Immunochromatic kits Xpect Legionella and BinaxNOW Legionella for detection of Legionella pneumophila urinary antigen have low sensitivities for the diagnosis of Legionnaires’ disease

The prevalence ofLegionella pneumophiliain water systems of residential facilities in Kuwait was performed during the period from November 2007 to November 2011. A total of 204 water samples collected from faucets and showerheads in bathrooms (n= 82), taps in kitchens (n= 51), and water tanks (n= 71), from different locations of residential facilities in Kuwait were screened forLegionella pneumophilaby the standard culture method and by real time polymerase chain reaction (RT-PCR). Out of the 204 samples, 89 (43.6%) samples were positive forLegionellaspp., 48 (23.5%) samples were detected by the standard culture method, and 85 (41.7%) were detected by RT-PCR. Of the culture positiveLegionellasamples, counts ranged between 10 to 2250 CFU/L. Serological typing of 48Legionellaisolates revealed that 6 (12.5%) of these isolates belonged toLegionella pneumophilaserogroup 1, 37 (77.1%) isolates toLegionella pneumophilaserogroup 3, and 1 isolate each (2.1%) belonged to serogroups 4, 7, and 10. The minimum inhibitory concentration (MICs) of the 46 environmentalL. pneumophilaisolates against the 10 antimicrobials commonly used forLegionellainfection treatments were determined. Rifampicin was found to be the most active againstL. pneumophilaserogroups isolatesin vitro.

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“…Further confirmation of serogroup was conducted with the Dresden panel of monoclonal antibodies [23]. …”

Section: Methodsmentioning

confidence: 99%

Detection and Quantification ofLegionella pneumophilafrom Water Systems in Kuwait Residential Facilities

Almatawah

Al‐Zenki

Qasem

et al. 2012

Journal of Pathogens

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“…13,14 Urine antigen testing is widely used for two organisms: S. pneumoniae , where the test performs well in adults; 15,16 and L. pneumophila , where the test is specific and much quicker than culture but lacks sensitivity, especially in less severe cases. 17 …”

Section: Introductionmentioning

confidence: 99%

The bacterial aetiology of adult community-acquired pneumonia in Asia: a systematic review

Peto

Nadjm

Horby

et al. 2014

Transactions of the Royal Society of Tropical Medicine and Hygiene

150

129

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BackgroundCommunity-acquired pneumonia (CAP) is a major cause of adult mortality in Asia. Appropriate empirical treatment depends on knowledge of the pathogens commonly responsible. However, assessing the aetiological significance of identified organisms is often difficult, particularly with sputum isolates that might represent contamination with oropharyngeal flora.MethodsA systematic review of all adult CAP aetiology studies from Asia, excluding the Middle East, published in English between 1 January 1990 and 1 March 2012 was conducted. Forty-eight studies reporting on 10 423 patients were included, representing data from China, India, Indonesia, Japan, Malaysia, The Philippines, Singapore, South Korea, Taiwan, Thailand and Vietnam. Data from large parts of Asia were unavailable and there was substantial heterogeneity in methodology.ResultsAs in western studies, Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella spp. and Haemophilus influenzae were all significant pathogens. However, compared with western studies, S. pneumoniae was of less relative importance. Gram-negative bacilli and Mycobacterium tuberculosis were more important, and in northeast Thailand Burkholderia pseudomallei was a major pathogen.ConclusionThese data have major implications for diagnostic strategies and empirical treatment. Narrow-spectrum antibiotics targeting S. pneumoniae may be inappropriate in many Asian settings, and agents active against TB may lead to partial response and delayed TB diagnosis.

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“…The most widely used clinical diagnostic method for all suspected legionellosis cases are rapid, non-invasive, urine detection tests that recognize the presence of soluble antigen [36]. These clinical tests provide high sensitivity for Sg1 infection diagnosis but they are unable to detect most non-Sg1 strains [37], [38]. Recently, we reported that 34% of culture confirmed cases of legionellosis in Ontario (n = 351) were caused by non-Sg1 L. pneumophila species in the last 3 decades [39].…”

Section: Introductionmentioning

confidence: 99%

Comparative Genomics Reveal That Host-Innate Immune Responses Influence the Clinical Prevalence of Legionella pneumophila Serogroups

et al. 2013

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Legionella pneumophila is the primary etiologic agent of legionellosis, a potentially fatal respiratory illness. Amongst the sixteen described L. pneumophila serogroups, a majority of the clinical infections diagnosed using standard methods are serogroup 1 (Sg1). This high clinical prevalence of Sg1 is hypothesized to be linked to environmental specific advantages and/or to increased virulence of strains belonging to Sg1. The genetic determinants for this prevalence remain unknown primarily due to the limited genomic information available for non-Sg1 clinical strains. Through a systematic attempt to culture Legionella from patient respiratory samples, we have previously reported that 34% of all culture confirmed legionellosis cases in Ontario (n = 351) are caused by non-Sg1 Legionella. Phylogenetic analysis combining multiple-locus variable number tandem repeat analysis and sequence based typing profiles of all non-Sg1 identified that L. pneumophila clinical strains (n = 73) belonging to the two most prevalent molecular types were Sg6. We conducted whole genome sequencing of two strains representative of these sequence types and one distant neighbour. Comparative genomics of the three L. pneumophila Sg6 genomes reported here with published L. pneumophila serogroup 1 genomes identified genetic differences in the O-antigen biosynthetic cluster. Comparative optical mapping analysis between Sg6 and Sg1 further corroborated this finding. We confirmed an altered O-antigen profile of Sg6, and tested its possible effects on growth and replication in in vitro biological models and experimental murine infections. Our data indicates that while clinical Sg1 might not be better suited than Sg6 in colonizing environmental niches, increased bloodstream dissemination through resistance to the alternative pathway of complement mediated killing in the human host may explain its higher prevalence.

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Immunochromatic kits Xpect Legionella and BinaxNOW Legionella for detection of Legionella pneumophila urinary antigen have low sensitivities for the diagnosis of Legionnaires’ disease

Cited by 39 publications

References 16 publications

Detection and Quantification ofLegionella pneumophilafrom Water Systems in Kuwait Residential Facilities

Detection and Quantification ofLegionella pneumophilafrom Water Systems in Kuwait Residential Facilities

The bacterial aetiology of adult community-acquired pneumonia in Asia: a systematic review

Comparative Genomics Reveal That Host-Innate Immune Responses Influence the Clinical Prevalence of Legionella pneumophila Serogroups

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