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Chapter 49 : Legionella

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Legionella, Page 1 of 2

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Abstract:

Legionnaires’ disease (LD) is a type of pneumonia caused by the spp. is the most common cause of the disease and, along with , causes disease in both immunocompetent and immunosuppressed people. The >50 other named spp. rarely cause LD and do so exclusively in immunocompromised patients. The spp. are aerobic Gram-negative bacilli that are found mainly in aqueous environments. Humans are accidental hosts of these bacteria, acquiring LD by inhalation or aspiration of environmental bacteria. The bacteria can be grown on buffered yeast extract medium. Bacterial identification can be difficult because of the nonreactivity of the bacteria in biochemical tests. Laboratory diagnosis of LD is based on the use of selective culture media, detection of urinary antigen, antibody detection, and molecular amplification methods, such as PCR. Culture diagnosis is insensitive but very specific, having the highest yield in severely ill and immunosuppressed patients. Urine antigen testing is fast, easy, and relatively sensitive, especially for community-acquired LD, but around 30% of LD patients have negative urine tests. Molecular-amplification diagnosis, such as PCR, appears to be more sensitive than other methods, but the lack of FDA-cleared assays limits its use to large reference laboratories in the United States. Strain typing is mainly sequence based, with monoclonal antibody reactivity being a useful, quick screening test.

Citation: Edelstein P, LÜCK C. 2015. Legionella, p 887-904. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch49
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Figures

Image of FIGURE 1
FIGURE 1

Photomicrographs of . (A) Gimenez stain of intracellular bacteria from a patient with lung infection. (B) Gram stain using a basic fuchsin counterstain of a colony taken from a BCYEα plate. Note the dramatic size and shape differences between the intracellular and extracellular bacteria. (C) Direct immunofluorescent staining of in lung. doi:10.1128/9781555817381.ch49.f1

Citation: Edelstein P, LÜCK C. 2015. Legionella, p 887-904. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch49
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Image of FIGURE 2
FIGURE 2

Photographs of colonies growing on BCYEα agar. Note the internal speckling and different colors that may be seen, sometimes in the same culture. doi:10.1128/9781555817381.ch49.f2

Citation: Edelstein P, LÜCK C. 2015. Legionella, p 887-904. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch49
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Image of FIGURE 3
FIGURE 3

Identification flow scheme for basic identification of spp. grown from a BCYEα plate. Abbreviations: BCYE, BCYEα; BCYE-L, BCYEα made without -cysteine; BAP, tryptic soy blood agar; UV light, colony fluorescence and color when illuminated with long-wave (360-nm) UV light. doi:10.1128/9781555817381.ch49.f3

Citation: Edelstein P, LÜCK C. 2015. Legionella, p 887-904. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch49
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References

