%0 Journal Article
%T Clinical features of Legionnaires' disease at three Belgian university hospitals, a retrospective study.
%A Moretti M
%A Allard SD
%A Dauby N
%A De Geyter D
%A Mahadeb B
%A Miendje VY
%A Balti EV
%A Clevenbergh P
%J Acta Clin Belg
%V 0
%N 0
%D Sep 2021 14
%M 34520336
%F 1.682
%R 10.1080/17843286.2021.1978211
%X <B>UNASSIGNED: </B>Legionnaires' disease (LD) is a recognised cause of community-acquired pneumonia. However, Legionella is an overlooked pathogen in hospital-acquired pneumonia. The European Surveillance System 2008-2017 found 23% of the Belgian LD reported cases being healthcare-related, with a higher death-rate than in community-acquired patients. This study aims to describe patients admitted for community-acquired LD or affected by hospital-acquired LD and investigate discriminants associated with lethality.<BR><B>UNASSIGNED: </B>Medical records were retrospectively reviewed at three Belgian University Hospitals, between 1 January 2016 up to 31 January 2019. Hospital-acquired LD was defined as symptom onset at 10 days or more after admission, according to the Centres for Disease Control and prevention. Community-acquired LD was defined as diagnosis at admission or within 10 days after admission.<BR><B>UNASSIGNED: </B>Fifty patients were included in the study, among them 26% were diagnosed with hospital-acquired LD. The case-fatality rate was 22%, with eight of the eleven deceased patients (73%) being in the hospital-acquired LD group. Medical history of asthma or chronic obstructive pulmonary disease and higher sequential organ failure assessment (SOFA) score at diagnosis were more frequently observed in the hospital-acquired LD group. Furthermore, significantly lower SOFA score at diagnosis of LD and higher rates of treatment with levofloxacin or moxifloxacin were observed in survivors.<BR><B>UNASSIGNED: </B>In the current cohort, LD death-rate was mainly driven by hospital-acquired LD patients. Hospital-acquired LD might especially affect patients with chronic respiratory disease. Respiratory fluoroquinolones treatment and lower SOFA score at diagnosis may be associated with favourable outcomes.