Clinical Microbiology and Antimicrobial Chemotherapy. 2012; 14(2):100-106
To determine significance of Legionella pneumonia for hematological patients in ICUs, and to evaluate prospects of the proposed algorithm for diagnosis of legionellosis.
A total of 37 hematological ICU patients were assessed for legionellosis between December 2010 and February 2012. Bronchoalveolar lavage (BAL) fluid culture and Legionella urinary antigen test (rapid immunochromatographic assay) were used to diagnose legionellosis.
Diagnosis of legionellosis was confirmed in 4 (11%) patients, of which 3 had fatal outcome. The diagnosis was made using BAL culture in 3 of these 4 patients. Legionella pneumophila serogroup 1, subtype France/Allent (Hem1 strain), Legionella pneumophila serogroup 3 (Hem2 strain), and Legionella pneumophila serogroup 9 (Hem3 strain) were isolated. Diagnosis of infection caused by Legionella pneumophila serogroup 1 in forth patient was confirmed by the twice positive urinary antigen test.
Two standardized diagnostic tests for legionellosis (BAL fluid culture and urinary antigen test) were used for the assessment of patients with pneumonia. The proposed algorithm should be added to standard of care for hematological patients with pneumonia and other patients at risk. Rapid immunochromatographic assay is a simple and available test, and it can be recommended for the assessment of all patients with pneumonia.