Chapter 55 : Detection of Antibodies to

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

Preview this chapter:
Zoom in

Detection of Antibodies to , Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555815905/9781555813642_Chap55-1.gif /docserver/preview/fulltext/10.1128/9781555815905/9781555813642_Chap55-2.gif


Determination of the levels of antibody to was one of the first methods used to diagnose Legionnaires’ disease and was especially valuable when culture diagnosis was at a primitive stage. This chapter describes antibody testing because it is still very widely used and is of major importance for epidemiologic and research studies. Patients infected with some serogroups may not demonstrate antibody to other serogroups. About 40% of people who eventually seroconvert have agglutinating antibodies detected during the first week of infection. Detection of specific IgA antibodies may also increase the sensitivity and specificity of the enzyme-linked immunosorbent assay (ELISA). The sensitivity of the kits for measurement of antibody to SG2 to SG6 is unknown, but they do appear to be reasonably sensitive in comparison to the indirect immunofluorescent-antibody (IFA) method (70 to 90%) for the estimation of SG1 antibodies. Cross-reactive antibody is occasionally found in patients with non-Legionella infections. Up to 25% of people with enteritis have cross-reactive antibodies to . However, as many as 10% of patients with tuberculosis had cross-reactive antibodies to other serogroups and species. It is unclear whether this absorption removes only nonspecific antibodies and what criteria should be used to evaluate the serologic results of testing before and after the use of this blocking antigen. Pontiac fever is an acute, nonfatal febrile illness associated with but not proven to be caused by it.

Citation: Edelstein P. 2006. Detection of Antibodies to , p 468-476. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch55

Key Concept Ranking

Enzyme-Linked Immunosorbent Assay
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


