1887

Chapter 3 : Diagnostics and Clinical Disease Treatment: Usefulness of Microbiological Diagnostic Methods for Detection of Infections

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Ebook: Choose a downloadable PDF or ePub file. Chapter is a downloadable PDF file. File must be downloaded within 48 hours of purchase

Buy this Chapter
Digital (?) $15.00

Preview this chapter:
Zoom in
Zoomout

Diagnostics and Clinical Disease Treatment: Usefulness of Microbiological Diagnostic Methods for Detection of Infections, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555815660/9781555813901_Chap03-1.gif /docserver/preview/fulltext/10.1128/9781555815660/9781555813901_Chap03-2.gif

Abstract:

Microbiological diagnostic methods play the key role in establishing the etiological diagnosis since the clinical presentation is not specific for infections. Currently available are culture, urinary antigen detection, direct fluorescent antigen testing, detection of nucleic acid, and serology. Culture is still the gold standard among the diagnostic methods for infections. The sensitivity of culture for the diagnosis of Legionnaire's disease has been estimated to be in the range of 11 to 65% in retrospective studies usually performed in reference laboratories. The most important technique for the identification of legionellae in the clinical laboratory is the serological characterization of isolated strain. The antigen excreted with urine has been characterized as heat-stable and resistant to enzymatic cleavage with a molecular weight of about 10 kDa. The advantages of urinary antigen detection are obvious: specimens are easy to obtain and can be investigated repeatedly; antigenuria is detectable very early and, therefore, often gives the first evidence for infection. Direct fluorescent antibody (DFA) testing of respiratory specimens is a rapid method for the detection of antigen. The excretion of DNA fragments in the urine is described for several bacterial pathogens, suggesting the suitability of urine PCR for the detection of DNA. The indirect fluorescent antibody (IFA) test is the only method for antibody detection that has been evaluated and standardized. None of the diagnostic tests presently available offers the desired quality with respect to sensitivity and specificity. Therefore, the standard technique is to use several diagnostic tests in parallel.

Citation: Christian Lück P, Helbig J, von Baum H, Marre R. 2006. Diagnostics and Clinical Disease Treatment: Usefulness of Microbiological Diagnostic Methods for Detection of Infections, p 15-21. In Cianciotto N, Kwaik Y, Edelstein P, Fields B, Geary D, Harrison T, Joseph C, Ratcliff R, Stout J, Swanson M (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555815660.ch03

Key Concept Ranking

Outer Membrane Proteins
0.50543475
Rapid Immunochromatographic Assay
0.46811685
Urinary Tract Infections
0.44302326
0.50543475
Highlighted Text: Show | Hide
Loading full text...

Full text loading...

Figures

Image of FIGURE 1
FIGURE 1

Prevalence of spp. and serogroups among clinical and environmental isolates isolated in Germany from 1986 to 2005 and characterized at the Institute of Medical Microbiology and Hygiene, University of Dresden.

Citation: Christian Lück P, Helbig J, von Baum H, Marre R. 2006. Diagnostics and Clinical Disease Treatment: Usefulness of Microbiological Diagnostic Methods for Detection of Infections, p 15-21. In Cianciotto N, Kwaik Y, Edelstein P, Fields B, Geary D, Harrison T, Joseph C, Ratcliff R, Stout J, Swanson M (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555815660.ch03
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 2
FIGURE 2

colonies with atypical colony appearance grown on GVPC agar.

Citation: Christian Lück P, Helbig J, von Baum H, Marre R. 2006. Diagnostics and Clinical Disease Treatment: Usefulness of Microbiological Diagnostic Methods for Detection of Infections, p 15-21. In Cianciotto N, Kwaik Y, Edelstein P, Fields B, Geary D, Harrison T, Joseph C, Ratcliff R, Stout J, Swanson M (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555815660.ch03
Permissions and Reprints Request Permissions
Download as Powerpoint

