Molecular diagnosis of Legionella infections - Clinical utility of front-line screening as part of a pneumonia diagnostic algorithm

ESCMID Study Group for Molecular Diagnostics and the ESCMID Study Group for Legionella Infections, Basel, Switzerland; Naomi J Gadsby; Kristjan O Helgason; Elizabeth M Dickson; Jonathan M Mills; Diane S J Lindsay; Giles F Edwards; Mary F Hanson; Kate E Templeton

doi:10.1016/j.jinf.2015.10.011

Molecular diagnosis of Legionella infections - Clinical utility of front-line screening as part of a pneumonia diagnostic algorithm

ESCMID Study Group for Molecular Diagnostics and the ESCMID Study Group for Legionella Infections, Basel, Switzerland, Naomi J Gadsby, Kristjan O Helgason, Elizabeth M Dickson, Jonathan M Mills, Diane S J Lindsay, Giles F Edwards, Mary F Hanson, Kate E Templeton

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVES: Urinary antigen testing for Legionella pneumophila serogroup 1 is the leading rapid diagnostic test for Legionnaires' Disease (LD); however other Legionella species and serogroups can also cause LD. The aim was to determine the utility of front-line L. pneumophila and Legionella species PCR in a severe respiratory infection algorithm.

METHODS: L. pneumophila and Legionella species duplex real-time PCR was carried out on 1944 specimens from hospitalised patients over a 4 year period in Edinburgh, UK.

RESULTS: L. pneumophila was detected by PCR in 49 (2.7%) specimens from 36 patients. During a LD outbreak, combined L. pneumophila respiratory PCR and urinary antigen testing had optimal sensitivity and specificity (92.6% and 98.3% respectively) for the detection of confirmed cases. Legionella species was detected by PCR in 16 (0.9%) specimens from 10 patients. The 5 confirmed and 1 probable cases of Legionella longbeachae LD were both PCR and antibody positive.

CONCLUSIONS: Front-line L. pneumophila and Legionella species PCR is a valuable addition to urinary antigen testing as part of a well-defined algorithm. Cases of LD due to L. longbeachae might be considered laboratory-confirmed when there is a positive Legionella species PCR result and detection of L. longbeachae specific antibody response.

Original language	English
Journal	Journal of Infection
DOIs	https://doi.org/10.1016/j.jinf.2015.10.011
Publication status	Published - 26 Nov 2015

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10.1016/j.jinf.2015.10.011

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ESCMID Study Group for Molecular Diagnostics and the ESCMID Study Group for Legionella Infections, Basel, Switzerland, Gadsby, N. J., Helgason, K. O., Dickson, E. M., Mills, J. M., Lindsay, D. S. J., Edwards, G. F., Hanson, M. F., & Templeton, K. E. (2015). Molecular diagnosis of Legionella infections - Clinical utility of front-line screening as part of a pneumonia diagnostic algorithm. Journal of Infection. https://doi.org/10.1016/j.jinf.2015.10.011

@article{707c686b798342f9a28683eaf1992045,

title = "Molecular diagnosis of Legionella infections - Clinical utility of front-line screening as part of a pneumonia diagnostic algorithm",

abstract = "OBJECTIVES: Urinary antigen testing for Legionella pneumophila serogroup 1 is the leading rapid diagnostic test for Legionnaires' Disease (LD); however other Legionella species and serogroups can also cause LD. The aim was to determine the utility of front-line L. pneumophila and Legionella species PCR in a severe respiratory infection algorithm.METHODS: L. pneumophila and Legionella species duplex real-time PCR was carried out on 1944 specimens from hospitalised patients over a 4 year period in Edinburgh, UK.RESULTS: L. pneumophila was detected by PCR in 49 (2.7%) specimens from 36 patients. During a LD outbreak, combined L. pneumophila respiratory PCR and urinary antigen testing had optimal sensitivity and specificity (92.6% and 98.3% respectively) for the detection of confirmed cases. Legionella species was detected by PCR in 16 (0.9%) specimens from 10 patients. The 5 confirmed and 1 probable cases of Legionella longbeachae LD were both PCR and antibody positive.CONCLUSIONS: Front-line L. pneumophila and Legionella species PCR is a valuable addition to urinary antigen testing as part of a well-defined algorithm. Cases of LD due to L. longbeachae might be considered laboratory-confirmed when there is a positive Legionella species PCR result and detection of L. longbeachae specific antibody response.",

author = "{ESCMID Study Group for Molecular Diagnostics and the ESCMID Study Group for Legionella Infections, Basel, Switzerland} and Gadsby, {Naomi J} and Helgason, {Kristjan O} and Dickson, {Elizabeth M} and Mills, {Jonathan M} and Lindsay, {Diane S J} and Edwards, {Giles F} and Hanson, {Mary F} and Templeton, {Kate E}",

year = "2015",

month = nov,

day = "26",

doi = "10.1016/j.jinf.2015.10.011",

language = "English",

journal = "Journal of Infection",

issn = "0163-4453",

publisher = "W.B. Saunders Company",

}

ESCMID Study Group for Molecular Diagnostics and the ESCMID Study Group for Legionella Infections, Basel, Switzerland, Gadsby, NJ, Helgason, KO, Dickson, EM, Mills, JM, Lindsay, DSJ, Edwards, GF, Hanson, MF & Templeton, KE 2015, 'Molecular diagnosis of Legionella infections - Clinical utility of front-line screening as part of a pneumonia diagnostic algorithm', Journal of Infection. https://doi.org/10.1016/j.jinf.2015.10.011

