Prospective evaluation of RT-PCR on sputum versus culture, urinary antigens and serology for Legionnaire's disease diagnosis. Issue 2 (August 2016)

• Record Type: Journal Article
• Authors: Botelho-Nevers, Elisabeth; Grattard, Florence; Viallon, Alain; Allegra, Séverine; Jarraud, Sophie; Verhoeven, Paul; Marcuccilli, Adrien; Lucht, Fréderic; Pozzetto, Bruno; Berthelot, Philippe
• Is Part Of: Journal of infection. Volume 73:Issue 2(2016)
• Page Start: 123
• Page End: 128
• Publication Date: 2016-08
• Subjects: Legionella pneumophila -- Legionnaires' disease -- Legionellosis -- Diagnosis -- PCR -- Pneumonia -- Bacteriological methods; Infection -- Periodicals; Bacterial Infections -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.905
• DOI: 10.1016/j.jinf.2016.04.039
• Languages: English
• ISSNs: 0163-4453

Abstract

Summary: Objectives: Legionnaires' disease (LD) is a severe disease associated with community and hospital-acquired pneumonia, frequently under diagnosed. The main aim of our study was to determine the value of PCR for the diagnosis of LD in routine clinical practice. Methods: In a prospective study, from March 2007 to April 2010, the value of PCR on non-invasive respiratory specimens (NIRS) was compared to those of the other available tools for LD diagnosis in patients hospitalized for pneumonia. Results: Among 254 consecutive cases of pneumonia included, 24 cases were LD (19 confirmed and 5 probable) representing the first documented microbiological etiology. Molecular diagnosis of LD was performed on NIRS by using 16S rRNA PCR, and secondarily mip PCR, with no discrepant results between the 2 methods: it was found positive in 14 cases and led to identify 2 supplementary probable cases of LD. Based on clinical and at least 2 positive LD tests, PCR yielded a better diagnostic value than antigen urinary test (12 vs 10 cases). Conclusion: These results revealed that molecular diagnosis of LD on NIRS is reliable and may contribute to better identify cases of LD.