Factors related to persistence of Legionella urinary antigen excretion in patients with Legionnaires' disease

The aim of this prospective study was to compare patient characteristics, clinical data, and evolution of Legionella pneumophila pneumonia according to the duration of Legionella urinary antigen excretion. Urine samples from 61 patients with Legionella pneumonia diagnosed by detection of urinary antigen were obtained periodically until urinary antigen could no longer be detected. Cases were divided into two groups based on the duration of urinary antigen excretion: group I (46 patients, <60 days) and group II (15 patients, greater than or equal to60 days). Groups were compared for patient characteristics, clinical data, and evolution of pneumonia. Antigen excretion greater than or equal to60 days was observed significantly more frequently in immunosuppressed patients (P=0.001) in whom the time to apyrexia was >72 h (P=0.002), although only the time to apyrexia remained significant on multivariate analysis (P=0.006). In conclusion, the duration of Legionella urinary antigen excretion was <60 days in most patients but was longer in immunosuppressed patients with a longer time to defervescence of fever.