Clinical utility of urinary antigen test and molecular method for detection of Legionella pneumophila.

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Thana’a R AbdulRahman
Keyword(s):  
Legionella Pneumophila ◽  
Point Of View ◽  
P Value ◽  
Antigen Test ◽  
Rt Pcr ◽  
Urinary Antigen ◽  
Urinary Antigen Test ◽  
Serum Samples ◽  
High Prevalence ◽  
Legionnaires Disease

Legionella pneumophila is gram-negative bacterium which causes Legionnaires’ disease and Pontiac fever.To determine the frequency of serogroup 1 and other serogroup of Legionellapneumophila in pneumonic patients and the clinical utilityofLegionellapneumoniaurinary antigen test (LPUAT)in terms of sensitivity and specificity andcomparethe results with q Real Time PCR using serum samples. A total of 100 pneumonic patients were enrolled in this studyduring a period between October 2016 to April 2017; all patients under therapy with antibiotics.Serum and urine specimens were obtained from all patients; urine samples were processed for urinary antigen test. Serum samples were collected and submitted to DNA extraction for detection of L. pneumophila mip gene by q RT PCRassay. The percentage of L. pneumophila in two hospitals In Baghdad was 30%. Of these 26% was serogroup 1 detected by UAT. In the other hand, 23 % of samples were positive by q RT- PCR based mip gene,of these 19 % were serogroup 1 and 4% were other serogroups. The sensitivity of UAT is high (P value< 0.001), which means statistically highlysignificance than q RT PCR. Legionellapneumophila urinary antigen test is a rapid tool for early diagnosis of Legionella infection which highlights the need of using this test in hospitals and health institutions and there is a high prevalence of L.pneumophila in Iraqthat refer to the necessity of considering this microorganism point of view in future studies for detection and treatment in pneumonic patients.

scholarly journals Unusual clinical picture in an overweight patient with Legionella pneumophila: A case report

2017 ◽  
Vol 4 (3) ◽  
pp. 31
Author(s):  
Leonidas Grigorakos ◽  
Daria Lazarescu ◽  
Anthi Georgiadou ◽  
Maria Bikou ◽  
Magda Gkouni ◽  
...  
Keyword(s):  
Case Report ◽  
Legionella Pneumophila ◽  
Clinical Picture ◽  
Clinical Condition ◽  
Antigen Test ◽  
Overweight Patient ◽  
Urinary Antigen ◽  
Urinary Antigen Test ◽  
Legionnaires Disease ◽  
Continue Therapy

This case report describes a case of a patient with Legionnaires’ disease (LD) manifested three days upon his return from a medical conference, which took place in a hotel close to the seaside. Our patient presented to the hospital febrile, weak, confused and with mild difficulty in breathing. After being subjected to several tests, he was diagnosed with LD. Even though his initial urinary antigen test (UAT) was negative, subsequent immunofluorescent assays (IFA) were positive for Legionella pneumophila (LP). The patient was immediately initiated specific antibiotics therapy and supportive measures. After 11 days he was released from the hospital with considerable melioration of his clinical condition and with specific instructions to continue therapy at home.

scholarly journals The impact of diagnosis by legionella urinary antigen test on the epidemiology and outcomes of Legionnaires' disease

2001 ◽  
Vol 127 (2) ◽  
pp. 275-280 ◽  
Author(s):  
N. FORMICA ◽  
M. YATES ◽  
M. BEERS ◽  
J. CARNIE ◽  
G. HOGG ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Community Acquired Pneumonia ◽  
Antigen Test ◽  
Urinary Antigen ◽  
Urinary Antigen Test ◽  
Disease Epidemiology ◽  
The Public ◽  
Life Threatening ◽  
Legionnaires Disease ◽  
The Impact