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1. Zusman T,, Yerushalmi G,, Segal G. 2003. Functional similarities between the icm/dot pathogenesis systems of Coxiella burnetii and Legionella pneumophila. Infect Immun 71:37143723.
2. Garrity GM,, Brown A,, Vickers RM. 1980. Tatlockia and Fluoribacter: two new genera of organisms resembling Legionella pneumophila. Int J Syst Bacteriol 30:609614.
3. Fry NK,, Warwick S,, Saunders NA,, Embley TM. 1991. The use of 16S ribosomal RNA analyses to investigate the phylogeny of the family Legionellaceae. J Gen Microbiol 137:12151222.
4. Adeleke AA,, Fields BS,, Benson RF,, Daneshvar MI,, Pruckler JM,, Ratcliff RM,, Harrison TG,, Weyant RS,, Birtles RJ,, Raoult D,, Halablab MA. 2001. Legionella drozanskii sp. nov., Legionella rowbothamii sp. nov. and Legionella fallonii sp. nov.: three unusual new Legionella species. Int J Syst Evol Microbiol 51:11511160.
5. Gomez-Valero L,, Rusniok C,, Jarraud S,, Vacherie B,, Rouy Z,, Barbe V,, Medigue C,, Etienne J,, Buchrieser C. 2011. Extensive recombination events and horizontal gene transfer shaped the Legionella pneumophila genomes. BMC Genomics 12:536.
6. Cazalet C,, Rusniok C,, Bruggemann H,, Zidane N,, Magnier A,, Ma L,, Tichit M,, Jarraud S,, Bouchier C,, Vandenesch F,, Kunst F,, Etienne J,, Glaser P,, Buchrieser C. 2004. Evidence in the Legionella pneumophila genome for exploitation of host cell functions and high genome plasticity. Nat Genet 36:11651173.
7. Cazalet C,, Jarraud S,, Ghavi-Helm Y,, Kunst F,, Glaser P,, Etienne J,, Buchrieser C. 2008. Multigenome analysis identifies a worldwide distributed epidemic Legionella pneumophila clone that emerged within a highly diverse species. Genome Res 18:431441.
8. Whiley H,, Bentham R. 2011. Legionella longbeachae and legionellosis. Emerg Infect Dis 17:579583.
9. Lau R,, Maqsood S,, Harte D,, Caughley B,, Deacon R. 2013. Prevalence of Legionella strains in cooling towers and legionellosis cases in New Zealand. J Environ Health 75:8289.
10. Cazalet C,, Gomez-Valero L,, Rusniok C,, Lomma M,, Dervins-Ravault D,, Newton HJ,, Sansom FM,, Jarraud S,, Zidane N,, Ma L,, Bouchier C,, Etienne J,, Hartland EL,, Buchrieser C. 19 February 2010. Analysis of the Legionella longbeachae genome and transcriptome uncovers unique strategies to cause Legionnaires’ disease. PLoS Genet 6:e1000851. 10.1371/journal.pgen.1000851.
11. Ratcliff RM. 2013. Sequence-based identification of Legionella. Methods Mol Biol 954:5772.
12. Cianciotto NP,, Hilbi H,, Buchrieser C,. 2013. Legionnaires’ disease, p 147216. In Rosenberg E,, DeLong EF,, Lory S,, Stackebrandt E,, Thompson F (ed), The Prokaryotes: Human Microbiology, 4th ed. Springer-Verlag, New York, NY.
13. Kozak NA,, Buss M,, Lucas CE,, Frace M,, Govil D,, Travis T,, Olsen-Rasmussen M,, Benson RF,, Fields BS. 2010. Virulence factors encoded by Legionella longbeachae identified on the basis of the genome sequence analysis of clinical isolate D-4968. J Bacteriol 192:10301044.
14. Edelstein PH,, Edelstein MA,, Shephard LJ,, Ward KW,, Ratcliff RM. 2012. Legionella steelei sp. nov., isolated from human respiratory specimens in California, USA, and South Australia. Int J Syst Evol Microbiol 62:17661771.
15. Edelstein PH,, Roy CR,. 2014. Legionella, p 26332644. In Bennett JE,, Dolin R,, Blaser MJ (ed), Mandells, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 8th ed. Elsevier, Philadelphia, PA.
16. Fraser DW,, Tsai TR,, Orenstein W,, Parkin WE,, Beecham HJ,, Sharrar RG,, Harris J,, Mallison GF,, Martin SM,, McDade JE,, Shepard CC,, Brachman PS. 1977. Legionnaires’ disease: description of an epidemic of pneumonia. N Engl J Med 297:11891197.
17. McDade JE,, Shepard CC,, Fraser DW,, Tsai TR,, Redus MA,, Dowdle WR. 1977. Legionnaires’ disease: isolation of a bacterium and demonstration of its role in other respiratory disease. N Engl J Med 297:11971203.
18. Osterholm MT,, Chin TD,, Osborne DO,, Dull HB,, Dean AG,, Fraser DW,, Hayes PS,, Hall WN. 1983. A 1957 outbreak of Legionnaires’ disease associated with a meat packing plant. Am J Epidemiol 117:6067.
19. Rowbotham TJ. 1986. Current views on the relationships between amoebae, legionellae and man. Isr J Med Sci 22:678689.
