The burden of Legionnaires' disease in New Zealand (LegiNZ): a national surveillance study
| Autor: | Andrew Burns, Stephen T. Chambers, Claire Cameron, Juliet A Elvy, Richard J. Everts, Susan Taylor, Michelle N.D. Balm, Kevin Barratt, Vani Sathyendran, Murray C Robinson, Paul Huggan, Mark W Beale, Sandy Slow, Timothy K. Blackmore, Dragana Drinković, David Harte, Joanne L. Mitchell, Antje van der Linden, Sally A. Roberts, Alyssa W Thompson, James E. Ussher, Patricia Priest, Christopher J Mansell, Vicki M Raeder, David R. Murdoch, Trevor P. Anderson, David A. Hammer, Melanie J Williams, Roslyn G. Podmore, Virginia Hope |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Legionella longbeachae Adolescent Legionella 030106 microbiology Population Disease Polymerase Chain Reaction Disease Outbreaks Legionella pneumophila Young Adult 03 medical and health sciences 0302 clinical medicine Epidemiology medicine Humans 030212 general & internal medicine Child education Disease Notification Aged Aged 80 and over education.field_of_study biology business.industry Incidence Incidence (epidemiology) Outbreak Middle Aged biology.organism_classification medicine.disease Infectious Diseases Population Surveillance Emergency medicine Female Legionnaires' disease Legionnaires' Disease business New Zealand |
| Zdroj: | The Lancet Infectious Diseases. 19:770-777 |
| ISSN: | 1473-3099 |
| DOI: | 10.1016/s1473-3099(19)30113-6 |
| Popis: | Summary Background Legionnaires' disease is under-diagnosed because of inconsistent use of diagnostic tests and uncertainty about whom to test. We assessed the increase in case detection following large-scale introduction of routine PCR testing of respiratory specimens in New Zealand. Methods LegiNZ was a national surveillance study done over 1-year in which active case-finding was used to maximise the identification of cases of Legionnaires' disease in hospitals. Respiratory specimens from patients of any age with pneumonia, who could provide an eligible lower respiratory specimen, admitted to one of 20 participating hospitals, covering a catchment area of 96% of New Zealand's population, were routinely tested for legionella by PCR. Additional cases of Legionnaires' disease in hospital were identified through mandatory notification. Findings Between May 21, 2015, and May 20, 2016, 5622 eligible specimens from 4862 patients were tested by PCR. From these, 197 cases of Legionnaires' disease were detected. An additional 41 cases were identified from notification data, giving 238 cases requiring hospitalisation. The overall incidence of Legionnaires' disease cases in hospital in the study area was 5·4 per 100 000 people per year, and Legionella longbeachae was the predominant cause, found in 150 (63%) of 238 cases. Interpretation The rate of notified disease during the study period was three-times the average over the preceding 3 years. Active case-finding through systematic PCR testing better clarified the regional epidemiology of Legionnaires' disease and uncovered an otherwise hidden burden of disease. These data inform local Legionnaires' disease testing strategies, allow targeted antibiotic therapy, and help identify outbreaks and effective prevention strategies. The same approach might have similar benefits if applied elsewhere in the world. Funding Health Research Council of New Zealand. |
| Databáze: | OpenAIRE |
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