Detección de Legionella Pneumophila como agente etiológico de neumonía grave adquirida en la comunidad
Detection of Legionella Pneumophila as an etiologic agent of community-acquired severe pneumonia
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Hernández, J. I., Abello Polo, V., Medina Orjuela, A., Pacheco Gaona, J. O., & Ríos, D. I. (2002). Detección de Legionella Pneumophila como agente etiológico de neumonía grave adquirida en la comunidad. Revista Repertorio De Medicina Y Cirugía, 11(3), 74–79. https://doi.org/10.31260/RepertMedCir.v11.n3.2002.288
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Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
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Los microorganismos aislados con mayor frecuencia en pacientes con neumonía grave adquirida en la comunidad (NAC) son: Streptococcus pneumoniae, Legionella pneumophila y gérmenes Gram negativos. En Colombia no se han reportado casos de neumonía por Legionella ya que se requiere un medio de cultivo especial para su aislamiento. Con el fin de determinar el papel de este microorganismo como agente etiológico de la neumonía grave adquirida en la comunidad, se hizo un estudio descriptivo, sobre una población de 187 enfermos, quienes constituyen la totalidad de los casos de NAC que ingresaron al Hospital de San José, en la ciudad de Bogotá, Colombia, entre octubre de 1999 a junio de 2001 y de los cuales 20 representan los casos de NAC grave. En este estudio, la Legionella pneumophila no se aisló como agente etiológico de NAC grave, por lo tanto la indicación terapéutica de los macrólidos en nuestro medio, sospechando esta patología, debe ser reevaluada.
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1. American thoracic society board of directors: Guidelines for the Initial Management of Adults with Community Acquired Pneumonia: Diagnosis, Assessment of Severity and Initial Antimicrobial Therapy. Am Rev Resp Dis. 1993; 148: 1418-1426.
2.American thoracic society board of directors. Hospital- acquired Pneumonia in Adults: Diagnosis, Assessment of Severity, Initial Antimicrobial therapy, and preventative strategies- A Consensus Statement. Am J Respir Crit Care Med. 1995; 153: 1711-1725.
3. Camacho F, Páez J, Awad C. Enfermedades del Tórax. Colombia: Ediciones Médicas Zambon, 1992: 226.
4. Campbell D. Overview of Community Acquired Pneumonia. Med Clin N Am. 1994; 78: 1035-1047.
5. Carbon C. Estrategias diagnósticas y tratamiento de neumonía atípica. Iladiba 1995: 7-9.
6. Fauci A, Braunwald E y col. Harrison's Principies of Internal Medicine. 14 ed. USA: Mc Graw- Hill Companies INC. 1998; 2: 1437-1438.
7. Dean N. Use of prognostic scoring and outcome assessment tools in the admission decision for community-acquired pneumonia. Clin Chest Med. 1999; 20: 521-529.
8. Heath C, Grove D, Looke D. Delay in appropriate therapy of Legionella Pneumonia associated with increased mortality. Eur J Clin Microbiol Infect Dis. 1996; 15: 286-290.
9. Pachón J, Prados D, Capote F et al. Severe Community Acquired Pneumonia, etiology, prognosis and treatment. Am Rev Respir Dis. 1990; 142: 369-373.
10. Edwing S, Torres A. Severe Community Acquired Pneumonia. En: Clinics in Chest Medicine. 1999; 20:123-130
11. Farr B, Sloman A, Fisch M. Predicting dead in Patients Hopitalized for Community-Acquired Pneumonia. Annals of Internal Medicine. 1991; 115: 428-436.
12. Edelstein P. Legionaires' Disease, State-of-the-Art Clinical Article. Clinical Infectious Diseases.1993;16: 741-749.
13. Carratala J, Gudiol F, Pallares R, Dorca J et al. Risk factors for Nosocomial Legionella Pneumophila Pneumonia. Am J Respir Crit Care Med.1994; 149: 625-629.
14. Cunha B. Severe Community-Acquired Pneumonia Critical Care Clinics. 1998;14: 105-117.
15. Lieberman D, Porath A, Schalaeffler F et al. Legionella species Community-Acquired Pneumonia. Chest. 1996; 109 p. 1243-1249.
16. Feldman C. Pneumonia in the elderly. Clin Chest Med. 1999; 20: 563-573.
17. Fiore A, Nourti P, Levine O et al. Epidemic Legionnaires' Disease: Two Decades Later: Old sources, new diagnostic methods. Clin Infect Dis. 1998; 26: 426-433
18. Feldman C, Ross S, Goolam MA et al. The aetiology of severe community acquired pneumonia and its impact on initial, empiric, antimicrobial treatment. Resp Med.1995; 89: 187.
19. Kohler R. Neumonía Severa: Cuando y por qué hospitalizar. Postgraduate Medicine. 1999; 6-7: 33-45.
20. Fein A, Niederman M. Guidelines for the initial management of Community-Acquired Pneumonia: Savory Recipe or Cookboock for disaster?. Am J Resp Crit Care Med. 1995; 152: 1149-1153.
