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Healthcare-Associated Legionella Disease: A Multi-Year Assessment of Exposure Settings in a National Healthcare System in the United States
Healthcare facilities are high-risk environments for Legionella disease (LD), including Legionnaires’ disease, but transmission in these settings is often overlooked. We used the LD database at the U.S. Department of Veterans Affairs (VA) national healthcare system to assess the type of healthcare e...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7911807/ https://www.ncbi.nlm.nih.gov/pubmed/33525457 http://dx.doi.org/10.3390/microorganisms9020264 |
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author | Ambrose, Meredith Roselle, Gary A. Kralovic, Stephen M. Gamage, Shantini D. |
author_facet | Ambrose, Meredith Roselle, Gary A. Kralovic, Stephen M. Gamage, Shantini D. |
author_sort | Ambrose, Meredith |
collection | PubMed |
description | Healthcare facilities are high-risk environments for Legionella disease (LD), including Legionnaires’ disease, but transmission in these settings is often overlooked. We used the LD database at the U.S. Department of Veterans Affairs (VA) national healthcare system to assess the type of healthcare exposure for LD cases. Cases were extracted from the database for 1 September 2012 through 31 July 2019, focusing on cases with an overnight stay at a VA facility during the 10-day exposure window prior to symptom onset. Patient medical charts were reviewed for demographics and types of healthcare setting exposure(s). There were 99 LD cases in the cohort: 31.3% were classified as having definite VA exposure, 37.4% were classified as possible VA with inpatient exposure, and 31.3% were classified as possible VA with both inpatient and outpatient exposure. For definite VA LD cases, 67.7% had some type of exposure in the long-term care setting. While 63% of the 99 cases had exposure in the acute care setting only, both the long-term care and acute care settings contributed substantially to the total number of exposure days. A review of patient movement during the exposure period showed the variable and sometimes extensive use of the VA system, and it provides insights useful for epidemiologic investigations and potential preventive actions. |
format | Online Article Text |
id | pubmed-7911807 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-79118072021-02-28 Healthcare-Associated Legionella Disease: A Multi-Year Assessment of Exposure Settings in a National Healthcare System in the United States Ambrose, Meredith Roselle, Gary A. Kralovic, Stephen M. Gamage, Shantini D. Microorganisms Article Healthcare facilities are high-risk environments for Legionella disease (LD), including Legionnaires’ disease, but transmission in these settings is often overlooked. We used the LD database at the U.S. Department of Veterans Affairs (VA) national healthcare system to assess the type of healthcare exposure for LD cases. Cases were extracted from the database for 1 September 2012 through 31 July 2019, focusing on cases with an overnight stay at a VA facility during the 10-day exposure window prior to symptom onset. Patient medical charts were reviewed for demographics and types of healthcare setting exposure(s). There were 99 LD cases in the cohort: 31.3% were classified as having definite VA exposure, 37.4% were classified as possible VA with inpatient exposure, and 31.3% were classified as possible VA with both inpatient and outpatient exposure. For definite VA LD cases, 67.7% had some type of exposure in the long-term care setting. While 63% of the 99 cases had exposure in the acute care setting only, both the long-term care and acute care settings contributed substantially to the total number of exposure days. A review of patient movement during the exposure period showed the variable and sometimes extensive use of the VA system, and it provides insights useful for epidemiologic investigations and potential preventive actions. MDPI 2021-01-28 /pmc/articles/PMC7911807/ /pubmed/33525457 http://dx.doi.org/10.3390/microorganisms9020264 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Ambrose, Meredith Roselle, Gary A. Kralovic, Stephen M. Gamage, Shantini D. Healthcare-Associated Legionella Disease: A Multi-Year Assessment of Exposure Settings in a National Healthcare System in the United States |
title | Healthcare-Associated Legionella Disease: A Multi-Year Assessment of Exposure Settings in a National Healthcare System in the United States |
title_full | Healthcare-Associated Legionella Disease: A Multi-Year Assessment of Exposure Settings in a National Healthcare System in the United States |
title_fullStr | Healthcare-Associated Legionella Disease: A Multi-Year Assessment of Exposure Settings in a National Healthcare System in the United States |
title_full_unstemmed | Healthcare-Associated Legionella Disease: A Multi-Year Assessment of Exposure Settings in a National Healthcare System in the United States |
title_short | Healthcare-Associated Legionella Disease: A Multi-Year Assessment of Exposure Settings in a National Healthcare System in the United States |
title_sort | healthcare-associated legionella disease: a multi-year assessment of exposure settings in a national healthcare system in the united states |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7911807/ https://www.ncbi.nlm.nih.gov/pubmed/33525457 http://dx.doi.org/10.3390/microorganisms9020264 |
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