{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:01:48Z","timestamp":1787162508352,"version":"build-2736575974"},"reference-count":62,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Background: Legionella pneumophila is frequently acquired in the community and generally linked to contaminated domestic hot water systems, hotels, or other environmental sources or of unknown origin. L. pneumophila is a leading cause of pneumonia, especially in high-risk patients such as those over 50 who are immunocompromised or people with pre-existing illnesses. This study examines the factors linked to L. pneumophila acquired in the community in adult patients with hospitalization due to pneumonitis. Methods: This case-control study included 140 hospitalized adult patients admitted to the University Hospital Paolo Giaccone of Palermo between January 2019 and December 2024. Demographic, laboratory, clinical, and microbiological data were collected electronically. Urinary antigen testing and the BioFire FilmArray Pneumonia Panel were used to detect L. pneumophila and were performed within 48 h upon admission. Results: Of 140 pneumonia patients, 70 were positive (SG) and 70 were negative (CG) for L. pneumophila. Comorbidities were significantly associated with the presence of L. pneumophila (p = 0.0046). The most frequent comorbidity was only heart failure (p &lt; 0.0015) and, similarly, for smoke (p = 0.0487). There was no difference in mortality between the two groups (SG). Levofloxacin was the most frequent therapy used in SG (p &lt; 0.0001). Additionally, SG showed significantly lower blood sodium, phosphate, and platelet levels (all p &lt; 0.0001) compared to the CG. In contrast, blood parameters such as LDH, CRP, AST, and ALT were significantly higher (all p &lt; 0.0001). Conclusions: Our research highlights the critical need for early detection of L. pneumophila infections, especially in patients with high CRP levels, moderate hypophosphatemia, or heart failure. In these patients with L. pneumophila, early treatment with macrolide and fluoroquinolone is mandatory to reduce mortality.<\/jats:p>","DOI":"10.3390\/pathogens15010013","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T11:30:18Z","timestamp":1766489418000},"page":"13","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Community-Acquired Legionella pneumophila Pneumonia: A Case-Control Study in Adult Inpatients from 2019 to 2024"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4418-5855","authenticated-orcid":false,"given":"Paola","family":"Di Carlo","sequence":"first","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8086-6362","authenticated-orcid":false,"given":"Nicola","family":"Serra","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences and Dentistry, Audiology Section, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa Maria Assunta","family":"Fasciana","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Fasciana","sequence":"additional","affiliation":[{"name":"Degree Course in Medicine and Surgery, University of Palermo, 93100 Caltanissetta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1871-4285","authenticated-orcid":false,"given":"Luca","family":"Pipit\u00f2","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Giammanco","sequence":"additional","affiliation":[{"name":"Degree Course in Medicine and Surgery, University of Palermo, 93100 Caltanissetta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Capuano","sequence":"additional","affiliation":[{"name":"AORN Santobono-Pausilipon, Healthcare Directorate, 80128 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6767-8823","authenticated-orcid":false,"given":"Caterina","family":"Carollo","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Caputo","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8808-379X","authenticated-orcid":false,"given":"Tommaso Vincenzo","family":"Bartolotta","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Hospital \u201cPaolo Giaccone\u201d, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2779-7879","authenticated-orcid":false,"given":"Consolato Maria","family":"Sergi","sequence":"additional","affiliation":[{"name":"Anatomic Pathology Division, Children\u2019s Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON K1H 8M5, Canada"},{"name":"Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1992-1796","authenticated-orcid":false,"given":"Antonio","family":"Cascio","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s44197-025-00342-9","article-title":"The Global Burden and Trends of Legionella spp. Infection-Associated Diseases from 1990 to 2021: An Observational Study","volume":"15","author":"Zhong","year":"2025","journal-title":"J. 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