References

/content/book/10.1128/9781555815660.ch03
1. Blazquez, R. M.,, F. J. Espinosa,, C. M. Martnez-Toldos,, L. Alemany,, M. C. Garca-Orenes, and, M. Segovia. 2005. Sensitivity of urinary antigen test in relation to clinical severity in a large outbreak of Legionella pneumonia in Spain. Eur. J. Clin. Microbiol. Infect. Dis. 24:800806.
2. DenBoer, J.W. and, E. P. Yzerman. 2004. Diagnosis of Legionella infection in Legionnaires’ disease. Eur. J. Clin. Micobiol. Infect. Dis. 23:871878.
3. Dominguez, J. A.,, N. Gali,, P. Pedroso,, A. Fargas,, E. Padilla,, J. M. Manterola, and, L. Matas. 1998. Comparison of the Binax Legionella Urinary Antigen Enzyme Immunoassay (EIA) with the Biotest Legionella Urin Antigen EIA for detection of Legionella antigen in both concentrated and nonconcentrated urine samples. J. Clin. Microbiol. 36:27182722.
4. Edelstein, P. H. 2000. Detection of selected fastidious bacteria. Clin. Infect. Dis. 31:846.
5. Fields, B. S.,, R. F. Benson, and, R. E. Besser.2002. Legionella and Legionnaires’ disease: 25 years of investigation. Clin. Microbiol. Rev. 15:506526.
6. Guerrero, C., C. M. Toldos,, G. Yague,, C. Ramirez,, T. Rodriguez, and, M. Segovia.2004. Comparison of diagnostic sensitivities of three assays (Bartels Enzyme Immunoassay [EIA], Biotest EIA, and Binax NOW immunochromatographic Test) for detection of Legionella pneumophila serogroup 1 antigen in urine. J. Clin. Mi-crobiol. 42:467468.
7. Hayden, R. T.,, J. R. Uhl,, X. Qian,, M. K. Hopkins,, M. C. Aubry,, A. H. Limper,, R.V. Lloyd, and, F. R. Cockerill. 2001. Direct detection of Legionella species from bronchoalveolar lavage and open lung biopsy specimens: comparison of lightcycler pcr, in situ hybridization, direct fluorescence antigen detection, and culture. J. Clin. Microbiol. 39:26182626.
8. Helbig, J. H.,, J. B. Kurtz,, M. C. Pastoris,, C. Pelaz, and, P. C. Lück. 1997. Antigenic lipopolysaccharide components of Legionella pneumophila recognized by monoclonal antibodies: possibilities and limitations for division of the species into serogroups. J. Clin. Microbiol. 35:28412845.
9. Helbig, J. H.,, S. A. Uldum,, P. C. Lück, and, T. G. Harrison. 2001. Detection of Legionella pneumophila antigen in urine samples by the Bi-naxNOW immunochromatographic assay and comparison with both Binax Legionella Urinary Enzyme Immunoassay (EIA) and Biotest Legionella Urin Antigen EIA. J. Med. Microbiol. 50:509516.
10. Helbig, J. H.,, S. A. Uldum,, S. Bernander,, P. C. Lück,, G. Wewalka,, B. Abraham,, V. Gaia, and, T. G. Harrison. 2003. Clinical utility of urinary antigen detection for diagnosis of community-acquired, travel-associated, and nosocomial Legionnaires’ disease. J. Clin. Microbiol. 41:838840.
11. Koide, M.,, F. Higa,, M. Tateyama,, H. Saku-gawa, and, A. Saito. 2004. Comparison of polymerase chain reaction and two urinary antigen detection kits for detecting Legionella in clinical samples. Eur. J. Clin. Microbiol. Infect. Dis. 23:221223.
12. Lindsay, D., S. J., W. H. Abraham, W. Findlay,, P. Christie,, F. Johnston, and, G. F. S. Edwards.2004. Laboratory diagnosis of Legionnaires’ disease due to Legionella pneumophila serogroup 1: comparison of phenotypic and genotypic methods. J. Med. Microbiol. 53:183187.
13. Lück, P. C.,, L. Igel,, J. H. Helbig,, E. Kuhlisch, and, L. Jatzwauk. 2004. Comparison of commercially available media for the recovery of Legionella species. Int. J. Hyg. Environ. Health 207:589593.
14. Miyamoto, H.,, H. Yamamoto,, K. Arima,, J. Fujii,, K. Maruta,, K. Izu, T. Shiomori, and, S. Yoshida. 1997. Development of a new seminested PCR method for detection of Legionella species and its application to surveillance of legionellae in hospital cooling tower water. Appl. Environ. Microbiol. 63:24892494.
15. Murdoch, D. R.,, E. J. Walford,, L. C. Jennings,, G. J. Light,, M. I. Schousboe,, A. Y. Chereshsky,, S. T. Chambers, and, G. I. Town. 1996. Use of the polymerase chain reaction to detect Legionella DNA in urine and serum samples from patients with pneumonia. Clin. Infect. Dis. 23:475480.
16. Ratcliff, R. M.,, J. A. Lanser,, P. A. Manning, and, M. W. Heuzenroeder. 1998. Sequence-based classification scheme for the genus Legionella targeting the mip gene. J. Clin. Microbiol. 36:15601567.
17. Reischl, U.,, H. J. Linde,, N. Lehn,, O. Landt,, K. Barratt, and, N. Wellinghausen. 2002. Direct detection and differentiation of Legionella spp. and Legionella pneumophila in clinical specimens by dual-color real-time PCR and melting curve analysis. J. Clin. Microbiol. 40:38143817.
18. Sopena, N.,, M. Sabri,, M. L. Pedro-Botet,, E. Reynaga,, M. Garca-Nez,, J. Domnguez, and, L. Matas. 2002. Factors related to persistence of Legionella urinary antigen excretion in patients with Legionnaires disease. Eur. J. Clin. Microbiol. Infect. Dis. 21:845848.
19. Yu, V. L.,, J. F. Plouffe,, M. C. Pastoris,, J. E. Stout,, M. Schousboe,, A. Widmer,, J. Summersgill,, T. File,, C. M. Heath,, D. L. Paterson, and, A. Chereshsky. 2002. Distribution of Legionella species and serogroups isolated by culture in patients with sporadic community-acquired Legionellosis: an international collaborative survey. J. Infect. Dis. 186:127128.
20. Yzerman, E. P.,, B. Den,, K. D. Lettinga,, J. Schellekens,, J. Dankert, and, M. Peeters.2002. Sensitivity of three urinary antigen tests associated with clinical severity in a large outbreak of Legionnaires’ disease in The Netherlands. J. Clin. Microbiol. 40:32323236.

Tables

Generic image for table
TABLE 1

Sensitivity of diagnostic methods in 112 cases of community-acquired pneumonia in adults detected in the German pneumonia study CAPNETZ (http://www.CAPNETZ.de)

Citation: Christian Lück P, Helbig J, von Baum H, Marre R. 2006. Diagnostics and Clinical Disease Treatment: Usefulness of Microbiological Diagnostic Methods for Detection of Infections, p 15-21. In Cianciotto N, Kwaik Y, Edelstein P, Fields B, Geary D, Harrison T, Joseph C, Ratcliff R, Stout J, Swanson M (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555815660.ch03

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error