Clinical and Laboratory Diagnosis of Legionella Pneumonia

Abstract

Legionella pneumonia is a relatively rare but extremely progressive pulmonary infection with high mortality. Traditional cultural isolation remains the gold standard for the diagnosis of Legionella pneumonia. However, its harsh culture conditions, long turnaround time, and suboptimal sensitivity do not meet the clinical need for rapid and accurate diagnosis, especially for critically ill patients. So far, pathogenic detection techniques including serological assays, urinary antigen tests, and mass spectrometry, as well as nucleic acid amplification technique, have been developed, and each has its own advantages and limitations. This review summarizes the clinical characteristics and imaging findings of Legionella pneumonia, then discusses the advances, advantages, and limitations of the various pathogenetic detection techniques used for Legionella pneumonia diagnosis. The aim is to provide rapid and accurate guiding options for early identification and diagnosis of Legionella pneumonia in clinical practice, further easing healthcare burden.

Cell-SELEX for aptamer discovery and its utilization in constructing electrochemical biosensor for rapid and highly sensitive detection of Legionella pneumophila serogroup 1

“…Conventional methods employed for Legionella detection, including culture-based techniques, enzyme-linked immunosorbent assays (ELISA), micro-agglutination (MA) and indirect fluorescent antibody (IFA)-based assays, are hindered by limitations in sensitivity, specificity, and/or turnaround time 3 , 4 . Polymerase chain reaction (PCR), especially on-site PCR, offers a more straightforward and reliable method for Legionella identification in field settings.…”

“…The direct fluorescent antibody (DFA) assay represents a rapid test with a sensitivity of 71% for L. pneumophila serogroup 1 (SG-1) and a specificity approaching 99%. Nevertheless, this method demands extensive expertise and labor to execute 6 , 7 . Another sensitive approach for Legionella detection is loop-mediated isothermal amplification (LAMP) based on electrochemical (EC) transduction principles 8 .…”

Noninvasive respiratory support with high-flow nasal cannula in endoscopic surgery in a patient with Legionella Pneumophila pneumonia: a case report

“…Humans usually become infected with Legionella through inhaling Legionella -containing aerosols from contaminated water sources (e.g., rain, pipes, air-conditioning systems) or inhaling directly contaminated water sources in specific conditions, such as water births. After entering the respiratory tract, Legionella can survive and replicate exponentially in human alveolar macrophages, releasing toxins and virulence factors, resulting in L. pneumophila (Bai et al 2023 ).…”

Evaluation of the BioFire® FilmArray® Pneumonia plus Panel for Detecting Bacterial Etiological Agents of Lower Respiratory Tract Infections in an Oncologic Hospital. Comparison with Conventional Culture Method

“…Although our work aimed not to compare methods for detecting atypical bacteria, it is known that culture, which is the gold standard for detecting Legionella infections, is characterized by low sensitivity and takes a long time ( Cristovam et al 2017 ). The PNP test, characterized by greater sensitivity and a short time for obtaining results, may be an alternative to a standard diagnostic procedure in oncologic patients with impaired cellular immunity ( Bai et al 2023 ).…”