Legionellosis after hematopoietic stem cell transplantation.
Journal
Bone marrow transplantation
ISSN: 1476-5365
Titre abrégé: Bone Marrow Transplant
Pays: England
ID NLM: 8702459
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
20
10
2020
accepted:
29
04
2021
revised:
20
04
2021
pubmed:
24
5
2021
medline:
14
10
2021
entrez:
23
5
2021
Statut:
ppublish
Résumé
Limited data are available on legionellosis after hematopoietic stem cell transplant (HSCT). The aim of this study was to report the cases of legionellosis and to identify predictors of legionellosis, legionellosis-associated death, and non-relapse mortality (NRM). All cases of post-HSCT legionellosis from the EBMT registry were included and matched with controls in a 3:1 ratio for the analyses of risk factors. In the years 1995-2016, 80 cases from 52 centers in 14 countries were identified (mainly from France, Italy, and Spain). Median time from HSCT to legionellosis was 203 days (range, 0-4099); 19 (23.8%) patients developed early legionellosis (within-day +30 post-HSCT). Patients were mainly male (70%), after allogeneic HSCT (70%), with acute leukemia (27.5%), lymphoma (23.8%), or multiple myeloma (21.3%), and the median age of 46.6 (range, 7.2-68.2). Predictors of legionellosis were allogeneic HSCT (OR = 2.27, 95%CI:1.08-4.80, p = 0.03) and recent other infection (OR = 2.96, 95%CI:1.34-6.52, p = 0.007). Twenty-seven (33.8%) patients died due to legionellosis (44% after early legionellosis), NRM was 50%. Predictors of NRM were female sex (HR = 2.19, 95%CI:1.13-4.23, p = 0.02), early legionellosis (HR = 2.24, 95%CI:1.13-4.46, p = 0.02), and south-eastern geographical region (HR = 2.16, 95%CI:1.05-4.44, p = 0.036). In conclusion, legionellosis is a rare complication after HSCT, mainly allogeneic, occurring frequently within 30 days after HSCT and associated with high mortality.
Identifiants
pubmed: 34023859
doi: 10.1038/s41409-021-01333-7
pii: 10.1038/s41409-021-01333-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2555-2566Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Nature Limited.
Références
Fraser DW, Tsai TR, Orenstein W, Parkin WE, Beecham HJ, Sharrar RG, et al. Legionnaires’ disease: description of an epidemic of pneumonia. N Engl J Med. 1977;297:1189–97.
doi: 10.1056/NEJM197712012972201
Fields BS, Benson RF, Besser RE. Legionella and Legionnaires’ disease: 25 years of investigation. Clin Microbiol Rev. 2002;15:506–26.
doi: 10.1128/CMR.15.3.506-526.2002
European Centre for Disease Prevention and Control. Legionnaires’ disease. In ECDC. Annual epidemiological report for 2016. Stockholm: ECDC 2018.
Horwitz MA. Cell-mediated immunity in Legionnaires’ disease. J Clin Investig. 1983;71:1686–97.
doi: 10.1172/JCI110923
Lanternier F, Ader F, Pilmis B, Catherinot E, Jarraud S, Lortholary O. Legionnaire’s disease in compromised hosts. Infect Dis Clin North Am. 2017;31:123–35.
doi: 10.1016/j.idc.2016.10.014
Chow JW, Yu VL. Legionella: a major opportunistic pathogen in transplant recipients. Semin Respir Infect. 1998;13:132–9.
pubmed: 9643391
Harrington RD, Woolfrey AE, Bowden R, McDowell MG, Hackman RC. Legionellosis in a bone marrow transplant center. Bone Marrow Transpl. 1996;18:361–8.
