Comparison of community-acquired and nosocomial legionella pneumonia cases in Konya, Turkey

Aim: Legionella pneumophila is an important cause of community and hospital-acquired pneumonia. The aim of this study was to compare the clinical findings, risk factors, and laboratory and radiological data of 20 nosocomial and 26 community-acquired cases with the diagnosis of L. pneumophila pneumonia between April 2017 and October 2019 retrospectively. Material and Methods: Twenty patients with nosocomially acquired Legionella pneumonia (NALP), and twenty-six patients with community-acquired Legionella pneumonia (CALP) were included in the study. We applied the Centers for Disease Control (CDC) and World Health Organization (WHO) criteria for the diagnosis both of nosocomial infection and Legionella pneumonia. The diagnosis was based on the positivity of urinary antigen test for Legionella pneumonia (Acro Biotech, USA). Statistical analysis was performed using chi-square and independent student t-test using SPSS Statistics 25.0 program. Results: Among the risk factors, older age was more common in the NALP group than in the CALP group, whilst chronic lung disease and cancer were more common in the NALP group than in the CALP group. The radiological features at presentation and during the evolution were similar in both groups. While CRP level was found to be high in the CALP group, ALT, AST, total and direct bilirubin levels, prothrombin time and INR values were significantly higher in the NALP group. Statistical analysis showed that myalgia was more common in the CALP group than in the NALP group. When both groups were compared in terms of mortality rates and SOFA and APACHE scores, no statistically significant difference was detected. Discussion: As a result of our study, radiological and laboratory findings of the cases with community-acquired and nosocomial Legionella pneumonia in our region were found to be similar to previous studies.