Molecular diagnosis of Legionella infections - Clinical utility of front-line screening as part of a pneumonia diagnostic algorithm. / ESCMID Study Group for Molecular Diagnostics and the ESCMID Study Group for Legionella Infections, Basel, Switzerland; Gadsby, Naomi J; Helgason, Kristjan O et al.
In: Journal of Infection, 26.11.2015.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Molecular diagnosis of Legionella infections - Clinical utility of front-line screening as part of a pneumonia diagnostic algorithm

AU - ESCMID Study Group for Molecular Diagnostics and the ESCMID Study Group for Legionella Infections, Basel, Switzerland

AU - Gadsby, Naomi J

AU - Helgason, Kristjan O

AU - Dickson, Elizabeth M

AU - Mills, Jonathan M

AU - Lindsay, Diane S J

AU - Edwards, Giles F

AU - Hanson, Mary F

AU - Templeton, Kate E

PY - 2015/11/26

Y1 - 2015/11/26

N2 - OBJECTIVES: Urinary antigen testing for Legionella pneumophila serogroup 1 is the leading rapid diagnostic test for Legionnaires' Disease (LD); however other Legionella species and serogroups can also cause LD. The aim was to determine the utility of front-line L. pneumophila and Legionella species PCR in a severe respiratory infection algorithm.METHODS: L. pneumophila and Legionella species duplex real-time PCR was carried out on 1944 specimens from hospitalised patients over a 4 year period in Edinburgh, UK.RESULTS: L. pneumophila was detected by PCR in 49 (2.7%) specimens from 36 patients. During a LD outbreak, combined L. pneumophila respiratory PCR and urinary antigen testing had optimal sensitivity and specificity (92.6% and 98.3% respectively) for the detection of confirmed cases. Legionella species was detected by PCR in 16 (0.9%) specimens from 10 patients. The 5 confirmed and 1 probable cases of Legionella longbeachae LD were both PCR and antibody positive.CONCLUSIONS: Front-line L. pneumophila and Legionella species PCR is a valuable addition to urinary antigen testing as part of a well-defined algorithm. Cases of LD due to L. longbeachae might be considered laboratory-confirmed when there is a positive Legionella species PCR result and detection of L. longbeachae specific antibody response.

AB - OBJECTIVES: Urinary antigen testing for Legionella pneumophila serogroup 1 is the leading rapid diagnostic test for Legionnaires' Disease (LD); however other Legionella species and serogroups can also cause LD. The aim was to determine the utility of front-line L. pneumophila and Legionella species PCR in a severe respiratory infection algorithm.METHODS: L. pneumophila and Legionella species duplex real-time PCR was carried out on 1944 specimens from hospitalised patients over a 4 year period in Edinburgh, UK.RESULTS: L. pneumophila was detected by PCR in 49 (2.7%) specimens from 36 patients. During a LD outbreak, combined L. pneumophila respiratory PCR and urinary antigen testing had optimal sensitivity and specificity (92.6% and 98.3% respectively) for the detection of confirmed cases. Legionella species was detected by PCR in 16 (0.9%) specimens from 10 patients. The 5 confirmed and 1 probable cases of Legionella longbeachae LD were both PCR and antibody positive.CONCLUSIONS: Front-line L. pneumophila and Legionella species PCR is a valuable addition to urinary antigen testing as part of a well-defined algorithm. Cases of LD due to L. longbeachae might be considered laboratory-confirmed when there is a positive Legionella species PCR result and detection of L. longbeachae specific antibody response.

U2 - 10.1016/j.jinf.2015.10.011

DO - 10.1016/j.jinf.2015.10.011

M3 - Article

C2 - 26632328

SN - 0163-4453

JO - Journal of Infection

JF - Journal of Infection

ER -

ESCMID Study Group for Molecular Diagnostics and the ESCMID Study Group for Legionella Infections, Basel, Switzerland, Gadsby NJ, Helgason KO, Dickson EM, Mills JM, Lindsay DSJ et al. Molecular diagnosis of Legionella infections - Clinical utility of front-line screening as part of a pneumonia diagnostic algorithm. Journal of Infection. 2015 Nov 26. doi: 10.1016/j.jinf.2015.10.011

Molecular diagnosis of Legionella infections - Clinical utility of front-line screening as part of a pneumonia diagnostic algorithm

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