Sero diagnosis of Legionella infection in community acquired pneumonia (original) (raw)
Related papers
2017
OBJECTIVE: To assess the prevalence of Legionella pneumophila infection determined by seropositivity in patients admitted with Community Acquired Pneumophila. STUDY DESIGN: A cross sectional Analytical study. st th PLACE AND DURATION: At Chest Diseases Ward, Fauji Foundation Hospital, Rawalpindi, from December 1 , 2002 to February 28 , 2003. METHODOLOGY: Study population included 65 patients of Community Acquired Pneumophila. All patients had undergone Serological testing for Legionella Pneumophila by Enzyme Immune Assay (EIA). The blood samples were collected and sent to lab within 3 days of admission... Data included age, gender and serology results. Results were reported Positive at titre of 1; 256. RESULTS: Among total of 65 patients, male to female ratio was 1:1.5. The age range was 12-85 years; with mean age of 39.24 ± 13.37 years (SD). Among these patients admitted with Community Acquired Pneumophila 40% were found to be serologically positive for Legionella Pneumophila. CONC...
Legionella Species Community-Acquired Pneumonia: A Review of 56 Hospitalized Adult Patients
Chest Journal, 1996
Background: In a prospective study, Legionella species (Lsp) was identified as the causative agent in 56 (16.2%) of 346 adult patients hospitalized over the course of 1 year with community-acquired pneumonia (CAP), in the Soroka Medical Center, Beer-Sheva, Israel. Objective: To characterize patients with Lsp CAP in our study. Methods: The diagnosis of infection with Lsp was based on serologic testing of antibodies using the indirect immunofluorescent method. Results: In 35 (62.5%) of the patients, at least one other etiologic agent for CAP was identified in addition to Lsp. The patient population was relatively young, with relatively low rates of chronic comorbidity, and a broad spectrum of disease severity compared with previously published studies. No single epidemiologic, clinical, laboratory, or radiographic characteristic differentiated between Lsp CAP and other CAP patients in our study. Three patients (5.4%) who were not treated with erythromycin died. However, in contrast, nine patients who were treated with (3-lactam antibiotics recovered completely. Conclusions: Lsp is a common cause of CAP in our region, usually as a coinfection with another causative agent. Lsp CAP, which cannot be characterized on the basis of clinical, routine laboratory, or radiographic data, requires specific microbiologic or serologic diagnosis. Treatment with eryth¬ romycin appears to be important to reduce mortality from this disease, but in a significant number of patients, the disease may be self-limited. (CHEST 1996; 109:1243-49) Key words: community-acquired pneumonia; Israel; Legionella species Abbreviations: APACHE=acute physiology and chronic health evaluation; CAP=community-acquired pneumonia; EIA= enzyme immunoassay; Lsp=Legionella species HPhe identification of Legionella pneumophila as the causative agent of Legionnaire's disease1'2 brought in its wake the discovery of an entire species of Gram-negative bacteria known as Legionella species (Lsp).3 The major clinical expressions of infection with Lsp are pneumonia and, particularly, communityacquired pneumonia (CAP). Three hundred forty-six adult patients hospitalized with CAP were included in a prospective study con¬ ducted over the course of 1 year in the Soroka Med¬ ical Center in Beer-Sheva, Israel. Serologic evidence for Lsp as the etiologic agent of CAP was found in 56 patients (16.2%). The aim of the present study was to
Investigation of Legionella pneumophila and other Legionella species in atypical pneumonia patients
Türk hijiyen ve deneysel biyoloji dergisi, 2022
Investigation of Legionella pneumophila and other Legionella species in atypical pneumonia patients Atipik pnömonili hastalarda Legionella pneumophila ve diğer Legionella türlerinin araştırılması Kerim PARLAK 1 (ID), Ayşegül GÖZALAN 2 (ID), Sibel AYDOĞAN 3 (ID), Adem KOYUNCU 4 (ID), Hatice Canan HASANOĞLU 5 (ID), Selin NAR ÖTGÜN 6 (ID), Ziya Cibali AÇIKGÖZ 7 (ID) ÖZET Amaç: Bu çalışmada atipik pnömoni tanısı alan 50 hastada kültür, üriner antijen testi ve moleküler yöntemler kullanarak Legionella türlerinin araştırılması amaçlanmıştır. Yöntem: Solunum yolu örneklerinden Legionella türlerinin izolasyonu için seçici olmayan BCYE-α (Oxoid, İngiltere) ve seçici BMPA (Oxoid, İngiltere) besiyerleri kullanılmıştır. İdrar örneklerinde L. pneumophila serogrup 1'e özgü bakteriyel antijenin varlığı Alere BinaxNOW Legionella Üriner Antijen Kart (Abbott, ABD) testi ile araştırılmıştır.Tüm solunum yolu örnekleri Duplicα RealTime Legionella pneumophila 23S rRNA spesifik bölgesini saptayan (Euroclone Diagnostica, İtalya) ticari kit ve iki laboratuvar yapımı PCR yöntemi ile test edilmiştir. Laboratuvar yapımı jel elektroforez PCR testinde Legionella spp. için 16S ribozomal RNA gen kısmi dizilerinden tasarlanan Leg primerleri ve L. pneumophila için Lmip (macrophage infectivity potentiator) genini hedefleyen primerler ABSTRACT Objective: The aim of this study is to investigate Legionella species in 50 