Bacteriological and serological diagnosis of community-acquired acute pneumonia, specially Legionnaire's disease. Multicentric prospective study of 274 hospitalized patients.

In 1982 and 1983 a prospective study was carried out involving 274 adult patients hospitalized with community-acquired acute pneumonia. The results of the bacteriological and serological diagnoses are presented here. Conventional and standardized bacteriological methods were used. All the serodiagnoses of LD were carried out with the 13 antigens produced by the "Centre National de Référence" (L. pneumophila 1, 2, 3, 4, 5, 6; L. micdadei; L. bozemanii, L. dumoffii, L. jordanis; L. gormanii; L. longbeachae 1 and 2). Standardized criteria were used for the interpretation of results. Conventional methods were used for the other serodiagnoses. Because the laboratory results had been interpreted very rigorously, an etiological diagnosis was established only in 51% of pneumonia cases. Other reasons, such as the frequent prescription of antibiotics prior to hospitalization, may explain why no aetiology could be determined in 49% of cases. The microbial agents responsible were: S. pneumoniae, Legionella and M. pneumoniae in 62% of cases; H. influenzae, K. pneumoniae, Chlamydia and S. aureus in 21.6%; and viruses in 8.6%. 29 (10%) of the 274 pneumonia cases were caused by Legionella, being second to S. pneumoniae. The preponderance of L. pneumophila was striking (22 cases), 3 Legionella strains were isolated (L. pneumophila serogroup 1:2 strains, serogroup 6:1 strain). Three associated or successive infections were observed (influenza, Leptospirosis, Coxiella infection). As regards the other bacteria, implication of the strain isolated was based on its multiple occurrence in several samples.(ABSTRACT TRUNCATED AT 250 WORDS)