Legionnaires' disease at a Dutch flower show: prognostic factors and impact of therapy

Emerg Infect Dis. 2002 Dec;8(12):1448-54. doi: 10.3201/eid0812.020035.


After a large outbreak of Legionnaires' disease in the Netherlands, we determined risk factors for intensive care unit (ICU) admission and death and the impact of adequate therapy on ICU-free survival among 141 hospitalized patients. Overall mortality rate was 13%, and ICU mortality rate was 36%. Smoking, temperature >38.5 degrees C, and bilateral infiltrates shown on chest x-ray were independent risk factors for ICU admission or death (all p<0.05). Starting adequate therapy within 24 hours after admission resulted in a higher ICU-free survival rate compared to therapy initiation after 24 hours: 78% versus 54%, respectively (p=0.005). However, delay in providing therapy to patients with urinary antigen tests with negative results did not influence outcome. These data suggest that by using the urinary antigen test on admission a more tailored approach to patients with community-acquired pneumonia may be applied.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Disease Outbreaks*
  • Female
  • Humans
  • Intensive Care Units
  • Legionnaires' Disease / diagnosis
  • Legionnaires' Disease / epidemiology*
  • Legionnaires' Disease / mortality
  • Logistic Models
  • Male
  • Netherlands / epidemiology
  • Prognosis
  • Risk Factors
  • Survival Rate
  • Time Factors


  • Anti-Bacterial Agents