Molecular diagnosis of Legionella infections - Clinical utility of front-line screening as part of a pneumonia diagnostic algorithm
Molecular diagnosis of Legionella infections - Clinical utility of front-line screening as part of a pneumonia diagnostic algorithm
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DOI：
10.1016/j.jinf.2015.10.011
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发表时间：
2016-02-01
影响因子：
28.2
通讯作者：
Templeton, Kate E.
中科院分区：
文献类型：
--
作者：
Gadsby, Naomi J.;Helgason, Kristjan O.;Templeton, Kate E.
目的：嗜肺军团菌血清群1的尿抗原检测是军团病（LD）的主要快速诊断检测;然而，其他军团菌属和血清群也可导致LD。目的是确定前线L的效用。嗜肺军团菌和军团菌PCR在严重呼吸道感染算法中的应用。对英国爱丁堡4年期间的1944例住院患者标本进行了嗜肺军团菌和军团菌双重实时PCR。通过PCR在36例患者的49份（2.7%）标本中检测到嗜肺菌。在LD爆发期间，结合L。呼吸道PCR和尿抗原检测的敏感性和特异性最高（分别为92.6%和98.3%）。10例患者的16份（0.9%）标本中检出军团菌。5例确诊病例和1例疑似病例均为PCR和抗体阳性。作为明确定义的算法的一部分，嗜肺菌和军团菌PCR是对尿抗原检测的有价值的补充。例L.当军团菌属PCR结果呈阳性且检测到军团菌时，可认为longbeachae已得到实验室确认。longbeachae特异性抗体应答。(C)2015年，英国传染病协会。由爱思唯尔有限公司出版。保留所有权利。
Objectives: Urinary antigen testing for Legionella pneumophila serogroup 1 is the leading rapid diagnostic test for Legionnaires' Disease (LD); however other Legionella species and serogroups can also cause LD. The aim was to determine the utility of front-line L. pneumophila and Legionella species PCR in a severe respiratory infection algorithm.Methods: L. pneumophila and Legionella species duplex real-time PCR was carried out on 1944 specimens from hospitalised patients over a 4 year period in Edinburgh, UK.Results: L. pneumophila was detected by PCR in 49 (2.7%) specimens from 36 patients. During a LD outbreak, combined L. pneumophila respiratory PCR and urinary antigen testing had optimal sensitivity and specificity (92.6% and 98.3% respectively) for the detection of confirmed cases. Legionella species was detected by PCR in 16 (0.9%) specimens from 10 patients. The 5 confirmed and 1 probable cases of Legionella longbeachae LD were both PCR and antibody positive.Conclusions: Front-line L. pneumophila and Legionella species PCR is a valuable addition to urinary antigen testing as part of a well-defined algorithm. Cases of LD due to L. longbeachae might be considered laboratory-confirmed when there is a positive Legionella species PCR result and detection of L. longbeachae specific antibody response. (C) 2015 The British Infection Association. Published by Elsevier Ltd. All rights reserved.