AI Article Synopsis
- Current diagnosis of legionellosis relies heavily on urinary antigen testing (UAT) for Legionella pneumophila serogroup 1 (Lp1), but this method often misses non-Lp1 infections.
- A study reviewed results from 14 Belgian laboratories, revealing that 44.4% of UAT results were false negatives and were reclassified as legionellosis using PCR testing.
- The findings highlighted that 39.4% of legionellosis cases could have been overlooked or delayed without a syndromic testing approach, emphasizing the advantages of molecular methods, particularly in lower respiratory tract samples.
Article Abstract
Currently, diagnosis of legionellosis relies mainly on urinary antigen testing (UAT) for Legionella pneumophila serogroup 1 (Lp1). However, this test has several limitations, particularly missing non-Lp1 infections. The purpose of this large multicenter study was to investigate the risk of missing legionellosis relying on UAT solely. Molecular results of Legionella detection as part of a first-line (syndromic) testing algorithm for severe respiratory tract infections were investigated retrospectively and compared with UAT results in 14 Belgian laboratories. Overall, 44.4% (20/45) UAT results appeared false negative and were reclassified as legionellosis based on PCR findings [Legionnaires' disease, 37.5% (15/40); Pontiac fever, 100% (5/5)]. A total of 39.4% (26/66) diagnosis probably would have been missed or delayed without a syndromic approach, as UAT or specific molecular testing for Legionella was not requested by the clinician. Furthermore, we confirmed the higher sensitivity of molecular Legionella detection in lower respiratory tract compared with upper respiratory tract specimens (p = 0.010).
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| http://dx.doi.org/10.1007/s10096-019-03785-8 | DOI Listing |
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