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. 2023 Jun 29;11(7):1693.
doi: 10.3390/microorganisms11071693.

Legionellosis-Associated Hospitalization in Spain from 2002 to 2021

Enrique Gea-Izquierdo  1   2 , Ruth Gil-Prieto  1 , Valentín Hernández-Barrera  1 , Gil Rodríguez-Caravaca  1   3 , Ángel Gil-de-Miguel  1   4
Affiliations

Legionellosis-Associated Hospitalization in Spain from 2002 to 2021

Enrique Gea-Izquierdo et al. Microorganisms. .

Abstract

Legionellosis is a respiratory disease of bacterial and environmental origin that usually presents two distinct clinical entities, "Legionnaires' disease" (LD) and "Pontiac fever". LD is an important cause of hospital-acquired pneumonia (HAP). The objective of this study is to describe the epidemiology of legionellosis-associated hospitalization (L-AH) in Spain from 2002 to 2021 and the burden of hospitalization due to legionellosis. Discharge reports from the Minimum Basic Data Set (MBDS) were used to retrospectively analyze hospital discharge data with a diagnosis of legionellosis, based on the ICD-9-CM and ICD-10-CM diagnosis codes, from 2002 to 2021. 21,300 L-AH occurred throughout the year during 2002-2021. The incidence of hospitalization associated per 100,000 inhabitants by month showed a similar trend for the 2002-2011, 2012-2021, and 2002-2021 periods. In Spain, during 2002-2021, the hospitalization rate (HR) in the autonomous communities ranged from 4.57 (2002-2011) to 0.24 (2012-2021) cases per 100,000 inhabitants. The HR of legionellosis in Spain has substantially increased across the 2002-2021 period, and the estimate is consistent with available European data. It is considered that in-depth epidemiological surveillance studies of legionellosis and improvements in the prevention and control of the disease are required in Spain.

Keywords: COVID-19; Legionnaires’ disease; Spain; hospitalization; legionellosis.

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Conflict of interest statement

No conflict of interest to report.

Figures

Figure 1
Figure 1
Incidence of hospitalization associated with legionellosis per 100,000 inhabitants by month in Spain.
Figure 2
Figure 2
Distribution of the average hospital admissions per season of legionellosis in Spain, from 2002–2011, 2012–2021, and 2002–2021.
Figure 3
Figure 3
Joinpoint regression analysis of the adjusted hospitalization rates for legionellosis: Spain (a), Andalusia (b), Aragon (c), Asturias (d), Balearic Islands (e), Canary Islands (f), Cantabria (g), Castilla Leon (h), Castilla La Mancha (i), Catalonia (j), Community of Valencia (k), Extremadura (l), Galicia (m), Community of Madrid (n), Murcia (o), Navarre (p), Basque Country (q), La Rioja (r), Ceuta (s), and Melilla (t) by year, from 2002–2021. Asterisk indicates that the annual percentage change (APC) is significantly different from zero at the alpha = 0.05 level.
Figure 3
Figure 3
Joinpoint regression analysis of the adjusted hospitalization rates for legionellosis: Spain (a), Andalusia (b), Aragon (c), Asturias (d), Balearic Islands (e), Canary Islands (f), Cantabria (g), Castilla Leon (h), Castilla La Mancha (i), Catalonia (j), Community of Valencia (k), Extremadura (l), Galicia (m), Community of Madrid (n), Murcia (o), Navarre (p), Basque Country (q), La Rioja (r), Ceuta (s), and Melilla (t) by year, from 2002–2021. Asterisk indicates that the annual percentage change (APC) is significantly different from zero at the alpha = 0.05 level.
Figure 3
Figure 3
Joinpoint regression analysis of the adjusted hospitalization rates for legionellosis: Spain (a), Andalusia (b), Aragon (c), Asturias (d), Balearic Islands (e), Canary Islands (f), Cantabria (g), Castilla Leon (h), Castilla La Mancha (i), Catalonia (j), Community of Valencia (k), Extremadura (l), Galicia (m), Community of Madrid (n), Murcia (o), Navarre (p), Basque Country (q), La Rioja (r), Ceuta (s), and Melilla (t) by year, from 2002–2021. Asterisk indicates that the annual percentage change (APC) is significantly different from zero at the alpha = 0.05 level.
Figure 3
Figure 3
Joinpoint regression analysis of the adjusted hospitalization rates for legionellosis: Spain (a), Andalusia (b), Aragon (c), Asturias (d), Balearic Islands (e), Canary Islands (f), Cantabria (g), Castilla Leon (h), Castilla La Mancha (i), Catalonia (j), Community of Valencia (k), Extremadura (l), Galicia (m), Community of Madrid (n), Murcia (o), Navarre (p), Basque Country (q), La Rioja (r), Ceuta (s), and Melilla (t) by year, from 2002–2021. Asterisk indicates that the annual percentage change (APC) is significantly different from zero at the alpha = 0.05 level.
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