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. 2025 Aug 25;17(1):21.
doi: 10.1186/s41479-025-00173-z.

Clinical features and prognosis of severe legionnaires' disease requiring intensive care unit admission: a multicentric retrospective cohort study

Anaïs Dartevel  1 , Louis-Marie Galerneau  1   2 , Vincent Peigne  3 , Nicholas Sedillot  4 , Stephan Ehrmann  5 , Alexandre Lautrette  6 , Kada Klouche  7 , Julien Poissy  8 , Guillaume Thiery  9 , Bertrand Sauneuf  10 , Jean-Philippe Rigaud  11 , Michel Ramakers  12 , Cédric Daubin  13 , Carole Schwebel  1 , Nicolas Terzi  14
Affiliations

Clinical features and prognosis of severe legionnaires' disease requiring intensive care unit admission: a multicentric retrospective cohort study

Anaïs Dartevel et al. Pneumonia (Nathan). .

Abstract

Introduction: Legionella is the second cause of community-acquired pneumonia in Intensive Care Unit (ICU) patients. The aim of this study was to describe the epidemiology and outcome in patients with Legionella pneumonia (LP) in French ICUs.

Methods: A multi-center, retrospective, observational study in 12 French ICUs was performed between January 2014 and December 2019.

Results: LP was diagnosed in 162 patients during the study period. Invasive mechanical ventilation was required in 95 patients (58%), 73 (45%) of whom had acute respiratory distress syndrome (ARDS). Most of these patients were treated with a combination of antibiotics (128, patients; 79%). The most common combination consisted in a fluoroquinolone and a macrolide (118 patients). Median length of stay in an ICU was 11 [5; 11] days. At 28 days, 19 (12%) out of the 162 patients had not survived. In multivariate analyses, age (Incidence risk Ratio: IRR, 1.07; 95% CI, 1.01; 1.14) and a high Sequential Organ Failure Assessment (SOFA) score in the first 48 h (IRR, 1.47; 95% CI, 1.09; 2) were significantly associated with mortality.

Conclusion: In this French multicentric cohort, the LP prognosis in ICUs was apparently more favorable than in the literature, possibly because of the timely and improved LP management in ICUs.

Keywords: Antibiotherapy; Intensive Care Unit; Legionella pneumophila; Septic shock.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Eligible patients were informed about the study by letter from each participating center. Their data were included in the study if they did not object. The study was approved by the Ethics Committee of the French Intensive Care Society (SRLF, Société de Réanimation de la Langue Française, CE 22–040). Consent for publication: All authors consent for publication. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Risk factors for mortality at D-28 after admission to ICU for LP (n = 19)
Fig. 2
Fig. 2
Multivariate analysis of length of stay in ICU (n = 141)
Fig. 3
Fig. 3
Multivariate analysis of ventilator-free days at 60 days (n = 93)
See this image and copyright information in PMC

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