Influenceof antimicrobial therapy on the sensitivity of legionella PCR - three case report

Abstract

Background: L. pneumophila is a possible causative agent of severe community and hospital acquired pneumonia. Available diagnostic tests have a lot of shortcomings. Detection of Legionella DNA with the PCR technique is a promissing new method allowing diagnosis within clinically useful time.Methods: Three cases of severe Legionella pneumonia were followed with the PCR technique, urinary antigen and serologic methods.Results: Diagnostic tests have different sensitivity and specificity and also different shortcomings. Serologic tests are unable to provide diagnosis within clinically useful time. Urinary antigen is specific just for L. pneumophila serotype 1. Antimicrobial treatment has impact on the sensitivity of Legionella PCR.Conclusions: Detection of L. pneumophila infection with the PCR technique in addition to urinary antigen testing is likely to be the best diagnostic tool for the detection of all species within a time frame that will affect clinical management.

Keywords

• Legionella PCR
• respiratory samples
• antimicrobial therapy