Legionnaires' disease is an uncommon but important cause of life-threatening community-acquired or nosocomial pneumonia. The urinary antigen enzyme immunoassay test, used in Victoria since 1995, now accounts for the majority of initial laboratory notifications (81% in 1999). We review the impact of the test on the disease epidemiology and the public health investigative process. We focus on the major subgroup of cases due to Legionella pneumophila serogroup 1, comparing delays until notification and mortality for urinary antigen detected cases with culture detected cases. The urinary antigen test facilitates a 5-day reduction for the delay between onset of illness and notification. We observed that there was minimal clinical heterogeneity of urinary antigen detected cases whether they were subsequently culture confirmed or not. We encourage clinician use of the urinary antigen test in cases of community-acquired pneumonia where Legionnaires' disease is a possible diagnosis, in conjunction with culture of clinical specimens.

scholarly journals Urinary antigene and PCR can both be used to detect Legionella pneumophila in children’s hospital-acquired pneumonia

2019 ◽  
Vol 29 (2) ◽  
Author(s):  
Sayed-Yousef Mojtahedi ◽  
Aliakbar Rahbarimanesh ◽  
Samileh Noorbakhsh ◽  
Hossein Shokri ◽  
Saeedreza Jamali-Moghadam-Siyahkali ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Pediatric Intensive Care ◽  
Antigen Test ◽  
Urinary Antigen ◽  
Urinary Antigen Test ◽  
Legionella Pneumonia ◽  
Hospital Acquired Pneumonia ◽  
The Difference ◽  
Underlying Diseases ◽  
Hospital Acquired

Legionella pneumophila is the causative agent of more than 95% cases of severe Legionella pneumonia. Nosocomial pneumonias in different hospital wards is an important medical and pharmaceutical concern. This study aimed to detect Legionella with two methods: polymerase chain reaction (PCR) and detection of urine antigenic test (UAT) in patients suffering from nosocomial pneumonia admitted to pediatric intensive care unit (PICU) of children hospitals. This study was conducted in PICU wards of Rasool Akram and Bahrami children hospitals, Tehran, Iran during 2013 - 2014. In patients diagnosed with hospital-acquired pneumonia, intratracheal secretion samples for PCR and urine sample for UAT were taken. Simultaneously, PCR and urinary antigen test were conducted using commercial kits. The results of urinary antigen test and PCR were analyzed by SPSS v.19 for statistical comparison. In this study, 96 patients aging 2.77 years on average with two age peaks of less than 1 year and 7-8 year were enrolled. More than half of the patients were under 1 year old. The most common underlying diseases were seizure, Acute Lymphoblastic Lymphoma, Down syndrome and metabolic syndromes. The positivity rate of Legionella urinary antigen test was 16.7% and positivity rate of PCR test was 19.8%. There were no significant associations between the results obtained by both assays with age, gender or underlying diseases. In conclusion, PCR is a better detection method for Legionella infection than urinary antigen test, but the difference between the two methods was not significant.

scholarly journals Legionnaires' Disease - Results of a Multicenter Canadian Study

2003 ◽  
Vol 14 (3) ◽  
pp. 154-158 ◽  
Author(s):  
Thomas J Marrie ◽  
Emidio de Carolis ◽  
Victor L Yu ◽  
Janet Stout ◽  
Keyword(s):  
Legionella Pneumophila ◽  
Tertiary Care ◽  
Community Acquired Pneumonia ◽  
The Other ◽  
Urinary Antigen ◽  
Serum Samples ◽  
Eastern Canada ◽  
Legionnaires Disease ◽  
Canadian Provinces ◽  
A Prospective Study

