Legionnaires’ Disease at a Dutch Flower Show: Prognostic Factors and Impact of Therapy

摘要

After a large outbreak of Legionnaires' disease in the Netherlands, we determined risk factors for intensivecare unit (ICU) admission and death and the impact of adequate therapy on ICU-free survival among 141hospitalized patients. Overall mortality rate was 13%, and ICU mortality rate was 36%. Smoking, tempera-ture >38.5°C, and bilateral infiltrates shown on chest x-ray were independent risk factors for ICU admis-sion or death (all p<0.05). Starting adequate therapy within 24 hours after admission resulted in a higherICU-free survival rate compared to therapy initiation after 24 hours: 78% versus 54%, respectively(p=0.005). However, delay in providing therapy to pa tients with urinary antigen tests with negative resultsdid not influence outcome. These data suggest that by using the urinary antigen test on admission a moretailored approach to patients with community-acquired pneumonia may be applied