• Tuberculosis and Respiratory Diseases
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• v.68 no.2
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• pp.74-79
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• 2010

Background: Legionella pneumophila has been recognized as an important cause of pneumonia. However, limited data are available in the literature regarding legionella pneumonia in Korea. The objective of this study was to compare epidemiological data and clinical presentation of legionella pneumonia and pneumococcal pneumonia. Methods: We retrospectively compared clinical, radiological, and laboratory data, antimicrobial treatment, and treatment outcomes between 28 cases of legionella pneumonia and 56 cases of pneumococcal pneumonia. Diagnoses of both legionella and pneumococcal pneumonia were based on commercial urinary antigen tests. Results: Legionella pneumonia patients included 23 men and 5 women, with a mean age of 61.6 years (range 36~88). Fifteen were smokers and 26 had some underlying diseases. Legionella pneumonia occurred more frequently in healthcare-associated settings than pneumococcal pneumonia (42.9% vs 21.4%, respectively, p=0.040). There were no significant differences in clinical signs and symptoms. Compared to patients with pneumococcal pneumonia, patients with legionella pneumonia presented more frequently with anemia (39.3% vs 8.9%, p=0.001), increased C-reactive protein (57.1% vs 30.4%, p=0.018) and increased alkaline phosphatase (46.4% vs 16.1%, p=0.003). Also, legionella pneumonia patients more often showed pleural effusion on simple chest X-rays (50.0% vs 12.5%, p<0.001). Conclusion: Legionella pneumonia and pneumococcal pneumonia can not be distinguished by clinical manifestations alone. However, legionella pneumonia occurred as a healthcare-associated pneumonia more frequently and was more often associated with anemia and increased CRP and alkaline phosphatase levels.

• Journal of Environmental Health Sciences
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• v.47 no.5
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• pp.472-478
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• 2021

Background: The Legionella case detection and notification rate have increased in public artificial water environments where people visit, including large buildings, public baths, and hospitals. Objectives: In this study, the distribution of Legionella and its epidemiologic characteristics were analyzed in the water systems of public facilities in Chungcheongnam-do Province in South Korea. Methods: Culture and PCR analysis were performed on 2,991 environmental water system samples collected from 2017 to 2019, and associations with year, facilities, seasons, and temperature of water system were statistically analyzed by using R-Studio for Windows. Descriptive data was compared using chi-square tests and independent t-tests. Results: The detection rate of Legionella increased from 3.1% in 2017 to 10.3% in 2019, appearing most frequently in the order of public baths, large-scale buildings, hospitals, and apartments. It was detected mainly in summer from June to August, over 1.0×10³ CFU/L on average in 133 cases (66.5%). Lots of germs were detected in bathtub water, cooling tower water, and warm water (p<0.001), and it was detected at higher rates in the cities where multipurpose facilities were concentrated than in rural areas (p=0.018). Conclusions: This study suggests that continuous monitoring and control are required for Legionella in the water system environment of high risk facilities. Moreover, these results will be helpful to prepare efficient management plans to prevent the Legionellosis that occurs in Chungcheongnam-do Province.