BackgroundLegionella testing conducted at environmental laboratories plays an essential role in assessing the risk of disease transmission associated with water systems. However, drawbacks of culture-based methodology used for Legionella enumeration can have great impact on the results and interpretation which together can lead to underestimation of the actual risk. Up to 20% of the samples analysed by these laboratories produced inconclusive results, making effective risk management impossible. Overgrowth of competing microbiota was reported as an important factor for culture failure. For quantitative polymerase chain reaction (qPCR), the interpretation of the results from the environmental samples still remains a challenge. Inhibitors may cause up to 10% of inconclusive results. This study compared a quantitative method based on immunomagnetic separation (IMS method) with culture and qPCR, as a new approach to routine monitoring of Legionella.ResultsFirst, pilot studies evaluated the recovery and detectability of Legionella spp using an IMS method, in the presence of microbiota and biocides. The IMS method results were not affected by microbiota while culture counts were significantly reduced (1.4 log) or negative in the same samples. Damage by biocides of viable Legionella was detected by the IMS method. Secondly, a total of 65 water samples were assayed by all three techniques (culture, qPCR and the IMS method). Of these, 27 (41.5%) were recorded as positive by at least one test. Legionella spp was detected by culture in 7 (25.9%) of the 27 samples. Eighteen (66.7%) of the 27 samples were positive by the IMS method, thirteen of them reporting counts below 103 colony forming units per liter (CFU l−1), six presented interfering microbiota and three presented PCR inhibition. Of the 65 water samples, 24 presented interfering microbiota by culture and 8 presented partial or complete inhibition of the PCR reaction. So the rate of inconclusive results of culture and PCR was 36.9 and 12.3%, respectively, without any inconclusive results reported for the IMS method.ConclusionThe IMS method generally improved the recovery and detectability of Legionella in environmental matrices, suggesting the possibility to use IMS method as valuable indicator of risk. Thus, this method may significantly improve our knowledge about the exposure risk to these bacteria, allowing us to implement evidence-based monitoring and disinfection strategies.

BackgroundLegionellosis is an uncommon form of pneumonia. After a clinical encounter, the necessary antibiotic treatment is available if the diagnosis is made early in the illness. Before the clinical encounter, early detection of the main pathogen involved, Legionella pneumophila, in hazardous environments is important in preventing infectious levels of this bacterium. In this study a qualitative test based on combined magnetic immunocapture and enzyme-immunoassay for the fast detection of Legionella pneumophila in water samples was compared with the standard method, in both comparative and collaborative trials. The test was based on the use of anti-Legionella pneumophila antibodies immobilized on magnetic microspheres. The final protocol included concentration by filtration, resuspension and immunomagnetic capture. The whole assay took less than 1 hour to complete.ResultsA comparative trial was performed against the standard culture method (ISO 11731) on both artificially and naturally contaminated water samples, for two matrices: chlorinated tap water and cooling tower water. Performance characteristics of the test used as screening with culture confirmation resulted in sensitivity, specificity, false positive, false negative, and efficiency of 96.6%, 100%, 0%, 3.4%, and 97.8%, respectively. The detection limit at the level under which the false negative rate increases to 50% (LOD50) was 93 colony forming units (CFU) in the volume examined for both tested matrices. The collaborative trial included twelve laboratories. Water samples spiked with certified reference materials were tested. In this study the coincidence level between the two methods was 95.8%.ConclusionResults demonstrate the applicability of this immunosensing technique to the rapid, simple, and efficient detection of Legionella pneumophila in water samples. This test is not based on microbial growth, so it could be used as a rapid screening technique for the detection of L. pneumophila in waters, maintaining the performance of conventional culture for isolation of the pathogen and related studies.

The presence of Listeria monocytogenes in 225 natural samples, including different food types, was investigated by three methods: (i) culture-based standard procedure ISO 11290-1, (ii) mini-VIDAS (Vitek Immuno Diagnostic Assay System) LMO, an enzyme linked fluorescent assay (ELFA) commercially available, and (iii) PCR using a previously established procedure. Identification of isolates recovered from the standard method and mini-VIDAS, on Oxford and PALCAM selective plates, was carried out using the API-Lis system and also by PCR, using L. monocytogenes specific primers. In all, 65 samples (64 meat products and one smoked salmon) were positive with any of the three procedures assayed. Taking into account the results based on PCR identification, the standard culture-based method found 22 and the mini-VIDAS 23, while PCR detected 60 positive samples in a total of 225 food samples. For comparative purposes, a set of "known positive samples" was established as reference that included 33 natural samples from which L. monocytogenes isolates (identified by specific PCR) had been recovered. The mini-VIDAS and ISO 11290-1 methods were equally sensitive. Compared to them PCR was clearly the more accurate and efficient procedure for detection of L. monocytogenes in food. Moreover, it showed no false negative results. The PCR approach can be completed in 48 working hours, and because of its specificity might eventually be cheaper than the other two procedures. Consequently we recommend PCR for routine detection of L. monocytogenes in food. Zusammenfassung(Redaktion): 225 Lebensmittelproben wurden auf das Vorhandensein von Listeria monocytogenes mit Hilfe von drei verschiedenen Methoden untersucht: (i) durch die auf Kultivierung basierende Standard-Methode nach ISO 11290-1, (ii) durch mini-VIDAS (Vitek Immuno Diagnostic Assay System) LMO, einem Enzym-basierten Verfahren mittels Fluoreszenz-Nachweis (ELFA; im Handel erhältlich) und (iii) durch ein PCR-Verfahren, das jüngst von den Autoren etabliert worden ist. Die Identifikation von Isolaten durch Einsatz der Standard-oder der mini-VI-DAS-Methode wurde nachvollzogen durch Verwendung des API-Lis-Systems und auch durch die PCR unter Verwendung von L. monocytogenes-spezifischen Primern. Insgesamt wurden 65 Lebensmittelproben durch jede der drei Methoden als positiv identifiziert. Durch die Standard-Methode wurden 22, durch die mini-VIDAS 23 und durch die PCR 60 positive Proben unter den 225 Lebensmittelproben identifiziert. Zu Vergleichszwecken wurden Referenzproben (belastet mit L. monocytogenes) durch PCR positiv identifiziert.Das mini-VIDAS-und das Verfahren nach ISO 11290-1 waren von gleicher Sensitivität; aber im Vergleich zu ihnen war die PCR deutlich exakter und effizienter, um L. monocytogenes in Lebensmitteln nachzuweisen. Das Ergebnis des Nachweises mittels PCR kann nach 48 Arbeitsstunden vorliegen. Daher empfehlen die Autoren ihre PCR als Routine-Verfahren für den Nachweis von L. monocytogenes in Lebensmitteln.