BACKGROUND: There has never been a cross-Canada surveillance project to determine the rate ofLegionellaspecies as a cause of community-acquired pneumonia requiring hospitalization and to determine whether there are any regional differences in the rates of Legionnaires' disease in Canada. Anecdotally, Legionnaires' disease is thought to be uncommon in Western Canada.METHODS: From January, 1996 through to October 31, 1997, a prospective study of the etiology of community acquired pneumonia requiring admission to 15 tertiary care hospitals in eight Canadian provinces was conducted. A urine sample from each patient was tested forLegionella pneumophilaserogroup 1 antigen using a commercially available ELISA assay. A culture of sputum or other respiratory specimens for Legionellaceae was carried out at the discretion of the attending physician. Two hundred thirty-four patients had acute and 6-week convalescent serum samples tested for antibodies toL pneumophilaserogroups 1 through 6 using an ELISA method.RESULTS: 28 of the 850 patients (3.2%) had Legionnaires' disease; 18 of 823 (2.1%) were positive forL pneumophilaserogroup 1 by urinary antigen testing. The rate of Legionnaires' disease, based on urinary antigen, at the Halifax site was higher than that at the other sites (seven of 163 patients versus 11 of 660 [P=0.04]). Of the 28 cases of Legionnaires' disease identified using all methods, 11 of 277 patients (3.9%) were enrolled from Western provinces versus 17 of 573 patients (2.9%) from Eastern provinces (P=nonsignificant).CONCLUSIONS: Legionnaires' disease is just as common in Western as in Eastern Canada.L pneumophilaserogroup 1 may be more common in Halifax than at the other sites studied.

scholarly journals Outbreak of legionnaires’ disease in Amsterdam, June-July 2006

2006 ◽  
Vol 11 (28) ◽  
Author(s):  
Collective Editorial team ◽  
A van den Hoek
Keyword(s):  
Antigen Test ◽  
Urinary Antigen ◽  
Urinary Antigen Test ◽  
Legionnaires Disease ◽  
June July

An outbreak of legionnaires’ disease is occurring in Amsterdam, where 23 cases confirmed by urinary antigen test were reported between 6 and 13 July 2006, and one patient has died

scholarly journals Method Comparison of the ImmuView L. pneumophila and L. longbeachae Urinary Antigen Test with the BinaxNOW Legionella Urinary Antigen Card for Detection of Legionella pneumophila Serogroup 1 Antigen in Urine

2019 ◽  
Vol 58 (3) ◽  
Author(s):  
Paul Badoux ◽  
Lianne Kracht-Kosten ◽  
Bjorn Herpers ◽  
Sjoerd Euser
Keyword(s):  
Sensitivity And Specificity ◽  
Legionella Pneumophila ◽  
Limit Of Detection ◽  
Method Comparison ◽  
Urine Samples ◽  
Analytical Sensitivity ◽  
Antigen Test ◽  
Urinary Antigen ◽  
Urinary Antigen Test ◽  
Content Type

ABSTRACT We compared the clinical performance of the ImmuView L. pneumophila and L. longbeachae urinary antigen test (SSI Diagnostica A/S, Hillerød, Denmark) to that of the BinaxNOW Legionella urinary antigen card (Binax; Abbott, Lake Buff, IL) using urine specimens from patients suspected of having pneumonia. In total, 100 frozen urine samples (derived from 50 Legionella cases and 50 noncases) were analyzed with both tests, as were 200 nonfrozen prospectively collected samples. For urine samples from five Legionella cases and two non-Legionella cases, analytical sensitivity (limit of detection) and repeatability were examined. The urine samples from the five Legionella cases were diluted with urine samples that tested Legionella urinary antigen negative with both tests. The analyses of the 100 frozen samples resulted in a sensitivity and specificity of both ImmuView and the BinaxNOW of 96.0% (48/50) and 100% (50/50), respectively. Of the 200 nonfrozen samples, there were three samples that showed a positive result for L. pneumophila by both tests. The analyses of reproducibility showed that for the 34 (diluted) samples that were tested at two consecutive times, 33 samples showed a consistent result for both the ImmuView and the BinaxNOW tests (Cohen’s kappa values of 0.916 and 0.928). In addition, the ImmuView test may have detected two L. longbeachae-positive urine samples, although other diagnostic tests could not confirm this. Both ImmuView and BinaxNOW showed high sensitivity and specificity for the detection of L. pneumophila serogroup 1 antigen in urine samples from clinical patients with a suspected lower respiratory tract infection.

scholarly journals Evaluation of the bioNexia Legionella Test, Including Impact of Incubation Time Extension, for Detection of Legionella pneumophila Serogroup 1 Antigen in Urine