patients with atypical pneumonia, using culture, urinary antigen test and molecular techniques. Methods: Non-selective BCYE-α media (Oxoid, England) and selective BMPA media (Oxoid, England) were used to isolate Legionella spp. from respiratory tract samples. The urinary samples of the patients were tested with the Alere BinaxNOW Legionella Urinary Antigen Card (Abbott, US) test to identify the presence of L. pneumophila serogroup 1 specific bacterial antigen. All respiratory tractsamples were tested with a commercial Duplicα RealTime Legionella pneumophila 23S rRNA specific region detection kit (Euroclone Diagnostica, Italy) and two home-made PCR methods. Home-made gel electrophoresis PCR tests were performed using Leg primers designed from 16S ribosomal RNA gene partial sequences for Legionella spp and primers targeting the Lmip (macrophage
The incidence of legionella pneumonia: A 1-year prospective study in a large community hospital
Lung, 1989
In a 1-year prospective study, 28 of 476 pneumonia patients (5.9%) were diagnosed as having legionella pneumonia. Legionella pneumonia was diagnosed in 12 (5%) of 240 community-acquired pneumonias and in 16 (6.8%) of 236 nosocomial pneumonias. Four methods of establishing diagnosis were used: serum antibody detection, direct proof of legionellae by immunofluorescence, culture, and legioneUa antigen detection in urine. The latter method proved to be clearly advantageous to all other methods in establishing the diagnosis. Twelve of the 28 patients (42.8%) died; all of them had severe underlying diseases. The fatality rate in patients treated with erythromycin was 18.8% (3/16 cases) and 75% (9/12 cases) in patients treated with antibiotics other than erythromycin. In 57.1% ( 16/28 patients) legionella pneumonia was acquired nosocomiallyo The results of our study underscore the need to use a broad spectrum of legionella diagnostic methods routinely and to administer antibiotics effective against legionellae in cases of pneumonia of unknown cause.
The American Journal of Tropical Medicine and Hygiene
Atypical pathogens including Mycoplasma pneumoniae and Legionella pneumophila are increasingly recognized as important causes of community-acquired pneumonia (CAP). Mycoplasma pneumoniae accounts for 20-40% of all CAP and L. pneumophila is responsible for 3-15% of cases. The paucity of data from India in this regard prompted us to conduct this prospective multicentric analysis to detect the prevalence of M. pneumoniae and L. pneumophila in our geographical region. A total of 453 patients with symptoms of pneumonia and 90 controls with no history of lower respiratory tract infections were included in the study. A duplex polymerase chain reaction (PCR) targeting 543 bp region of P1 adhesin gene of M. pneumoniae and 375 bp region of macrophage infectivity potentiator (mip) gene of L. pneumophila was standardized for simultaneous detection of these atypical pathogens. Respiratory secretions, blood, and urine samples were collected from each patient and control and were subjected to duplex PCR, culture and serology for M. pneumoniae and L. pneumophila. Urine samples were subjected for detecting L. pneumophila antigen. Among the 453 patients investigated for M. pneumoniae, 52 (11.4%) were positive for IgM antibodies, 17 were positive by culture, and seven tested positive by PCR (P1 gene). Similarly for L. pneumophila, 50 cases (11%) were serologically positive for IgM antibodies, one was positive by PCR (mip gene) and urine antigen detection. A total of eight samples were positive by duplex PCR for M. pneumoniae P1 gene (N = 7) and L. pneumophila mip gene (N = 1). Of the 90 controls, two samples (2.2%) showed IgM positivity, and 15 (16.7%) showed IgG positivity for M. pneumoniae. For L. pneumophila, three samples (3.3%) tested positive for IgM, and 12 (13.3%) tested positive for IgG antibodies. The study findings indicate the presence of M. pneumoniae and L. pneumophila in our geographical region, and a combination of laboratory approaches including PCR, culture, and serology is required for effective detection of these agents.
International Journal of Environmental Research and Public Health
The rapid identification of Legionella pneumonia is essential to optimize patient treatment and outcomes, and to identify potential public health risks. Previous studies have identified clinical factors which are more common in Legionella than non-Legionella pneumonia, and scores have been developed to assist in diagnosing cases. Since a Legionella pneumonia outbreak at VA Pittsburgh in 2012, nearly all patients with pneumonia have been tested for Legionella. The purpose of this study was to evaluate distinguishing characteristics between Legionella and non-Legionella pneumonia with the application of universal testing for Legionella in all cases of community-acquired pneumonia. We performed a retrospective case-control study matching Legionella and non-Legionella pneumonia cases occurring in the same month. Between January 2013 and February 2016, 17 Legionella and 54 non-Legionella cases were identified and reviewed. No tested characteristics were significantly associated with Legi...