We appreciate the commentary from Pierre et al
1
regarding our article published in the American Journal of Infection Control in 2012.
2
One of our goals was to start a discourse on the utilization of 30% prevalence of
Legionella in a hospital water system as a reliable decision point for determining the risk
of Legionnaires' disease and subsequent interventions, and we welcome the opportunity
to discuss this important issue further. As shown in our article, and will be further
demonstrated in this response, this 30% cut-off has been adopted and referenced by
various government agencies and peer-reviewed journal articles without critical evaluation
since its emergence in 1983. Given its ambiguous evolution and the significance that
has been apportioned to it, it was necessary and prudent to evaluate the validity
of this metric. Our study was the first and only systematic effort to do so.To read this article in full you will need to make a payment
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References
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Conflict of interest: None to report.
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© 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
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- Editorial commentary: Risk assessment and prediction for health care–associated Legionnaires' disease: Percent distal site positivity as a cut-pointAmerican Journal of Infection ControlVol. 42Issue 11
- PreviewLegionella has been reported as the single most commonly reported pathogen associated with disease outbreaks from drinking water.1 Two strategies have been proposed for risk assessment. The first is the strategy advocated by the Centers for Disease Control and Prevention (CDC) to search assiduously for Legionnaires' disease in all cases of hospital-acquired pneumonia. However, the diagnosis is commonly missed, even if the Infectious Diseases Society of America and American Thoracic Society guidelines are followed.
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