Healthcare-Associated <i>Legionella</i> Disease: A Multi-Year Assessment of Exposure Settings in a National Healthcare System in the United States
Healthcare facilities are high-risk environments for <i>Legionella</i> disease (LD), including Legionnaires’ disease, but transmission in these settings is often overlooked. We used the LD database at the U.S. Department of Veterans Affairs (VA) national healthcare system to assess the t...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-01-01
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| Series: | Microorganisms |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-2607/9/2/264 |
| _version_ | 1797406431816712192 |
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| author | Meredith Ambrose Gary A. Roselle Stephen M. Kralovic Shantini D. Gamage |
| author_facet | Meredith Ambrose Gary A. Roselle Stephen M. Kralovic Shantini D. Gamage |
| author_sort | Meredith Ambrose |
| collection | DOAJ |
| description | Healthcare facilities are high-risk environments for <i>Legionella</i> disease (LD), including Legionnaires’ disease, but transmission in these settings is often overlooked. We used the LD database at the U.S. Department of Veterans Affairs (VA) national healthcare system to assess the type of healthcare exposure for LD cases. Cases were extracted from the database for 1 September 2012 through 31 July 2019, focusing on cases with an overnight stay at a VA facility during the 10-day exposure window prior to symptom onset. Patient medical charts were reviewed for demographics and types of healthcare setting exposure(s). There were 99 LD cases in the cohort: 31.3% were classified as having definite VA exposure, 37.4% were classified as possible VA with inpatient exposure, and 31.3% were classified as possible VA with both inpatient and outpatient exposure. For definite VA LD cases, 67.7% had some type of exposure in the long-term care setting. While 63% of the 99 cases had exposure in the acute care setting only, both the long-term care and acute care settings contributed substantially to the total number of exposure days. A review of patient movement during the exposure period showed the variable and sometimes extensive use of the VA system, and it provides insights useful for epidemiologic investigations and potential preventive actions. |
| first_indexed | 2024-03-09T03:25:22Z |
| format | Article |
| id | doaj.art-54c13806106248e6adb37ef248854be3 |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-09T03:25:22Z |
| publishDate | 2021-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-54c13806106248e6adb37ef248854be32023-12-03T15:02:48ZengMDPI AGMicroorganisms2076-26072021-01-019226410.3390/microorganisms9020264Healthcare-Associated <i>Legionella</i> Disease: A Multi-Year Assessment of Exposure Settings in a National Healthcare System in the United StatesMeredith Ambrose0Gary A. Roselle1Stephen M. Kralovic2Shantini D. Gamage3National Infectious Diseases Service, Specialty Care Services, Veterans Health Administration, Department of Veterans Affairs, Washington, DC 20420, USANational Infectious Diseases Service, Specialty Care Services, Veterans Health Administration, Department of Veterans Affairs, Washington, DC 20420, USANational Infectious Diseases Service, Specialty Care Services, Veterans Health Administration, Department of Veterans Affairs, Washington, DC 20420, USANational Infectious Diseases Service, Specialty Care Services, Veterans Health Administration, Department of Veterans Affairs, Washington, DC 20420, USAHealthcare facilities are high-risk environments for <i>Legionella</i> disease (LD), including Legionnaires’ disease, but transmission in these settings is often overlooked. We used the LD database at the U.S. Department of Veterans Affairs (VA) national healthcare system to assess the type of healthcare exposure for LD cases. Cases were extracted from the database for 1 September 2012 through 31 July 2019, focusing on cases with an overnight stay at a VA facility during the 10-day exposure window prior to symptom onset. Patient medical charts were reviewed for demographics and types of healthcare setting exposure(s). There were 99 LD cases in the cohort: 31.3% were classified as having definite VA exposure, 37.4% were classified as possible VA with inpatient exposure, and 31.3% were classified as possible VA with both inpatient and outpatient exposure. For definite VA LD cases, 67.7% had some type of exposure in the long-term care setting. While 63% of the 99 cases had exposure in the acute care setting only, both the long-term care and acute care settings contributed substantially to the total number of exposure days. A review of patient movement during the exposure period showed the variable and sometimes extensive use of the VA system, and it provides insights useful for epidemiologic investigations and potential preventive actions.https://www.mdpi.com/2076-2607/9/2/264Legionnaires’ disease<i>Legionella</i>healthcare-associatedhealthcare exposure |
| spellingShingle | Meredith Ambrose Gary A. Roselle Stephen M. Kralovic Shantini D. Gamage Healthcare-Associated <i>Legionella</i> Disease: A Multi-Year Assessment of Exposure Settings in a National Healthcare System in the United States Microorganisms Legionnaires’ disease <i>Legionella</i> healthcare-associated healthcare exposure |
| title | Healthcare-Associated <i>Legionella</i> Disease: A Multi-Year Assessment of Exposure Settings in a National Healthcare System in the United States |
| title_full | Healthcare-Associated <i>Legionella</i> Disease: A Multi-Year Assessment of Exposure Settings in a National Healthcare System in the United States |
| title_fullStr | Healthcare-Associated <i>Legionella</i> Disease: A Multi-Year Assessment of Exposure Settings in a National Healthcare System in the United States |
| title_full_unstemmed | Healthcare-Associated <i>Legionella</i> Disease: A Multi-Year Assessment of Exposure Settings in a National Healthcare System in the United States |
| title_short | Healthcare-Associated <i>Legionella</i> Disease: A Multi-Year Assessment of Exposure Settings in a National Healthcare System in the United States |
| title_sort | healthcare associated i legionella i disease a multi year assessment of exposure settings in a national healthcare system in the united states |
| topic | Legionnaires’ disease <i>Legionella</i> healthcare-associated healthcare exposure |
| url | https://www.mdpi.com/2076-2607/9/2/264 |
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