The Etiological Role of Legionella Pneumophila in Patients with Community-Acquired Pneumonia in Korea.

Song, Hong Seok; Suh, Ji Hyeon; Ahn, Jong Ho; Yoon, Byeong In; Lee, Seung Joon; Lee, Myung Goo; Jun, Man Jo; Kang, Min Jong; Lee, Jae Myung; Kim, Dong Gyu; Son, Jee Woong; Park, Myung Jae; Hyun, In Gyu; Jung, Ki Suck

doi:2001.50.4.409

Tuberc Respir Dis > Volume 50(4); 2001 > Article

Original Article

Tuberculosis and Respiratory Diseases 2001;50(4):409-414.
DOI: https://doi.org/10.4046/trd.2001.50.4.409 Published online April 1, 2001.

The Etiological Role of Legionella Pneumophila in Patients with Community-Acquired Pneumonia in Korea.

Hong Seok Song, Ji Hyeon Suh, Jong Ho Ahn, Byeong In Yoon, Seung Joon Lee, Myung Goo Lee, Man Jo Jun, Min Jong Kang, Jae Myung Lee, Dong Gyu Kim, Jee Woong Son, Myung Jae Park, In Gyu Hyun, Ki Suck Jung

Abstract

BACKGROUND
Legionella pneumophila has been recognized as an important cause of community-acquired pneumonia(CAP) requiring hospitalization. However, epidemiological data on the occurrence of legionella-related pneumonia is unavailable in Korea. The purpose of this study was to evaluated the etiological imprtance of legionella pneumophila serogroup 1 in patients hospitalized with CAP. METHOD: The CAP patient over 16 year-old were recruited from July 1999 to June 2000 at the Chunchon Sacred Heart Hospital. Fifty four patients (male 29, female 25, average age 63.8±15.3) were included in this study. A diagnosis of a legionella pneumophila infection was based on a urinary antigen test using the Binax Company enzyme immunoassay. The severity of pneumonia was assessed using the Fine's PORT scoring system. RESULT: The average Fine's PORT score was 99.7(±44.9). According to the risk classification proposed by the Infectious Disease Society of America, the number of patients in each class(from class I to class V) were 6(11.1%), 13(24.1%), 9(16.7%), 14(25.8%), and 12(22.2%), respectively. Thirty two patients(59.3%) were initially admitted to the intensive care unit. The mortality rate was 16.7%(9 in 54). In all patients, urinary antigens to Legionella pneumophila serogroup 1 were not detected. CONCLUSION: Legionella pneumophila may play little role in causing adult CAP in Korea. Therefore, the routine use of macrolide in the empirical treatment of the CAP patients based upon the ATS guidelines(1993) in Korea should be reevaluated.

Key Words: Legionella pneumophila, Community-acquired pneumonia, Binax enzyme immunoassay