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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...

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Autores principales: Ambrose, Meredith, Roselle, Gary A., Kralovic, Stephen M., Gamage, Shantini D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
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.
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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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