军团病对健康和福祉的长期影响:一项匹配队列研究(LongLEGIO)的基本原理、研究设计和基线结果

IF 1.9 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Melina Bigler, Malina Vaucher, Manuel Wiederkehr, Sophia Brülisauer, Werner C Albrich, Sarah Dräger, Valentin Gisler, Isabel Akers, Daniel Mäusezahl
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引用次数: 0

摘要

背景和研究目的:军团病是否存在急性感染后综合征?军团病是一种主要由军团菌引起的社区获得性肺炎。军团病和其他形式的细菌性社区获得性肺炎可能导致持续的健康和福祉损害。目前尚不清楚这些是由社区获得性肺炎病原体还是肺炎本身引起的。我们提出了一项匹配队列研究的基本原理和设计,以调查军团病的持续健康影响,并将其与其他细菌性(军团菌检测阴性)社区获得性肺炎的持续表现进行比较。我们还提出了研究队列的基线特征。方法:从高校和州/地区医院招募军团病患者和军团菌检测阴性的社区获得性肺炎确诊或临床疑似细菌性病因患者,按性别、年龄、医院类型和诊断日期进行匹配。在基线和开始使用适当抗生素后的2个月、6个月和12个月进行基于问卷的访谈。问卷的重点是患者报告的结果措施,并涵盖长期症状、卫生服务的使用和与健康有关的生活质量。结果:2023年6月至2024年6月,共纳入59例军团病患者(男性59.3%,中位年龄69岁[四分位数间距[IQR]: 57 ~ 80])和60例其他细菌性(军团菌检测阴性)社区获得性肺炎患者(男性63.3%,中位年龄69岁[IQR: 60 ~ 79])。13.6%的军团病患者和8.3%的其他细菌性社区获得性肺炎患者需要入住重症监护病房。慢性肾衰竭在军团菌病患者中更为普遍(15.3%对10.0%),而慢性阻塞性肺病(20.0%对11.9%)、恶性肿瘤(33.3%对13.6%)和免疫功能低下(25.0%对13.6%)在军团菌检测阴性的社区获得性肺炎患者中更为常见。此外,军团菌检测阴性的社区获得性肺炎患者报告的基线生活质量评分低于军团菌病患者。肺炎严重程度、合并症和自我报告的生活质量评分的差异将在未来的分析中考虑。结论:LongLEGIO研究将有助于急性感染后综合征的研究,并为更全面地评估军团病的疾病负担提供数据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Long-term impacts of Legionnaires' disease on health and wellbeing: rationale, study design and baseline findings of a matched cohort study (LongLEGIO).

Background and study aims: Is there a post-acute infection syndrome for Legionnaires' disease? Legionnaires' disease is a form of primarily community-acquired pneumonia caused by Legionella spp. bacteria. Legionnaires' disease and other forms of bacterial community-acquired pneumonia may lead to persistent health and wellbeing impairments. It remains unclear whether these are caused by the community-acquired pneumonia-causing pathogen or the pneumonia itself. We present the rationale and design of a matched cohort study to investigate the persistent health impacts of Legionnaires' disease and compare them with persistent manifestations of other bacterial (Legionella test-negative) community-acquired pneumonia. We also present baseline characteristics of the study cohorts.

Methods: Legionnaires' disease patients and Legionella test-negative community-acquired pneumonia patients with confirmed or clinically suspected bacterial aetiology were recruited from university and cantonal/regional hospitals and matched for sex, age, hospital type and date of diagnosis. Questionnaire-based interviews are conducted at baseline and 2, 6 and 12 months after the start of appropriate antibiotics. The questionnaires focus on patient-reported outcome measures and cover long-term symptoms, use of health services and health-related quality of life.

Results: Between June 2023 and June 2024, 59 patients with Legionnaires' disease (59.3% male, median age 69 years [interquartile range [IQR]: 57-80]) and 60 patients with other bacterial (Legionella test-negative) community-acquired pneumonia (63.3% male, median age 69 years [IQR: 60-79]) were enrolled. Admission to the intensive care unit was required for 13.6 % of Legionnaires' disease patients and 8.3 % of other bacterial community-acquired pneumonia patients. Chronic kidney failure was more prevalent among Legionnaires' disease patients (15.3% vs 10.0%), while chronic obstructive pulmonary disease (20.0% vs 11.9%), malignancies (33.3% vs 13.6%) and an immunocompromised status (25.0% vs 13.6%) were more common in Legionella test-negative community-acquired pneumonia patients. Furthermore, Legionella test-negative community-acquired pneumonia patients reported lower baseline quality of life scores than Legionnaires' disease patients. Differences in pneumonia severity, comorbidities and self-reported quality of life scores will be accounted for in future analyses.

Conclusions: The LongLEGIO study will contribute to research on post-acute infection syndromes and provide the data for a more holistic assessment of the disease burden of Legionnaires' disease.

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来源期刊
Swiss medical weekly
Swiss medical weekly 医学-医学:内科
CiteScore
5.00
自引率
0.00%
发文量
0
审稿时长
3-8 weeks
期刊介绍: The Swiss Medical Weekly accepts for consideration original and review articles from all fields of medicine. The quality of SMW publications is guaranteed by a consistent policy of rigorous single-blind peer review. All editorial decisions are made by research-active academics.
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