Legionnaires' disease in Switzerland: rationale and study protocol of a prospective national case-control and molecular source attribution study (SwissLEGIO)

Article Article scientifique Article Legionnaires' disease in Switzerland: rationale and study protocol of a prospective national case-control and molecular source attribution study (SwissLEGIO) eng 2023-03-11 2023-10 author Fischer Fabienne 0000-0001-9860-2242 Swiss Tropical and Public Health Institute, Allschwil, Switzerland.,University of Basel, Basel, Switzerland. 539481 author Bigler Melina 0000-0002-9534-8354 Swiss Tropical and Public Health Institute, Allschwil, Switzerland.,University of Basel, Basel, Switzerland. author Mäusezahl Daniel 0000-0001-5639-5337 Swiss Tropical and Public Health Institute, Allschwil, Switzerland. daniel.maeusezahl@unibas.ch.,University of Basel, Basel, Switzerland. daniel.maeusezahl@unibas.ch. author Hattendorf Jan 0000-0002-1176-401X Swiss Tropical and Public Health Institute, Allschwil, Switzerland.,University of Basel, Basel, Switzerland. author Regli Adrian 0000-0002-3564-8603 Institute for Medical Microbiology, University of Zurich, Zurich, Switzerland. 646294 author Julian Timothy R 0000-0003-1000-0306 Swiss Tropical and Public Health Institute, Allschwil, Switzerland.,University of Basel, Basel, Switzerland.,Eawag, Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland. author Rölli Franziska Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland. author Gaia Valeria Service of Microbiology, Institute of Laboratory Medicine, National Reference Centre for Legionella, EOC, Bellinzona, Switzerland. 554788 author Wymann Monica 0000-0002-7141-8207 Federal Office of Public Health, Bern, Switzerland. author Fridez Françoise Federal Food Safety and Veterinary Office, Bern, Switzerland. author Bertschi Stefanie Swiss Federal Office of Energy, Bern, Switzerland. SwissLEGIO Hospital Network collaborator Bernasconi Enos 663410 Département de médecine (DEMED) collaborator Schrenzel Jacques 29184 Département de médecine (DEMED) collaborator Tognon Mikael 644500 1467-1479 10.1007/s15010-023-02014-x 36905400 0300-8126 PMC10545568 https://link.springer.com/article/10.1007/s15010-023-02014-x Switzerland has one of the highest annual Legionnaires' disease (LD) notification rates in Europe (7.8 cases/100,000 population in 2021). The main sources of infection and the cause for this high rate remain largely unknown. This hampers the implementation of targeted Legionella spp. control efforts. The SwissLEGIO national case-control and molecular source attribution study investigates risk factors and infection sources for community-acquired LD in Switzerland. Over the duration of one year, the study is recruiting 205 newly diagnosed LD patients through a network of 20 university and cantonal hospitals. Healthy controls matched for age, sex, and residence at district level are recruited from the general population. Risk factors for LD are assessed in questionnaire-based interviews. Clinical and environmental Legionella spp. isolates are compared using whole genome sequencing (WGS). Direct comparison of sero- and sequence types (ST), core genome multilocus sequencing types (cgMLST), and single nucleotide polymorphisms (SNPs) between clinical and environmental isolates are used to investigate the infection sources and the prevalence and virulence of different Legionella spp. strains detected across Switzerland. The SwissLEGIO study innovates in combining case-control and molecular typing approaches for source attribution on a national level outside an outbreak setting. The study provides a unique platform for national Legionellosis and Legionella research and is conducted in an inter- and transdisciplinary, co-production approach involving various national governmental and national research stakeholders. Case–control study Legionella spp Legionnaires’ disease Surveillance Switzerland Whole genome sequencing Humans Legionnaires' Disease / epidemiology Legionnaires' Disease / diagnosis Legionella pneumophila / genetics Switzerland / epidemiology Prospective Studies Disease Outbreaks Case-Control Studies Dewey 616 56 Département de médecine 221 false 338 Génomique et microbiote 604 Infection 51 5 398369f7-b6dd-4e2e-b2ee-89cfa68fcba7 Article (Published version) Public ls15010-023-02014-x.pdf 2300737 application/pdf CC BY-4.0 b47491add22aeadf08bb5e7b03c9be36cbd9a378dd43bea03e58c8f4762bd6fd openAccess Faculté de médecine / Section de médecine clinique / Département de médecine

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Legionnaires' disease in Switzerland: rationale and study protocol of a prospective national case-control and molecular source attribution study (SwissLEGIO)	Infection			2023	83	266

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Fischer, Fabienne