Healthcare-associated Legionnaires’ disease: Limitations of surveillance definitions and importance of epidemiologic investigation

Laila M. Castellino, Shantini D. Gamage, Patti V. Hoffman, Stephen M. Kralovic, Mark Holodniy, Jack M. Bernstein, Gary A. Roselle

Research output: Contribution to journalArticle

2 Scopus citations


Healthcare-associated Legionnaires’ disease (HCA LD) causes significant morbidity and mortality, with varying guidance on prevention. We describe the evaluation of a case of possible HCA LD and note the pitfalls of relying solely on an epidemiologic definition for association of a case with a facility. Our detailed investigation led to the identification of a new Legionella pneumophila serogroup 1 sequence type, confirmed a healthcare association and helped build the framework for our ongoing preventive efforts. Our experience highlights the role of routine environmental cultures in the assessment of risk for a given facility. As clinicians increasingly rely on urinary antigen testing for the detection of L. pneumophila, our investigation emphasises the importance of clinical cultures in an epidemiologic investigation.

Original languageEnglish (US)
Pages (from-to)307-310
Number of pages4
JournalJournal of Infection Prevention
Issue number6
StatePublished - Nov 1 2017
Externally publishedYes



  • epidemiology
  • healthcare-associated infections
  • Legionella

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Advanced and Specialized Nursing
  • Infectious Diseases

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