21.Vélez H, Borrero J, Restrepo J, Rojas W. William. Neumología. 3era ed. Colombia: Corporación para Investigaciones Biológicas. 1986; 3: 583-585.
22. OXOID Manual, 1995, publicado por Unipath, España S.A. páginas 149-151.
23. OXOID Diagnostic Reagents. Unipath limited, Basingstoke, Hampshire, England. 1995
24. Hirani N, Macfarlane J. Impact of management guidelines on the outcome of sever community-acquired pneumonia. Thorax. 1997; 52: 17-21.
25. Mandel L. Antibiotic therapy for Community-Acquired Pneumonia. Clin Chest Med. 1999; 20: 589-598. Lieberman D, Porath A, sChlaeffer F et al. Legionella species Community-Acquired Pneumonia. Chest. 1996 p. 1243-1249.
2.American thoracic society board of directors. Hospital- acquired Pneumonia in Adults: Diagnosis, Assessment of Severity, Initial Antimicrobial therapy, and preventative strategies- A Consensus Statement. Am J Respir Crit Care Med. 1995; 153: 1711-1725.
3. Camacho F, Páez J, Awad C. Enfermedades del Tórax. Colombia: Ediciones Médicas Zambon, 1992: 226.
4. Campbell D. Overview of Community Acquired Pneumonia. Med Clin N Am. 1994; 78: 1035-1047.
5. Carbon C. Estrategias diagnósticas y tratamiento de neumonía atípica. Iladiba 1995: 7-9.
6. Fauci A, Braunwald E y col. Harrison's Principies of Internal Medicine. 14 ed. USA: Mc Graw- Hill Companies INC. 1998; 2: 1437-1438.
7. Dean N. Use of prognostic scoring and outcome assessment tools in the admission decision for community-acquired pneumonia. Clin Chest Med. 1999; 20: 521-529.
8. Heath C, Grove D, Looke D. Delay in appropriate therapy of Legionella Pneumonia associated with increased mortality. Eur J Clin Microbiol Infect Dis. 1996; 15: 286-290.
9. Pachón J, Prados D, Capote F et al. Severe Community Acquired Pneumonia, etiology, prognosis and treatment. Am Rev Respir Dis. 1990; 142: 369-373.
10. Edwing S, Torres A. Severe Community Acquired Pneumonia. En: Clinics in Chest Medicine. 1999; 20:123-130
11. Farr B, Sloman A, Fisch M. Predicting dead in Patients Hopitalized for Community-Acquired Pneumonia. Annals of Internal Medicine. 1991; 115: 428-436.
12. Edelstein P. Legionaires' Disease, State-of-the-Art Clinical Article. Clinical Infectious Diseases.1993;16: 741-749.
13. Carratala J, Gudiol F, Pallares R, Dorca J et al. Risk factors for Nosocomial Legionella Pneumophila Pneumonia. Am J Respir Crit Care Med.1994; 149: 625-629.
14. Cunha B. Severe Community-Acquired Pneumonia Critical Care Clinics. 1998;14: 105-117.
15. Lieberman D, Porath A, Schalaeffler F et al. Legionella species Community-Acquired Pneumonia. Chest. 1996; 109 p. 1243-1249.
16. Feldman C. Pneumonia in the elderly. Clin Chest Med. 1999; 20: 563-573.
17. Fiore A, Nourti P, Levine O et al. Epidemic Legionnaires' Disease: Two Decades Later: Old sources, new diagnostic methods. Clin Infect Dis. 1998; 26: 426-433
18. Feldman C, Ross S, Goolam MA et al. The aetiology of severe community acquired pneumonia and its impact on initial, empiric, antimicrobial treatment. Resp Med.1995; 89: 187.
19. Kohler R. Neumonía Severa: Cuando y por qué hospitalizar. Postgraduate Medicine. 1999; 6-7: 33-45.
20. Fein A, Niederman M. Guidelines for the initial management of Community-Acquired Pneumonia: Savory Recipe or Cookboock for disaster?. Am J Resp Crit Care Med. 1995; 152: 1149-1153.
21.Vélez H, Borrero J, Restrepo J, Rojas W. William. Neumología. 3era ed. Colombia: Corporación para Investigaciones Biológicas. 1986; 3: 583-585.
22. OXOID Manual, 1995, publicado por Unipath, España S.A. páginas 149-151.
23. OXOID Diagnostic Reagents. Unipath limited, Basingstoke, Hampshire, England. 1995
24. Hirani N, Macfarlane J. Impact of management guidelines on the outcome of sever community-acquired pneumonia. Thorax. 1997; 52: 17-21.
25. Mandel L. Antibiotic therapy for Community-Acquired Pneumonia. Clin Chest Med. 1999; 20: 589-598. Lieberman D, Porath A, sChlaeffer F et al. Legionella species Community-Acquired Pneumonia. Chest. 1996 p. 1243-1249.
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