Use of Laboratory Standards for Diagnosis of Legionellosis during the Outbreak of Pneumonia in Verhnyaya Pyshma (Sverdlovsk Region)

Abstract

Over the last years there was a significant improvement in diagnostics and prophylaxis of legionellosis that is due to introduction of current standards of laboratory diagnosis and quantitative analysis of the pathogen in the environmental objects. Use of international laboratory standards during the outbreak of pneumonia in Verhnyaya Pyshma (Sverdlovsk region) made it possible to determine etiology in timely manner. Because of the use of immunochromatography (one of the WHO standard methods) for detecting legionellae antigen in urine, ICU patients had their diagnosis confirmed in 30 min. Analysis of the environmental objects in Verhnyaya Pyshma using culture and real-time PCR demonstrated the wide distribution of Legionella spp. in water samples from the different sources. Epidemic Legionella pneumophila strains were isolated less frequently, and preliminary screening using real-time PCR showed a good correlation with the culture results. Allele profile of isolates was characterized by the molecular typing according to the modern standards (developed by European Working Group on Legionellosis).