Gw. Waterer et al., Legionella and community-acquired pneumonia: A review of current diagnostic tests from a clinician's viewpoint, AM J MED, 110(1), 2001, pp. 41-48
Citations number
88
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Many physicians are unaware of the limitations of the available tests for d
iagnosing infections with Legionella organisms. Geographic differences in t
he importance of nonpneumophila Legionella species as pathogens are underre
cognized, in part because available diagnostic tests are biased toward the
detection of pneumophila serogroup 1. Routine laboratory practices reduce t
he likelihood of culturing Legionella species from clinical isolates. Failu
re of seroconversion is common, particularly with nonpneumophila species; e
ven when seroconversion occurs, it may take much longer than 4 weeks. Urina
ry antigen testing has insufficient sensitivity to affect clinical manageme
nt in most regions of the United States, as it can reliably detect only L.
pneumophila serogroup 1 infections. Polymerase chain reaction-based techniq
ues offer hope of providing highly sensitive, rapid diagnostic tests for al
l Legionella species, but limitations in the current tests will make valida
ting them difficult. (C) 2001 by Excerpta Medica, Inc.