Kool JL, Fiore AE, Kioski CM, Brown EW, Benson RF, Pruckler JM, et al. More than 10 years of unrecognized nosocomial transmission of legionnaires’ disease among transplant patients. Infect Control Hosp Epidemiol. 1998;19:898–904.
doi: 10.2307/30142014
Sivagnanam S, Pergam SA. Legionellosis in transplantation. Curr Infect Dis Rep. 2016;18:9.
doi: 10.1007/s11908-016-0517-x
del Castillo M, Lucca A, Plodkowski A, Huang YT, Kaplan J, Gilhuley K, et al. Atypical presentation of Legionella pneumonia among patients with underlying cancer: a fifteen-year review. J Infect. 2016;72:45–51.
doi: 10.1016/j.jinf.2015.10.006
Han XY, Ihegword A, Evans SE, Zhang J, Li L, Cao H, et al. Microbiological and clinical studies of legionellosis in 33 patients with cancer. J Clin Microbiol. 2015;53:2180–7.
doi: 10.1128/JCM.00380-15
Styczynski J, Tridello G, Koster L, Iacobelli S, van Biezen A, van der Werf S, et al. Death after hematopoietic stem cell transplantation: changes over calendar year time, infections and associated factors. Bone Marrow Transpl. 2020;55:126–36.
doi: 10.1038/s41409-019-0624-z
Cunha BA, Burillo A, Bouza E. Legionnaires’ disease. Lancet. 2016;387:376–85.
doi: 10.1016/S0140-6736(15)60078-2
Lee JV, Joseph C. Guidelines for investigating single cases of Legionnaires’ disease. Commun Dis Public Health. 2002;5:157–62.
pubmed: 12166305
Gudiol C, Garcia-Vidal C, Fernandez-Sabe N, Verdaguer R, Llado L, Roca J, et al. Clinical features and outcomes of Legionnaires’ disease in solid organ transplant recipients. Transpl Infect Dis. 2009;11:78–82.
doi: 10.1111/j.1399-3062.2008.00337.x
Bangsborg JM, Uldum S, Jensen JS, Bruun BG. Nosocomial legionellosis in three heart-lung transplant patients: case reports and environmental observations. Eur J Clin Microbiol Infect Dis. 1995;14:99–104.
doi: 10.1007/BF02111866
Johnson JT, Yu VL, Wagner RL, Best MG. Nosocomial Legionella pneumonia in a population of head and neck cancer patients. Laryngoscope 1985;95:1468–71.
doi: 10.1288/00005537-198512000-00006
Cervia JS, Farber B, Armellino D, Klocke J, Bayer RL, McAlister M, et al. Point-of-use water filtration reduces healthcare-associated infections in bone marrow transplant recipients. Transpl Infect Dis. 2010;12:238–41.
doi: 10.1111/j.1399-3062.2009.00459.x
Yokoe D, Casper C, Dubberke E, Lee G, Munoz P, Palmore T, et al. Infection prevention and control in health-care facilities in which hematopoietic cell transplant recipients are treated. Bone Marrow Transpl. 2009;44:495–507.
doi: 10.1038/bmt.2009.261
Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. MMWR Recommend Rep. 2000;49(Rr-10):1-125, ce1-7.
World Health Organization. Legionella and the prevention of legionellosis. Geneva: World Health Organization; 2007.
Guidelines for prevention of nosocomial pneumonia. Centers for disease control and prevention. MMWR Recommend Rep. 1997;46:1–79.
Beauté J, Robesyn E, de Jong B. Legionnaires’ disease in Europe: all quiet on the eastern front?. Eur Respir J. 2013;42:1454–8.
doi: 10.1183/09031936.00089113
Prodinger WM, Bonatti H, Allerberger F, Wewalka G, Harrison TG, Aichberger C, et al. Legionella pneumonia in transplant recipients: a cluster of cases of eight years’ duration. J Hosp Infect. 1994;26:191–202.
doi: 10.1016/0195-6701(94)90042-6
Oren I, Zuckerman T, Avivi I, Finkelstein R, Yigla M, Rowe JM. Nosocomial outbreak of Legionella pneumophila serogroup 3 pneumonia in a new bone marrow transplant unit: evaluation, treatment and control. Bone Marrow Transpl. 2002;30:175–9.
