

• Published in: The Journal of infectious diseases Vol. 149; no. 5; pp. 703 - 713
• Main Authors: Dowling, John N., Pasculle, A. William, Frola, Frank N., Zaphyr, M. Kathryn, Yee, Robert B.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-05-1984; University of Chicago Press
• Subjects: Antibodies; Antibodies, Bacterial - analysis; Biological and medical sciences; Cross Infection - epidemiology; Disease outbreaks; Epidemiology; Hospital admissions; Humans; Immune Tolerance; Immunosuppressive Agents - therapeutic use; Infections; Kidney Transplantation; Legionella; Legionella - immunology; Legionnaires disease; Legionnaires' Disease - epidemiology; Legionnaires' Disease - microbiology; Medical sciences; Original Articles; Pneumonia; Specimens; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Time Factors; Transplantation; Infection; Pneumonia; Urinary system disease; Respiratory disease; Surgery; Bacteriosis; Complication; Legionella pneumophila; Homotransplantation; Kidney
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/149.5.703

In an analysis of legionellosis at Presbyterian-University Hospital in Pittsburgh during the 28 months after the original outbreak of pneumonia caused by Legionella micdadei, 101 consecutive renal-allograft recipients were studied. The prevalence of elevated titers of antibody to Legionella pneumophila or L. micdadei among the patients at the time of transplantation (21.6%) was not significantly different from that among kidney donors (13.4%; P > .25). Seroconversion occurred in 21 (23.6%) of 89 recipients during the six months after transplantation. Seven recipients who seroconverted were diagnosed as having legionella pneumonia, eight had fever and pneumonitis attributed to other causes but compatible (on clinical grounds) with legionella infection, and six had no clinical evidence of infectious pneumonia. The interval from transplantation to onset of pneumonia was shorter for recipients with evidence of L. micdadei pneumonia than for patients with L. pneumophila pneumonia (P = .006); this finding suggested that the former disease occurred when the recipients were most immunocompromised. The original outbreak of L. micdadei pneumonia was found to have subsided nine months after the last formally recognized case, but infections with L. pneumophila continued to occur thereafter.