Legionella 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.
2
Given that the clinical manifestations of Legionnaires' disease are nonspecific,
laboratory tests are required for diagnosis. The most accurate test is culture on
selective media, which is not widely available.To read this article in full you will need to make a payment
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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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- Response to commentary on “Assessing risk of health care–acquired Legionnaires' disease from environmental sampling: The limits of using a strict percent positivity approach”American Journal of Infection ControlVol. 42Issue 11
- PreviewWe appreciate the commentary from Pierre et al1 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.
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