ReviewLegionella and community-acquired pneumonia: a review of current diagnostic tests from a clinician’s viewpoint☆
Section snippets
The epidemiology of Legionella pneumonia
Although L. pneumophila serogroup 1 is the most common serogroup in most regions of the United States, the weighting of investigations toward identifying this serogroup has contributed to its dominance. Of 1,005 sporadic cases of Legionellosis reported to the Centers for Disease Control (CDC) through September 30, 1979, serogroup 1 was the major cause (15). Serology was the sole diagnostic test used in 82% of cases, but until October 1978 it was available only for serogroup 1. Indeed, 970 of
Diagnostic tests for Legionellae
There are problems with all available diagnostic tests, including inadequate sensitivity and specificity, and an inability to provide a result in a clinically useful time period (Table 1). The usefulness of some tests declines when the proportion of Legionella infections due to L. pneumophila serogroup 1 decreases. Distinction also needs to made between results achieved in a research laboratory and what physicians can realistically expect from commercial or local hospital laboratories.
Conclusion
Legionella species are underdiagnosed as pathogens in patients with community-acquired pneumonia. Although L. pneumophila serogroup 1 remains the most common serotype identified, other serogroups and other Legionella species are increasingly recognized. Geographic differences in the epidemiology of Legionella infection underscore the importance of knowing local patterns.(88).
None of the current diagnostic tests for Legionella infections have sufficient sensitivity to guide definitive therapy
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Diagnosing Viral and Atypical Pathogens in the Setting of Community-Acquired Pneumonia
2017, Clinics in Chest MedicineCitation Excerpt :A definitive diagnosis based on detecting the infection pathogen(s), therefore, remains critical if we are to improve the accuracy of empiric therapy. Very little has changed in the diagnosis of Legionella infection since we reviewed this topic comprehensively 15 years ago.14 In most settings, Legionella is underdiagnosed and therefore underrecognized owing to routine testing not being performed.15
Simultaneous detection of Legionella species and L. anisa, L. bozemanii, L. longbeachae and L. micdadei using conserved primers and multiple probes in a multiplex real-time PCR assay
2016, Diagnostic Microbiology and Infectious DiseaseRespiratory Disease in Pregnancy
2016, Obstetrics: Normal and Problem PregnanciesUrine antigen testing: Indication and contribution to the treatment of community-acquired pneumonia
2015, Revue des Maladies RespiratoiresHospital acquired pneumonia: Comparison of culture and real-time PCR assays for detection of Legionella pneumophila from respiratory specimens at Tehran Hospitals
2012, Acta Microbiologica et Immunologica Hungarica
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Dr. Waterer was supported by the Methodist Le Bonheur Healthcare Foundation and by the Athelstan and Amy Saw Medical Research Fellowship from the University of Western Australia.