NussNewell631
The mortality of community-acquired Legionnaires' disease ranges from 16 to 30 percent if untreated or treated with inactive antibiotics; the mortality for nosocomial Legionnaires' disease may approach 50 percent given the underlying disease of the individual. With the advent of improved diagnostic methods ultimately causing livlier and early in the day diagnosis therapies, death has been reduced to significantly less than 10 % in patients with community-acquired legionellosis.
Treating Legionella infection will undoubtedly be reviewed here. The pathogenesis, epidemiology, clinical symptoms, and diagnosis with this business are discussed separately.
Vulnerability ASSESSMENT
In since methods haven't been standardized vitro susceptibility answers are not easily interpretable for Legionella. Conventional in vitro susceptibility methods in agar and broth have proven unreliable. For example, the charcoal in buffered charcoal yeast extract agar used for Legionella solitude binds antibiotics, and therefore, exercise of those antibiotics from the organism is incorrectly decreased. Also, many commercially available antibiotics, which have exemplary in vitro activity against Legionella by traditional testing (eg, beta-lactam agents and aminoglycosides), have shown to be relatively ineffective in patients with Legionnaires' disease.
The intracellular site of the virus is pertinent to the effectiveness of the antibiotic. Antibiotics capable of achieving intracellular concentrations higher than the minimal inhibitory concentration (MIC) are far more effective clinically than medicines with poor intracellular penetration. Medicines with intracellular penetration include the macrolides, quinolones, tetracyclines, and rifampin.
The empiric discovering that tetracycline and erythromycin seemed to be more effective than beta-lactam agents and aminoglycosides in early outbreaks of Legionnaires' disease was consistent with in vitro results in intracellular and animal models of Legionnaires' disease. Determination of the vulnerability of Legionella spp to antimicrobial agents has become based on such intracellular and animal models of Legionella infection legionella-beheersplannen.nl
