Clinical Analysis Of The Department Of Neurology, Patients With Hospital-acquired Legionella Infection

Objective:Study of the First Affiliated Hospital of Shanxi Medical University, combined in patients with Neurology, the type of Legionella infection acquired in hospital, Analysis of Legionella infection in patients with clinical characteristics, and thus the hospital neurology of Legionella infection in the early diagnosis, treatment and prevention to provide reference assistance.Methods:Of December 2008-September 2009,The First Affiliated Hospital of Shanxi Medical University, Department of Neurology, treated 70 cases of Neurological patients combined pulmonary infection.Their urine and blood test results were analyzed forward-lookingly..Results:70 cases of Neurological patients who combined pulmonary infection with urine and blood test result show positive for Legionella infection of 9 cases, patients accounted for 12.9% of all detected. Stroke patients infected with Legionella were 7 cases,account 10.0%;Encephalitis in patients infected with Legionella were 0 cases;Epilepsy in patients infected with Legionella were 2 case,account 2.9%;Other neurology patients infected with Legionella were 0 cases.Male were 4 cases,account 5.7%;Female were 5 cases,account 7.1%9 cases of Legionella infection in patients with fever symptoms in 9 cases,account 100%;Cough or sputum in patients were 8 cases,account 88.9%;Chest tightness or chest pain in patients were 7 cases,account 77.8%;Dyspnea in patients were 3 cases,account 33.3 %;Nausea and vomiting in patients were 4 cases,account 44.4%;Abdominal pain and diarrhea in patients were 6 cases,accout 66.7%;Myalgia in patients were 1 cases,account 11.1%;Consciousness disorder in patients were 5 cases,account 55.6%;Hypoxemia in patients were 7 cases,account 77.8%;Abnormal chest X-ray in patients were 8 cases,account 88.9 %;WBC elevated in patients were 9 cases,account 100%;Transaminase elevated in patients were 6 cases,account 66.7%;Proteinuria in patients were 6 cases,account 66.7%;Granulocyte reduction in patients were 4 cases,account 44.4%;Hyponatremia in patients were 8 cases,account 88.9%;Past smoking and drinking in patients were 7 cases,account 77.8%;Oxygen therapy appeared,indwelling stomach tube,aerosol,breathing machines and other invasive procedures in patients were 9 cases,account 100%;Among these 9 cases,all patients with Legionella infection were not used immunosuppressant and hormone.The 9 infected patients of Legionella were all used antibiotics.Among of them,there are 3 cases used Azithromycin; 2 cases used Cefoperazone Sulbactam; 4 cases used Cefoperazone tazoboctam; 1 cases used Cefathiamidine; There were 3 cases used two antibiotics simultaneously.All patients were discharged improved.Conclusions:Legionella infections of patients are more of Neurology in patients with pulmonary infection. The man-made environment and air-conditioning condenser system in hospital where may be the main way of Legionella infection being acquired in hospital of neurology.The number of cases of Legionella infection in stroke patients are more than other types of neurological diseases.The result show that most of patients of positive Legionella infection are Legionella pneumophila by detecting serum antibodies in laboratoty. Legionella infection in patients with positive clinical symptoms, Positive Legionella infection in patients with clinical symptoms of fever, cough or sputum, chest tightness or chest pain, abdominal pain and diarrhea are more obvious than other symptoms; WBC elevated,transaminase elevated, proteinuria, hyponatremia are more obvious than others in laboratory examination; All positive patients had abnormal chest X-ray in auxiliary examination,tipping the symptoms with lung in patients of Legionella infection; These invasive procedures are used in all positive patients,tipping there maybe certain association in Legionella infection and invasive procedures; The susceptibility of patients may be increased in smoking, drinking, pulmonary underlying disease, hypertension, diabetes and kidney disease;A new generation of macrolide antibitics and new quinolones are effected in positive Legionella patients, and are more effective thanβ-lactam antibiotics, enzymes.