2017 ◽  
Vol 55 (6) ◽  
pp. 1733-1737 ◽  
Author(s):  
Paul Badoux ◽  
Sjoerd M. Euser ◽  
Jacob P. Bruin ◽  
Patrick P. G. Mulder ◽  
Ed P. F. Yzerman
Keyword(s):  
Legionella Pneumophila ◽  
Incubation Time ◽  
Urine Samples ◽  
Lower Sensitivity ◽  
Antigen Test ◽  
Urinary Antigen ◽  
Urinary Antigen Test ◽  
Prolonged Incubation ◽  
Content Type ◽  
Time Extension

ABSTRACTIn this study, we compared the bioNexia test (bioMérieux, Marcy-l'Étoile, France), a new immunochromatographic assay for the detection ofLegionella pneumophilaserogroup 1 in urine, with the BinaxNOW urinary antigen test (Alere, Waltham, Massachusetts, USA). After 15 min of incubation (in accordance with the manufacturers' instructions), the sensitivities and specificities were, respectively, 76.5% and 97.2% for the bioNexia test and 87.1% and 100% for the BinaxNOW test. After a prolonged incubation time of 60 min, the sensitivities and specificities increased to, respectively, 89.4% and 97.2% for the bioNexia test and 91.8% and 100% for the BinaxNOW test. When the tests were read after 15 min, the concentration of discrepant urine samples increased the sensitivities to 94.1% for both tests. In conclusion, we found that although the bioNexia test showed lower sensitivity for the detection ofL. pneumophilaantigen in nonconcentrated urine compared to the BinaxNOW test, a prolonged incubation time as well as the use of concentrated samples showed comparable sensitivities for both tests.

scholarly journals Travel associated legionnaires' disease in Europe: 2002

2004 ◽  
Vol 9 (2) ◽  
pp. 6-9 ◽  
Author(s):  
K D Ricketts ◽  
C Joseph ◽  
Keyword(s):  
Peak Activity ◽  
Antigen Test ◽  
Travel Patterns ◽  
Urinary Antigen ◽  
Urinary Antigen Test ◽  
Legionnaires Disease ◽  
Surveillance Scheme

Twenty countries reported 676 cases of travel associated legionnaires' disease to the EWGLINET surveillance scheme, and 94 clusters were detected. 80.5% of all cases were diagnosed by the urinary antigen test. On average there were 20.5 days between onset and report of cases, compared with 51.5 days in 1993. Between the introduction of the EWGLI investigation guidelines (on 1st July 2002) and the end of 2002, 37 six-week investigation reports were accepted as satisfactory and on time by the coordinating centre. 274 sites were investigated in total in 2002. The travel patterns of the main reporters in EWGLINET influenced the months of peak activity, and helped to determine which countries bore the greatest investigation burden.

scholarly journals Travel-associated legionnaires’ disease in Europe: 2004

2006 ◽  
Vol 11 (4) ◽  
pp. 13-14 ◽  
Author(s):  
K D Ricketts ◽  
B McNaught ◽  
C A Joseph
Keyword(s):  
Case Fatality Rate ◽  
Case Fatality ◽  
Control Measures ◽  
Antigen Test ◽  
Urinary Antigen ◽  
Urinary Antigen Test ◽  
Legionnaires Disease ◽  
And Control ◽  
Surveillance Scheme ◽  
Made In

Six hundred and fifty five cases of travel-associated legionnaires’ disease with onset in 2004 have been reported to the EWGLINET surveillance scheme by 25 countries. A total of 84.9% of cases were diagnosed by the urinary antigen test, and 37 cultures were obtained. Thirty seven deaths were reported, giving a case fatality rate of 5.6%. Eighty six new clusters were detected, 45% of which would not have been detected without the EWGLINET scheme. Ninety four accommodation sites were investigated and the names of four sites were published on the EWGLI website. Fifteen sites were associated with additional cases after a report was received to say that investigations and control measures had been satisfactorily carried out. Further improvements could be made in the data collected on deaths due to travel-associated legionnaires’ disease, and on the number of samples taken for culture throughout Europe.

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