Community-acquired Legionnaires' disease in a renal transplant recipient with unclear incubation period: the importance of molecular typing

Transplant recipients are at risk of developing Legionnaires' disease (LD) because of impaired cellular immunity. Here, we describe a renal transplant recipient who developed LD at least 10 days after hospital admission and transplantation. The hospital water network was initially suspected, but further testing determined that the probable source was the patient's domestic water supply. Our report also suggests that the patient's immunosuppressed state may have switched potential colonization to pneumonia.

Hospital washbasin water: risk of Legionella-contaminated aerosol inhalation

The contamination of aerosols by washbasin water colonized by Legionella in a hospital was evaluated. Aerosol samples were collected by two impingement technologies. Legionella was never detected by culture in all the (aerosol) samples. However, 45% (18/40) of aerosol samples were positive for Legionella spp. by polymerase chain reaction, with measurable concentrations in 10% of samples (4/40). Moreover, immunoassay detected Legionella pneumophila serogroup 1 and L. anisa, and potentially viable bacteria were seen on viability testing. These data suggest that colonized hospital washbasins could represent risks of exposure to Legionella aerosol inhalation, especially by immunocompromised patients.

[Indicators of quality for hospital antisepsis]

In any health care institution, the most important quality indicator for antisepsis is the existence of systems of reference of use, secondly the knowledge of those systems and then the compliance by the different classes of professionals. These refrentials must be regularly evaluated and updated according to general consensus.

[Hospital infection in maternity homes]

The results of the prospective survey of hospital infections in mothers and newborns at the obstetrical clinic of the Edouard Herriot Hospital in Lyon are presented. Surveillance lasting six successive years covered 18,026 deliveries with or without the use of cesarean section. The incidence of hospital infections (not taking into account cases of bacteriuria) was 1.6% in parturient women not subjected to cesarean section and 11.7% in those having had this operation. Urinary tract and parietal infections, endometritis were in leading cases. The average incidence of hospital infection in newborns was 2.68%, the leading clinical manifestations being peripheral staphylococcal lesions in the form of pustules.

[Nosocomial septicemia and pseudobacteremia caused by Serratia marcescens]

An epidemiological survey was carried out which included a dual epidemic of septicaemia and pseudo-bacteremia caused by Serratia marcescens. The survey enabled 15 septicaemias and 43 pseudobacteremias to be detected in a regional hospital between March and August, 1983. Two mishandlings were at the origin of the outbreak: citrated tube normally reserved for coagulation tests were severely contaminated by Serratia marcescens, and inaccurate samplings had been made. Once the mechanisms of contamination were found, specific preventive measures put an end to the epidemic. The authors insist on the need for uncontaminated tubes and citrate solutions and for the development of precise sampling methods which are essential to avoid the occurrence of pseudo-bacteremia or septicaemia. It is important to detect such epidemics at an early stage by an efficient control of nosocomial infections, thus avoiding their extension.