The impact of legionellosis into fatal outcomes of pneumonia in Irkutsk

Aim. To study the diagnosis of legionellosis in patients who died because of pneumonia in Irkutsk (2016-2018).

Materials and Methods. We performed 65 autopsies of patients who died from pneumonia in Irkutsk (2016-2018), studied their case histories, and interrogated 510 tap water samples for Legionella pneumophila by means of inoculation and polymerase chain reaction.

Results. Among 65 fatal pneumonia outcomes registered in Irkutsk during 2016-2018, legionellosis has been confirmed in three cases (4.6%). Two of these patients were at the late stages of HIV infection while the third, 74-yearold, patient had multiple comorbid conditions. Nosocomial infection was suspected in one of these cases. None of these three patients left Irkutsk during the last month of their life. The assumed transmission factor was tap water, as Legionella pneumophila was found in tap water samples collected in 2013 and 2015.

Conclusion. Patients with severe pneumonia need screening for legionellosis to perform the correct treatment, particularly during COVID-19 pandemic.

1. Gruzdeva OA, Filatov NN, Tartakovskij IS, Marin GG. Epidemiological features of legionellosis in the Russian Federation. Epidemiology and infectious diseases. 2017;22(2):86-92. (In Russ). https://doi.org/10.18821/1560-9529-2017-22-2-86-92

2. Tartakovskij IS, Gruzdeva OL, Galstjan GG. Prevention, diagnosis and treatment of legionellosis. Moscow : Studija MDV; 2013. (In Russ).

3. Borella P, Vecchi E, Incerti F, Marchesi I, Meacci M, Frezza G, Fregni Serpini G, Mansi A, Paduano S, Bargellini A. The relevance of molecular genotyping to allocate cases in a suspected outbreak of Legionella pneumonia in patients with prolonged immunosuppressive therapy. Int J Infect Dis. 2020;91:174-176. https://doi.org/10.1016/j.ijid.2019.11.002

4. Gruzdeva OA, Tartakovsky IS, Sharapchenkü SO, Gabrielyan NI. Risks of legionella pneumonia in patients receiving immunosuppressive therapy. Medical alphabet. 2020;34:22-27. (In Russ). https://doi.org/10.33667/2078-5631-2020-34-22-27

5. Tartakovsky IS, Gruzdeva OA, Sharapchenko SO, Gabrielyan Nina. The contamination of hospital water supply systems by legionella pneumophila. Russian journal of transplantology and artificial organs. 2021;23(1):125-130. (In Russ). https://doi.org/10.15825/1995-1191-2021-1-125-130

6. Onishchеnko CG, Lazikova GF, Chistyakova СG, Dеmina YuV, Nikonov BI, Romanеnko VV, Smirnova SS, Tеrеntyeva LN, Malozеmova TYu, Irizhеpova OV, Gavrilova NA, Avvakumova NP, Shitoeva EV. Epidemiologic versions in investigation of legionnaires' disease outbreak in town verkhnyaya pyshma. Journal of microbiology epidemiology immunobiology. 2008;2:77-82. (In Russ).

7. Arashiro T, Nakamura S, Asami T, Mikuni H, Fujiwara E, Sakamoto S, Miura R, Shionoya Y, Honda R, Furukawa K, Nakamura A, Saito H. SARS-CoV-2 and Legionella co-infection in a person returning from a Nile cruise. J Travel Med. 2020;27(3):taaa053. https://doi.org/10.1093/jtm/taaa053

8. Palazzolo C, Maffongelli G, D'Abramo A, Lepore L, Mariano A, Vulcano A, Bartoli TA, Bevilacqua N, Giancola ML, Di Rosa E, Nicastri E. Legionella pneumonia: increased risk after COVID-19 lockdown? Italy, May to June 2020. Euro Surveill. 2020;25(30):2001372. https://doi.org/10.2807/1560-7917.ES.2020.25.30.2001372

9. Korzhevskiy DE, Gilyarov AV. Osnovy gistologicheskoy tekhniki. Мoscow: SpetsLit; 2010. (In Russ).

10. Kravchenko NA, Yakovenko ON, Svistunov VV, Belinskaya E, Kogan GYu, Karnoukhova OG, Stepanenko LA, Bobrova OI, Sidorova EA, Anadaev EI, Aphanas'ev MV, Balakhonov SV, Botvinkin AD. Etiology of lethal pneumonia by results of microbiological and molecular and genetic researches of sectional material. Infectious diseases: news, views, education. 2016;17(4):93-99. (In Russ).