需要入住重症监护病房的重症军团病的临床特征及预后：一项多中心回顾性队列研究

Clinical features and prognosis of severe legionnaires' disease requiring intensive care unit admission: a multicentric retrospective cohort study.

作者信息

Dartevel Anaïs, Galerneau Louis-Marie, Peigne Vincent, Sedillot Nicholas, Ehrmann Stephan, Lautrette Alexandre, Klouche Kada, Poissy Julien, Thiery Guillaume, Sauneuf Bertrand, Rigaud Jean-Philippe, Ramakers Michel, Daubin Cédric, Schwebel Carole, Terzi Nicolas

机构信息

Medical Intensive Care Unit, University Hospital of Grenoble Alpes, Grenoble, CS, France.

Grenoble Alpes University, INSERM 1300, HP2, Grenoble, France.

出版信息

Pneumonia (Nathan). 2025 Aug 25;17(1):21. doi: 10.1186/s41479-025-00173-z.

DOI:10.1186/s41479-025-00173-z

PMID:40851006

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12376721/

Abstract

INTRODUCTION

Legionella is the second cause of community-acquired pneumonia in Intensive Care Unit (ICU) patients. The aim of this study was to describe the epidemiology and outcome in patients with Legionella pneumonia (LP) in French ICUs.

METHODS

A multi-center, retrospective, observational study in 12 French ICUs was performed between January 2014 and December 2019.

RESULTS

LP was diagnosed in 162 patients during the study period. Invasive mechanical ventilation was required in 95 patients (58%), 73 (45%) of whom had acute respiratory distress syndrome (ARDS). Most of these patients were treated with a combination of antibiotics (128, patients; 79%). The most common combination consisted in a fluoroquinolone and a macrolide (118 patients). Median length of stay in an ICU was 11 [5; 11] days. At 28 days, 19 (12%) out of the 162 patients had not survived. In multivariate analyses, age (Incidence risk Ratio: IRR, 1.07; 95% CI, 1.01; 1.14) and a high Sequential Organ Failure Assessment (SOFA) score in the first 48 h (IRR, 1.47; 95% CI, 1.09; 2) were significantly associated with mortality.

CONCLUSION

In this French multicentric cohort, the LP prognosis in ICUs was apparently more favorable than in the literature, possibly because of the timely and improved LP management in ICUs.

摘要

引言

军团菌是重症监护病房（ICU）患者社区获得性肺炎的第二大病因。本研究旨在描述法国ICU中军团菌肺炎（LP）患者的流行病学情况及转归。

方法

于2014年1月至2019年12月在法国12家ICU开展了一项多中心、回顾性观察研究。

结果

研究期间162例患者被诊断为LP。95例患者（58%）需要有创机械通气，其中73例（45%）发生急性呼吸窘迫综合征（ARDS）。这些患者大多接受了联合抗生素治疗（128例患者；79%）。最常见的联合用药是氟喹诺酮类和大环内酯类（118例患者）。ICU中位住院时间为11[5；11]天。28天时，162例患者中有19例（12%）死亡。多因素分析显示，年龄（发病风险比：IRR，1.07；95%可信区间，1.01；1.14）和最初48小时内较高的序贯器官衰竭评估（SOFA）评分（IRR，1.47；95%可信区间，1.09；2）与死亡率显著相关。