Evaluation of the prevalence of Legionella pneumophila in Iranian clinical samples: A systematic review and meta-analysis

Microb Pathog. 2019 Apr:129:93-98. doi: 10.1016/j.micpath.2019.02.008. Epub 2019 Feb 7.

Abstract

Background: Legionella pneumophila is the main cause for community-acquired pneumonia especially in hospital environments. In this systematic review and meta-analysis, we evaluated the prevalence of L. pneumophila in clinical samples obtained from Iranian patients.

Methods: The studies reporting L. pneumophila prevalence in Iranian clinical samples that were published between January 2000 and July 2016 were recruited. Comprehensive Meta-Analysis Software (version 3.3.070) was used for quantitative data analysis. Because of high heterogeneity between the studies according to the Cochrane Q and I2 statistics, a random-effects model was used for meta-analysis.

Results: Sixteen studies encompassing 1956 subjects were included in the meta-analysis. The overall prevalence of L. pneumophila was 9.6% in clinical samples obtained from the Iranian patients. The age spectrum ranged from 6 months to 80 years old. Dyspnea and cough comprised the most common clinical manifestations. In the subgroup analysis, the prevalence of L. pneumophila was higher in studies with sample size ≤100 (12.9%) in comparison with studies with sample size >100 (8.4%). In addition, the prevalence of L. pneumophila was higher in the years 2009-2016 (9.2%) compared with 2000-2008 (0.7%).

Conclusion: L. pneumophila is a major cause of community- and hospital-acquired pneumonia. It is of pivotal importance to implement sensitive and reliable molecular and culture-based techniques to detect and control this infection in healthcare environments.

Keywords: Clinical samples; Iran; Legionella pneumophila.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Community-Acquired Infections / epidemiology
  • Cross Infection / epidemiology
  • Female
  • Humans
  • Infant
  • Iran / epidemiology
  • Legionella pneumophila / isolation & purification*
  • Legionnaires' Disease / epidemiology*
  • Male
  • Middle Aged
  • Prevalence
  • Young Adult