1887

Abstract

Urinary antigen tests are the most widely used methods for diagnosing Legionnaires’ disease (LD). However, all available urinary antigen tests have the disadvantage that they have low or no sensitivity for serogroups (sgs) other than sg 1. Recently, Oxoid introduced the Xpect Legionella test for detection of sg 1 and sg 6. In this study, we have evaluated the Xpect kit together with the BinaxNOW kit and compared them with the Binax EIA kit. One hundred and fifteen urine samples from 91 patients with laboratory-confirmed LD were examined. Ninety-three samples were from 69 culture-proven cases of which 27 samples were from 23 non-sg 1 cases. At the patient level, the overall sensitivities for the three urinary antigen kits were 79 % for the Binax EIA, 47 % for the BinaxNOW and 32 % for the Xpect kit. None of the urine samples from the 10 sg 6 cases were positive by the Xpect kit whereas samples from four of the patients were positive by the Binax EIA. Overall, the sensitivities for both immunochromatic assays were poor and they should not be used as the sole method for the diagnosis of LD.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.035014-0
2012-02-01
2024-04-26
Loading full text...

Full text loading...

/deliver/fulltext/jmm/61/2/213.html?itemId=/content/journal/jmm/10.1099/jmm.0.035014-0&mimeType=html&fmt=ahah

References

  1. Bandt D., Monecke S. 2007; Development and evaluation of a real-time PCR assay for detection of Pneumocystis jiroveci. Transpl Infect Dis 9:196–202 [View Article][PubMed]
    [Google Scholar]
  2. Brown A. W., Lindsay D., Scopes E. 2009; Xpect Legionella urinary antigen immunochromatographic test: rapid diagnosis of legionellosis. Biomedical Science Congress, ICC Birmingham 28–30 September 2009, Medical Microbiology, session 2, short paper. http://www.shlmprl.scot.nhs.uk/posters/Xpect_Legionella_poster.pdf
  3. Corless C. E., Guiver M., Borrow R., Edwards-Jones V., Fox A. J., Kaczmarski E. B. 2001; Simultaneous detection of Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae in suspected cases of meningitis and septicemia using real-time PCR. J Clin Microbiol 39:1553–1558 [View Article][PubMed]
    [Google Scholar]
  4. Diederen B. M. W., Bruin J. P., Scopes E., Peeters M. F., IJzerman E. P. F. 2009; Evaluation of the Oxoid Xpect Legionella test kit for detection of Legionella pneumophila serogroup 1 antigen in urine. J Clin Microbiol 47:2272–2274 [View Article][PubMed]
    [Google Scholar]
  5. Domínguez J. A., Galí N., Pedroso P., Fargas A., Padilla E., Manterola J. M., Matas L. 1998; Comparison of the Binax Legionella urinary antigen enzyme immunoassay (EIA) with the Biotest Legionella Urin antigen EIA for detection of Legionella antigen in both concentrated and nonconcentrated urine samples. J Clin Microbiol 36:2718–2722[PubMed]
    [Google Scholar]
  6. Dumke R., Jacobs E. 2009; Comparison of commercial and in-house real-time PCR assays used for detection of Mycoplasma pneumoniae. J Clin Microbiol 47:441–444 [View Article][PubMed]
    [Google Scholar]
  7. Guerrero C., Toldos C. M., Yagüe G., Ramírez C., Rodríguez T., Segovia M. 2004; Comparison of diagnostic sensitivities of three assays (Bartels enzyme immunoassay [EIA], Biotest EIA, and Binax NOW immunochromatographic test) for detection of Legionella pneumophila serogroup 1 antigen in urine. J Clin Microbiol 42:467–468 [View Article][PubMed]
    [Google Scholar]
  8. Helbig J. H., Uldum S. A., Lück P. C., Harrison T. G. 2001; Detection of Legionella pneumophila antigen in urine samples by the BinaxNOW immunochromatographic assay and comparison with both Binax Legionella Urinary Enzyme Immunoassay (EIA) and Biotest Legionella Urin Antigen EIA. J Med Microbiol 50:509–516[PubMed]
    [Google Scholar]
  9. Helbig J. H., Bernander S., Castellani Pastoris M., Etienne J., Gaia V., Lauwers S., Lindsay D., Lück P. C., Marques T. other authors 2002; Pan-European study on culture-proven Legionnaires’ disease: distribution of Legionella pneumophila serogroups and monoclonal subgroups. Eur J Clin Microbiol Infect Dis 21:710–716 [View Article][PubMed]
    [Google Scholar]
  10. Helbig J. H., Uldum S. A., Bernander S., Lück P. C., Wewalka G., Abraham B., Gaia V., Harrison T. G. 2003; Clinical utility of urinary antigen detection for diagnosis of community-acquired, travel-associated, and nosocomial legionnaires’ disease. J Clin Microbiol 41:838–840 [View Article][PubMed]
    [Google Scholar]
  11. Jensen J. S., Søndergård-Andersen J., Uldum S. A., Lind K. 1989; Detection of Mycoplasma pneumoniae in simulated clinical samples by polymerase chain reaction. Brief report. APMIS 97:1046–1048 [View Article][PubMed]
    [Google Scholar]
  12. Jespersen S., Søgaard O. S., Fine M. J., Østergaard L. 2009; The relationship between diagnostic tests and case characteristics in Legionnaires’ disease. Scand J Infect Dis 41:425–432 [View Article][PubMed]
    [Google Scholar]
  13. Joseph C. A., Ricketts K. D.on behalf of the European Working Group for Legionella Infections 2010; Legionnaires disease in Europe 2007-2008. Euro Surveill 15:19493 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19493[PubMed]
    [Google Scholar]
  14. Kösters K., Reischl U., Schmetz J., Riffelmann M., Wirsing von König C. H. 2002; Real-time LightCycler PCR for detection and discrimination of Bordetella pertussis and Bordetella parapertussis. J Clin Microbiol 40:1719–1722 [View Article][PubMed]
    [Google Scholar]
  15. Olsen C. W., Uldum S. 2009; Legionella urinary antigen test as a routine diagnostic assay, one year's experience from Denmark. In Legionella 2009, October 13–17 2009, Institut Pasteur, Paris, France, p. 95, poster no. P16. http://www.pasteur.fr/infosci/conf/sb/legionella2009/fichiers/abstractbook_Legio2009.pdf
  16. Olsen C. W., Elverdal P., Jørgensen C. S., Uldum S. A. 2009; Comparison of the sensitivity of the Legionella urinary antigen EIA kits from Binax and Biotest with urine from patients with infections caused by less common serogroups and subgroups of Legionella. Eur J Clin Microbiol Infect Dis 28:817–820 [View Article][PubMed]
    [Google Scholar]
  17. Severin W. P. 1972; Latex agglutination in the diagnosis of meningococcal meningitis. J Clin Pathol 25:1079–1082 [View Article][PubMed]
    [Google Scholar]
  18. Uldum S., St-Martin G., Mølbak K. 2010; Legionella pneumonia 2009 EPI-News. http://www.ssi.dk/English/News/EPI-NEWS/2010/No%2041%20-%202010.aspx
  19. Yzerman E. P. F., den Boer J. W., Lettinga K. D., Schellekens J., Dankert J., Peeters M. 2002; Sensitivity of three urinary antigen tests associated with clinical severity in a large outbreak of Legionnaires’ disease in The Netherlands. J Clin Microbiol 40:3232–3236 [View Article][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.035014-0
Loading
/content/journal/jmm/10.1099/jmm.0.035014-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error