Specific Real-Time PCR for Simultaneous Detection and Identification ofLegionella pneumophilaSerogroup 1 in Water and Clinical Samples
ABSTRACTLegionella pneumophila, a bacterium that replicates within aquatic amoebae and persists in the environment as a free-living microbe, is the causative agent of Legionnaires' disease. Among the manyLegionellaspecies described,L. pneumophilais associated with 90% of human disease, and within the 15 serogroups (Sg),L. pneumophilaSg1 causes more than 84% of Legionnaires' disease worldwide. Thus, rapid and specific identification ofL. pneumophilaSg1 is of the utmost importance for evaluation of the contamination of collective water systems and the risk posed. Previously we had shown that about 20 kb of the 33-kb locus carrying the genes coding for the proteins involved in lipopolysaccharide biosynthesis (LPS gene cluster) byL. pneumophilawas highly specific for Sg1 strains and that three genes (lpp0831,wzm, andwzt) may serve as genetic markers. Here we report the sequencing and comparative analyses of this specific region of the LPS gene cluster inL. pneumophilaSg6, -10, -12, -13, and -14. Indeed, thewzmandwztgenes were present only in the Sg1 LPS gene cluster, which showed a very specific gene content with respect to the other five serogroups investigated. Based on this observation, we designed primers and developed a classical and a real-time PCR method for the detection and simultaneous identification ofL. pneumophilaSg1 in clinical and environmental isolates. Evaluation of the selected primers with 454Legionellaand 38 non-Legionellastrains demonstrated 100% specificity. Sensitivity, specificity, and predictive values were further evaluated with 209 DNA extracts from water samples of hospital water supply systems and with 96 respiratory specimens. The results showed that the newly developed quantitative Sg1-specific PCR method is a highly specific and efficient tool for the surveillance and rapid detection of high-riskL. pneumophilaSg1 in water and clinical samples.