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Abstract

Aim

To evaluate real-time PCR as a diagnostic method for Legionnaires’ disease (LD). Detection of DNA is among the laboratory criteria of a probable LD case, according to the European Centre for Disease Prevention and Control, although the utility and advantages, as compared to culture, are widely recognised.

Methods

Two independent laboratories, one using an in-house and the other a commercial real-time PCR assay, analysed 354 respiratory samples from 311 patients hospitalised with pneumonia between 2010–15. The real-time PCR reliability was compared with that of culture and urinary antigen tests (UAT). Concordance, specificity, sensitivity and positive and negative predictive values (PPV and NPV, respectively) were calculated.

Results

Overall PCR detected eight additional LD cases, six of which were due to (Lp) non-serogroup 1. The two real-time PCR assays were concordant in 99.4% of the samples. Considering in-house real-time PCR as the reference method, specificity of culture and UAT was 100% and 97.9% (95% CI: 96.2–99.6), while the sensitivity was 63.6% (95%CI: 58.6–68.6) and 77.8% (95% CI: 72.9–82.7). PPV and NPV for culture were 100% and 93.7% (95% CI: 91.2-96.3). PPV and NPV for UAT were 87.5% (95% CI: 83.6-91.4) and 95.8% (95% CI: 93.5-98.2).

Conclusion

Regardless of the real-time PCR assay used, it was possible to diagnose LD cases with higher sensitivity than using culture or UAT. These data encourage the adoption of PCR as routine laboratory testing to diagnose LD and such methods should be eligible to define a confirmed LD case.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2018-12-13
2024-11-21
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2018.23.50.1800032
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Improvement of Legionnaires’ disease diagnosis using real-time PCR assay: a retrospective analysis, Italy, 2010 to 2015
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Maria+Luisa+Ricci&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ricci Maria Luisa</a>, <a href="/search?value1=Antonella+Grottola&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Grottola Antonella</a>, <a href="/search?value1=Giulia++Fregni+Serpini&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fregni Serpini Giulia </a>, <a href="/search?value1=Antonino+Bella&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bella Antonino</a>, <a href="/search?value1=Maria+Cristina+Rota&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rota Maria Cristina</a>, <a href="/search?value1=Francesca+Frascaro&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Frascaro Francesca</a>, <a href="/search?value1=Emanuela+Pegoraro&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pegoraro Emanuela</a>, <a href="/search?value1=Marisa+Meacci&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Meacci Marisa</a>, <a href="/search?value1=Anna+Fabio&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fabio Anna</a>, <a href="/search?value1=Elena+Vecchi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vecchi Elena</a>, <a href="/search?value1=Antonietta+Girolamo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Girolamo Antonietta</a>, <a href="/search?value1=Fabio+Rumpianesi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rumpianesi Fabio</a>, <a href="/search?value1=Monica+Pecorari&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pecorari Monica</a>, <a href="/search?value1=Maria+Scaturro&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Scaturro Maria</a></span>. Improvement of Legionnaires’ disease diagnosis using real-time PCR assay: a retrospective analysis, Italy, 2010 to 2015. <a href="/content/ecdc">Euro Surveill.</a> 2018;23(50):pii=1800032. <a href="https://doi.org/10.2807/1560-7917.ES.2018.23.50.1800032" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2018.23.50.1800032</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 16 Jan 2018;&nbsp;&nbsp; <span class="generated">Accepted</span>: 06 Aug 2018 </span> </p>
/content/10.2807/1560-7917.ES.2018.23.50.1800032
/content/10.2807/1560-7917.ES.2018.23.50.1800032
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