doi: 10.1038/sj.bmt.1703628
Lanternier F, Tubach F, Ravaud P, Salmon D, Dellamonica P, Bretagne S, et al. Incidence and risk factors of Legionella pneumophila pneumonia during anti-tumor necrosis factor therapy: a prospective French study. Chest 2013;144:990–8.
doi: 10.1378/chest.12-2820
Bodro M, Carratala J, Paterson DL. Legionellosis and biologic therapies. Respir Med. 2014;108:1223–8.
doi: 10.1016/j.rmed.2014.04.017
Tubach F, Ravaud P, Salmon-Ceron D, Petitpain N, Brocq O, Grados F, et al. Emergence of Legionella pneumophila pneumonia in patients receiving tumor necrosis factor-alpha antagonists. Clin Infect Dis. 2006;43:e95–100.
doi: 10.1086/508538
Nunnink JC, Gallagher JG, Yates JW. Legionnaires’ disease in patients with cancer. Med Pediatr Oncol. 1986;14:81–5.
doi: 10.1002/mpo.2950140205
Jacobson KL, Miceli MH, Tarrand JJ, Kontoyiannis DP. Legionella pneumonia in cancer patients. Medicine 2008;87:152–9.
doi: 10.1097/MD.0b013e3181779b53
Mykietiuk A, Carratala J, Fernandez-Sabe N, Dorca J, Verdaguer R, Manresa F, et al. Clinical outcomes for hospitalized patients with Legionella pneumonia in the antigenuria era: the influence of levofloxacin therapy. Clin Infect Dis. 2005;40:794–9.
doi: 10.1086/428059
Viasus D, Di Yacovo S, Garcia-Vidal C, Verdaguer R, Manresa F, Dorca J, et al. Community-acquired Legionella pneumophila pneumonia: a single-center experience with 214 hospitalized sporadic cases over 15 years. Medicine 2013;92:51–60.
doi: 10.1097/MD.0b013e31827f6104
Benin AL, Benson RF, Besser RE. Trends in legionnaires disease, 1980–1998: declining mortality and new patterns of diagnosis. Clin Infect Dis. 2002;35:1039–46.
doi: 10.1086/342903
Cunha BA, Klein NC, Strollo S, Syed U, Mickail N, Laguerre M. Legionnaires’ disease mimicking swine influenza (H1N1) pneumonia during the “herald wave” of the pandemic. Heart Lung. 2010;39:242–8.
doi: 10.1016/j.hrtlng.2009.10.009
Meyer R, Rappo U, Glickman M, Seo SK, Sepkowitz K, Eagan J, et al. Legionella jordanis in hematopoietic SCT patients radiographically mimicking invasive mold infection. Bone Marrow Transpl. 2011;46:1099–103.
doi: 10.1038/bmt.2011.94
Gonzalez IA, Martin JM. Legionella pneumophilia serogroup 1 pneumonia recurrence postbone marrow transplantation. Pediatr Infect Dis J. 2007;26:961–3.
doi: 10.1097/INF.0b013e31812565aa
Larru B, Gerber JS, Ota KV. Medical treatment failure and complete left pneumonectomy after Legionella pneumophila pneumonia in a bone marrow transplant recipient. Pediatr Infect Dis J. 2012;31:979–81.
doi: 10.1097/INF.0b013e31825cb28f
Schindel C, Siepmann U, Han S, Ullmann AJ, Mayer E, Fischer T, et al. Persistent Legionella infection in a patient after bone marrow transplantation. J Clin Microbiol. 2000;38:4294–5.
doi: 10.1128/JCM.38.11.4294-4295.2000
Sivagnanam S, Podczervinski S, Butler-Wu SM, Hawkins V, Stednick Z, Helbert LA, et al. Legionnaires’ disease in transplant recipients: a 15-year retrospective study in a tertiary referral center. Transpl Infect Dis. 2017;19.