Detection of L. pneumophila non-serogroup 1 in hospital-acquired pneumonia: A cross-sectional study from Eastern India
Abstract
ABSTRACT Background and Objective: Legionella pneumophila (Lp) has been recognized as an important cause of Hospital Acquired Pneumonia (HAP). However, the frequency distribution of Lp as etiological agents of HAP is less studied in India. The aim of this study was to determine the frequency of Lp in cases of HAP by using a combination of culture, urinary Lp sg1 antigen testing, and Lp-specific 16S RNA gene PCR. Methods: Admitted patients fulfilling the clinical and radiological criteria of HAP were enrolled in the study between February 2023 and June 2024. Respiratory specimens of patients were subjected to culture in BCYE agar and the Lp-specific PCR, and urine Lp sg1 antigen testing. Results: Of the 195 suspected HAP patients enrolled, 160 (82.05%) were microbiologically confirmed as HAP. All respiratory specimens tested negative for Lp by culture and urine antigen tests. However, 20 of the 160 microbiologically confirmed HAP cases were positive for Lp by 16S rRNA gene PCR. New-onset pulmonary infiltrates were significantly associated with Lp HAP compared to non-Legionella HAP cases (50% vs. 5%, p < 0.001). Lp-positive HAP cases had higher total protein (6.13 vs. 5.56 g/dL, p = 0.043) and globulin (3.24 vs. 2.84 g/dL, P = 0.037), and lower serum phosphate levels (2.94 vs. 4.58 mg/dL, p < 0.001) compared to negative cases. In the present study, Lp was a co-pathogen in fifteen HAP cases (Eight cases with Klebsiella pneumoniae, six with Pseudomonas aeruginosa, and one with…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 195 participants or records.
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