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Prevention of Legionnaires' disease in transplant recipients: recommendations for a standardized approach
Author(s) -
Singh N.,
Stout J.E.,
Yu V.L.
Publication year - 2004
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/j.1399-3062.2004.062_2.x
Subject(s) - medicine , gerontology , center (category theory) , medical library , library science , medical school , medical education , computer science , pathology , chemistry , crystallography
The risk of infection in the transplant patient is largely determined by the interaction among three factors: the presence of anatomical/technical abnormalities (usually due to surgical misadventures or vascular access issues), the nature and extent of environmental exposures, and the patient’s net state of immunosuppression. Recognizing the importance of these factors, particularly the last two of these, one can regard the transplant patient (and other immunosuppressed hosts) as a ‘sentinel chicken’; that is, any increased tra⁄c in a variety of potential pathogens will be seen ¢rst and foremost in these patientswho have been staked out in the swamps of the hospital environment. Since the ¢rst outbreaks of Legionnaires’ disease were recognized, it has been clear that transplant patients bore a greater burden of disease than the general population. In addition to L. pneumophila, type 1 (which accounts for480%of the Legionella isolates), the other species of Legionella are found more commonly among transplant patients and other immunocompromised hosts. In this editorial, Drs Singh, Stout, and Yu, who have contributed so much to our knowledge about this group of pathogens, have provided a beautifully crafted synthesis of the diagnostic, epidemiologic, and therapeutic aspects of legionellosis.We are in their debt.