Application of Legionella pneumophila-specific quantitative real-time PCR combined with direct amplification and sequence-based typing in the diagnosis and epidemiological investigation of Legionnaires' disease

  • M. Mentasti
  • , N. K. Fry*
  • , B. Afshar
  • , C. Palepou-Foxley
  • , F. C. Naik
  • , T. G. Harrison
  • *Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

63 Citations (Scopus)

Abstract

The detection of Legionella pneumophila DNA in clinical specimens using quantitative real-time polymerase chain reaction (qPCR) combined with direct sequence-based typing (SBT) offers rapid confirmation and timely intervention in the investigation of cases of Legionnaires' disease (LD). We assessed the utility of a specific L. pneumophila qPCR assay targeting the macrophage infectivity potentiator (mip) gene and internal process control with three clinical specimen types from confirmed LD cases. The assay was completely specific for L. pneumophila, as demonstrated by positive results for 39/39 strains from all subspecies and 16 serogroups. No cross-reaction was observed with any of the 54 Legionella non-pneumophila (0/69 strains) or 21 non- Legionella (0/58 strains). All L. pneumophila culturepositive respiratory samples (81/81) were qPCR-positive. Of 80 culture-negative samples tested, 47 (58.8%) were qPCRpositive and none were inhibitory. PCR was significantly more sensitive than culture for samples taken ≤2 days of hospitalisation (94.7% vs. 79.6%), with the difference being even more marked for samples taken between 3 and 14 days (79.3% vs. 47.8%). Overall, the sensitivity of the qPCR was ∼ 30% greater than that of culture and direct typing on culturenegative PCR-positive samples resulted in full 7-allele profiles from 23/46, 5 to 6 alleles from 8/46 and ≥1 allele from 43/46 strains.

Original languageEnglish
Pages (from-to)2017-2028
Number of pages12
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
Volume31
Issue number8
DOIs
Publication statusPublished - Aug 2012

Bibliographical note

Funding Information:
Authors’ declaration This work was supported, in part, by funding from the European Centre for Disease Prevention and Control, “Laboratory support for surveillance of Legionnaires’ disease at European level”. Preliminary results from this study were presented at Legionella 2009, Institut Pasteur, Paris, France, 13–17 October 2009, abstract P38 and the Society for General Microbiology Spring Meeting, Harrogate International Centre, Harrogate, UK, 30 March–2 April 2009, abstract HAR29/ 06.

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