1. Bangsborg, J. M. 1997. Antigenic and genetic characterization of Legionella proteins: contributions to taxonomy, diagnosis and pathogenesis. APMIS (Suppl.) 70:153.
2. Bangsborg, J. M.,, A. Friss-Møsller,, C. Rechnitzer,, N. Høiby, and , K. Lind. 1988. The E. coli immunosorbent as used in serodiagnosis of Legionella infections studied by crossed immunoelectrophoresis. APMIS 96:177184.
3. Bangsborg, J. M.,, G. H. Shand,, K. Hansen, and , J. B. Wright. 1994. Performance of four different indirect enzyme-linked immunosorbent assays (ELISAs) to detect specific IgG, IgA, and IgM in Legionnaires’ disease. APMIS 102:501508.
4. Benin, A. L.,, R. F. Benson, and , R. E. Besser. 2002. Trends in Legionnaires disease, 1980-1998: declining mortality and new patterns of diagnosis. Clin. Infect. Dis. 35:10391046.
5. Bornstein, N.,, N. Janin,, G. Bourguignon,, M. Surgot, and , J. Fleurette. 1987. Prevalence of anti-Legionella antibodies in a healthy population and in patients with tuberculosis or pneumonia. Pathol. Biol. (Paris) 35:353356.
6. Boshuizen, H. C.,, J. W. den Boer,, H. de Melker,, J. F. Schellekens,, M. F. Peeters,, J. A. van Vliet, and , M. A. Conyn-van Spaendonck. 2003. Reference values for the SERION classic ELISA for detecting Legionella pneumophila antibodies. Eur. J. Clin. Microbiol. Infect. Dis. 22:706708.
7. Boswell, T. C. 1996. Serological cross reaction between legionella and campylobacter in the rapid microagglutination test. J. Clin. Pathol. 49:584586.
8. Boswell, T. C., and , G. Kudesia. 1992. Serological crossreaction between Legionella pneumophila and campylobacter in the indirect fluorescent antibody test. Epidemiol. Infect. 109:291295.
9. Collins, M. T.,, F. Espersen,, N. Høiby,, S. N. Cho,, A. Friss-Møller, and , J. S. Reif. 1983. Cross-reactions between Legionella pneumophilla (serogroup 1) and twenty-eight other bacterial species, including other members of the family Legionellaceae. Infect. Immun. 39:14411456.
10. Darelid, J.,, S. Lofgren,, B. E. Malmvall,, M. A. Olinder-Nielsen,, G. Briheim, and , H. Hallander. 2003. Legionella pneumophila serogroup 1 antibody kinetics in patients with Legionnaires’ disease: implications for serological diagnosis. Scand. J. Infect. Dis. 35:1520.
11. den Boer, J. W.,, E. P. Yzerman,, J. Schellekens,, K. D. Lettinga,, H. C. Boshuizen,, J. E. Van Steenbergen,, A. Bosman,, S. Van den Hof,, H. A. Van Vliet,, M. F. Peeters,, R. J. van Ketel,, P. Speelman,, J. L. Kool, and , M. A. Conyn-van Spaendonck. 2002. A large outbreak of Legionnaires’ disease at a flower show, the Netherlands, 1999. Emerg. Infect. Dis. 8:3743.
12. De Ory, F.,, J. M. Echevarria,, C. Pelaz,, A. Tellez,, M. A. Mateo, and , J. Lopez. 2000. Detection of specific IgM antibody in the investigation of an outbreak of pneumonia due to Legionella pneumophila serogroup 1. Clin. Microbiol. Infect. 6:6469.
13. Domínguez, J. A.,, N. Galí,, L. Matas,, P. Pedroso,, A. Hernandez,, F. Padilla, and , V. Ausina. 1999. Evaluation of a rapid immunochromatographic assay for the detection of Legionella antigen in urine samples. Eur. J. Clin. Microbiol. Infect. Dis. 18:896898.
14. Domínguez, J. A.,, N. Galí,, P. Pedroso,, A. Fargas,, F. Padilla,, J. M. Manterola, and , L. Matas. 1998. Comparison of the Binax Legionella urinary antigen enzyme immunoassay (EIA) with the Biotest Legionella urine antigen EIA for detection of Legionella antigen in both concentrated and nonconcentrated urine samples. J. Clin. Microbiol. 36:27182722.
15. Edelstein, P. H. 1993. Legionnaires’ disease. Clin. Infect. Dis. 16:741749.
16. Fallon, R. J., and , W. H. Abraham. 1982. Polyvalent heat-killed antigen for the diagnosis of infection with Legionella pneumophila. J. Clin. Pathol. 35:434438.
17. Fallon, R. J., and , R. E. Johnston. 1987. Heterogeneity of antibody response in infection with Legionella pneumophila serogroup 1. J. Clin. Pathol. 40:569572.
18. Fry, A. M.,, M. Rutman,, T. Allan,, H. Scaife,, F. Salehi,, R. Benson,, B. Fields,, S. Nowicki,, M. K. Parrish,, J. Carpenter,, F. Brown,, C. Lucas,, T. Horgan,, F. Koch, and , R. E. Besser. 2003. Legionnaires’ disease outbreak in an automobile engine manufacturing plant. J. Infect. Dis. 187:10151018.
19. Harrison, T. G.,, N. Doshi,, G. Hallas, and , R. C. George. 1999. Legionella pneumophila antibody assays. An evaluation of commercial kits and reagents for the estimation of Legionella pneumophila antibody levels, p. 140. Respiratory and Systemic Infection Laboratory, Central Public Health Laboratory, Colindale, England.
20. Harrison, T. G., and , A. G. Taylor. 1988. The diagnosis of Legionnaires’ disease by estimation of antibody levels, p. 113135. In T. G. Harrison and , A. G. Taylor (ed.), A Laboratory Manual for Legionella. John Wiley & Sons, Ltd., Chichester, England.
21. Lennette, D. A.,, E. T. Lennette,, B. B. Wentworth,, M. L. French, and , G. L. Lattimer. 1979. Serology of Legionnaires’ disease: comparison of indirect fluorescent antibody, immune adherence hemagglutination, and indirect hemagglutination tests. J. Clin. Microbiol. 10:876879.
22. Malan, A. K.,, T. B. Martins,, T. D. Jaskowski,, H. R. Hill, and , C. M. Litwin. 2003. Comparison of two commercial enzyme-linked immunosorbent assays with an immunofluorescence assay for detection of Legionella pneumophila types one to 6. J. Clin. Microbiol. 41:30603063.
23. Marshall, L. E.,, T. C. Boswell, and , G. Kudesia. 1994. False positive legionella serology in campylobacter infection: campylobacter serotypes, duration of antibody response and elimination of cross-reactions in the indirect fluorescent antibody test. Epidemiol. Infect. 112:347357.
24. Mclntyre, M.,, J. B. Kurtz, and , J. B. Selkon. 1990. Prevalence of antibodies to 15 antigens of Legionellaceae in patients with community-acquired pneumonia. Epidemiol. Infect. 104:3945.
25. Plouffe, J. F.,, T. M. File, Jr.,, R. F. Breiman,, B. A. Hackman,, S. J. Salstrom,, B. J. Marston,, B. S. Fields, and the Community Based Pneumonia Incidence Study Group. 1995. Reevaluation of the definition of Legionnaires’ disease: use of the urinary antigen assay. Clin. Infect. Dis. 20:12861291.
26. Reingold, A. L.,, B. M. Thomason,, B. J. Brake,, L. Thacker,, H. W. Wilkinson, and , J. N. Kuritsky. 1984. Legionella pneumonia in the United States: the distribution of serogroups and species causing human illness. J. Infect. Dis. 149:819.
27. Wilkinson, H. W. 1983. Status of serologic tests for Legionella antigen and antibody at the Centers for Disease Control. Zentbl. Bakteriol. Mikrobiol. Hyg. A 255:37.
28. Wilkinson, H. W.,, C. E. Farshy,, B. J. Fikes,, D. D. Cruce, and , L. P. Yealy. 1979. Measure of immunoglobulin G-, M-, and A-specific titers against Legionella pneumophila and inhibition of titers against nonspecific, gram-negative bacterial antigens in the indirect immunofluorescence test for legionellosis. J. Clin. Microbiol. 10:685689.
29. Wilkinson, H. W.,, A. L. Reingold,, B. J. Brake,, D. L. McGiboney,, G. W. Gorman, and , C. V. Broome. 1983. Reactivity of serum from patients with suspected legionellosis against 29 antigens of Legionellaceae and Legionella-like organisms by indirect immunofluorescence assay. J. Infect. Dis. 147:2331.
30. Yonke, C. A.,, H. E. Stiefel,, D. L. Wilson, and , B. B. Wentworth. 1981. Evaluation of an indirect hemagglutination test for Legionella pneumophila serogroups 1 to 4. J. Clin. Microbiol. 13:10401045.
31. 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.


Generic image for table

strains used for IFA antigens

Citation: Edelstein P. 2006. Detection of Antibodies to , p 468-476. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch55

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