Rapid diagnosis of Legionnaires' disease by urinary antigen detection

ABSTRACTLegionnaires’ disease (LD) refers to a serious form of acute pneumonia caused byLegionellaspecies. LD can be difficult to diagnose because the signs and symptoms are nonspecific, and therefore a rapid laboratory diagnosis is of paramount importance. In this study, a recently introduced immunochromatographic test (Immunocatch Legionella; Eiken Chemical Co., Ltd.) forLegionella pneumophila(serogroup 1) urinary antigen detection was compared with the Sofia Legionella fluorescent immunoassay (FIA) (Quidel) (routinely used in our laboratory) and with the widely used BinaxNOW Legionella assay (Alere). A total of 248 urine samples (60 frozen and 188 fresh) were evaluated. All of the samples were collected from patients with high clinical suspicion of Legionnaires’ disease. The three assays were performed simultaneously according to the manufacturers’ instructions. A total of 180 concordant negative and 66 concordant positive results were obtained. Only 2 discrepant results were registered. The sensitivity and specificity of Immunocatch compared with Sofia were, respectively, 98.5% and 99.4%. Cohen's kappa coefficient and overall percent agreement between Immunocatch and Sofia were also calculated and resulted in, respectively, 0.97 and 99.2%. These performances suggest that the Immunocatch test is a useful tool forLegionella pneumophila(serogroup 1) urinary antigen detection.

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Outbreak of legionnaires’ disease associated with visits to Belgium

Weekly releases (1997–2007) ◽

10.2807/esw.06.40.01889-en ◽

2002 ◽

Vol 6 (40) ◽

Author(s):

C Joseph

Keyword(s):

Small Group ◽

Respiratory Symptoms ◽

Antigen Detection ◽

Urinary Antigen ◽

First Case ◽

Legionnaires Disease ◽

Urinary Antigen Detection ◽

British People

Five cases of legionnaires’ disease have been reported in British people who all stayed at a hotel in Belgium in the ten days before onset of illness. All have been confirmed as L. pneumophila serogroup 1, one by culture of the organism and four by urinary antigen detection. The first case, who died, was a 63 year old man who became ill on 7 September 2002. He travelled with a small group of ten people, two of whom were reported to have had respiratory symptoms but were negative on testing for legionella infection. Three cases, one male and two female aged between 74 and 84 years were in a party of 46 people on a coach tour to Austria. They became ill between 21 and 24 September and two were hospitalised in France and one in England. The fifth case became ill on the 28 September and is also in hospital in France. This patient (female aged 65 years) was from a third group of 40 British tourists on another Austrian tour. All cases stayed only one night at the hotel in Belgium.

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Travel associated legionnaires’ disease in Europe in 1999

Eurosurveillance ◽

10.2807/esm.06.04.00212-en ◽

2001 ◽

Vol 6 (4) ◽

pp. 53-60 ◽

Cited By ~ 5

Author(s):

◽

Keyword(s):

Legionella Pneumophila ◽

Health And Safety ◽

Antigen Detection ◽

Urinary Antigen ◽

Legionnaires Disease ◽

Urinary Antigen Detection ◽

Package Travel ◽

And Control ◽

Surveillance Scheme

The European Surveillance Scheme for Travel Associated Legionnaires’ Disease was notified of the highest number of cases in travellers in 1999 since the scheme began in 1987. This reflects enhanced surveillance activities and an increase in the use of urinary antigen detection for Legionella pneumophila serogroup 1. The scheme's extensive reporting and investigation activities are complemented in some countries by the activities of tour operators, who have been legally responsible for the health and safety of their clients since the 1996 European Commission’s Package Travel Directive came into force. In recent years, the work conducted by the collaborators has helped establish good surveillance and control in sites used by travellers.

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Comparison of serologic tests with urinary antigen detection for diagnosis of legionnaires’ disease in patients with community-acquired pneumonia

Clinical Microbiology and Infection ◽

10.1111/j.1469-0691.1999.tb00124.x ◽

1999 ◽

Vol 5 (4) ◽

pp. 201-204 ◽

Cited By ~ 9

Author(s):

M. Sočan ◽

N. Marinič-Fiŝer ◽

D. Keŝe

Keyword(s):

Community Acquired Pneumonia ◽

Antigen Detection ◽

Urinary Antigen ◽

Serologic Tests ◽

Legionnaires Disease ◽

Urinary Antigen Detection

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Multiplex Urinary Antigen Detection for 13 Streptococcus pneumoniae Serotypes Improves Diagnosis of Pneumococcal Pneumonia in South African HIV-Infected Adults

Journal of Clinical Microbiology ◽

10.1128/jcm.01573-16 ◽

2016 ◽

Vol 55 (1) ◽

pp. 302-312 ◽

Cited By ~ 3

Author(s):

Werner C. Albrich ◽

Michael W. Pride ◽

Shabir A. Madhi ◽

Jan Callahan ◽

Peter V. Adrian ◽

...

Keyword(s):

South African ◽

Pneumococcal Pneumonia ◽

Antigen Detection ◽

Urinary Antigen ◽

Content Type ◽

Urinary Antigen Detection ◽

Dominant Serotype ◽

Quellung Reaction ◽

Urine Specimens ◽

Asymptomatic Hiv

ABSTRACT A serotype-specific urinary antigen detection (UAD) assay for 13 serotypes included in the pneumococcal conjugate vaccine (PCV13) was recently reported as a useful diagnostic tool for pneumococcal pneumonia. We aimed to assess the diagnostic accuracy of the UAD in HIV-infected South African adults. Urine specimens from a well-defined cohort of HIV-infected South African adults with pneumonia were evaluated retrospectively in the UAD assay. Pneumonia was considered pneumococcal if either sputum Gram stain, sputum culture, blood culture, or the immunochromatographic (ICT) BinaxNow S. pneumoniae test (composite diagnostic) was positive. Among 235 enrolled pneumonia patients, the UAD assay was more frequently positive (104 [44.3%]) than the composite diagnostic (71 [30.2%]; P < 0.001) and increased the pneumococcal etiology from 30.2% by an additional 22.6% to 52.8%. The UAD assay detected more pneumococcal etiologies (45.0%) than the serotype-independent ICT (23.4%, P < 0.001). UAD identified 6/7 patients with PCV13 serotype bacteremia without misclassification of bacteremia episodes due to non-PCV13 serotypes. UAD was positive for 5.1% of asymptomatic HIV-infected persons, with higher rates among those with nasopharyngeal carriage. Concordance between serotypes identified by UAD and by Quellung reaction and PCR serotyping was 70/86 (81.4%). UAD identified the dominant serotype in multiple serotype carriage. This study confirms the utility of the UAD assay for HIV-infected adults comparing favorably with other diagnostic tests. A highly valent UAD may become a new standard for detection of pneumococcal pneumonia in adults. Prior to PCV introduction, at least 53% of pneumonia cases were due to pneumococci in HIV-infected South African adults.

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