20. O’Connor BA,, Carman J,, Eckert K,, Tucker G,, Givney R,, Cameron S. 2007. Does using potting mix make you sick? Results from a Legionella longbeachae case-control study in South Australia. Epidemiol Infect 135:3439.
21. Ginevra C,, Forey F,, Campese C,, Reyrolle M,, Che D,, Etienne J,, Jarraud S. 2008. Lorraine strain of Legionella pneumophila serogroup 1, France. Emerg Infect Dis 14:673675.
22. Harrison TG,, Afshar B,, Doshi N,, Fry NK,, Lee JV. 2009. Distribution of Legionella pneumophila serogroups, monoclonal antibody subgroups and DNA sequence types in recent clinical and environmental isolates from England and Wales (2000–2008). Eur J Clin Microbiol Infect Dis 28:781791.
23. Doleans A,, Aurell H,, Reyrolle M,, Lina G,, Freney J,, Vandenesch F,, Etienne J,, Jarraud S. 2004. Clinical and environmental distributions of Legionella strains in France are different. J Clin Microbiol 42:458460.
24. Kozak NA,, Benson RF,, Brown E,, Alexander NT,, Taylor THJr,, Shelton BG,, Fields BS. 2009. Distribution of lag-1 alleles and sequence-based types among Legionella pneumophila serogroup 1 clinical and environmental isolates in the United States. J Clin Microbiol 47:25252535.
25. Helbig JH,, Uldum SA,, Bernander S,, Luck PC,, Wewalka G,, Abraham B,, Gaia V,, Harrison TG. 2003. Clinical utility of urinary antigen detection for diagnosis of community-acquired, travel-associated, and nosocomial legionnaires’ disease. J Clin Microbiol 41:838840.
26. Helbig JH,, Uldum SA,, Luck PC,, Harrison TG. 2001. Detection of Legionella pneumophila antigen in urine samples by the BinaxNOW immunochromatographic assay and comparison with both Binax Legionella Urinary Enzyme Immunoassay (EIA) and Biotest Legionella Urin Antigen EIA. J Med Microbiol 50:509516.
27. Marston BJ,, Plouffe JF,, File TMJr,, Hackman BA,, Salstrom SJ,, Lipman HB,, Kolczak MS,, Breiman RF. 1997. Incidence of community-acquired pneumonia requiring hospitalization. Results of a population-based active surveillance study in Ohio. The Community-Based Pneumonia Incidence Study Group. Arch Intern Med 157:17091718.
28. von Baum H,, Ewig S,, Marre R,, Suttorp N,, Gonschior S,, Welte T,, Lück C. 2008. Community-acquired Legionella pneumonia: new insights from the German competence network for community acquired pneumonia. Clin Infect Dis 46:13561364.
29. Murdoch DR,, Podmore RG,, Anderson TP,, Barratt K,, Maze MJ,, French KE,, Young SA,, Chambers ST,, Werno AM. 2013. Impact of routine systematic polymerase chain reaction testing on case finding for Legionnaires’ disease: a pre-post comparison study. Clin Infect Dis 57:12751281.
30. Centers for Disease Control and Prevention. 2011. Legionellosis—United States, 2000–2009. MMWR Morb Mortal Wkly Rep 60:10831086.
31. Beauté J,, Zucs P,, de Jong B. 2013. Legionnaires disease in Europe, 2009–2010. Euro Surveill 18:20417.
32. den Boer JW,, Yzerman EP,, Schellekens J,, Lettinga KD,, Boshuizen HC,, Van Steenbergen JE,, Bosman A,, Van den HS,, Van Vliet HA,, Peeters MF,, van Ketel RJ,, Speelman P,, Kool JL,, Conyn-van Spaendonck MA. 2002. A large outbreak of Legionnaires’ disease at a flower show, the Netherlands, 1999. Emerg Infect Dis 8:3743.
33. Isberg RR,, O’Connor TJ,, Heidtman M. 2009. The Legionella pneumophila replication vacuole: making a cosy niche inside host cells. Nat Rev Microbiol 7:1324.
34. Benin AL,, Benson RF,, Besser RE. 2002. Trends in legionnaires disease, 1980–1998: declining mortality and new patterns of diagnosis. Clin Infect Dis 35:10391046.
35. Edelstein PH. 1995. Antimicrobial chemotherapy for Legionnaires’ disease: a review. Clin Infect Dis 21:S265S276.
36. Mykietiuk A,, Carratalà J,, Fernández-Sabé N,, Dorca J,, Verdaguer R,, Manresa F,, Gudiol F. 2005. Clinical outcomes for hospitalized patients with Legionella pneumonia in the antigenuria era: the influence of levofloxacin therapy. Clin Infect Dis 40:794799.
37. Grau S,, Antonio JM,, Ribes E,, Salvado M,, Garces JM,, Garau J. 2006. Impact of rifampicin addition to clarithromycin in Legionella pneumophila pneumonia. Int J Antimicrob Agents 28:249252.
38. Fields BS,, Haupt T,, Davis JP,, Arduino MJ,, Miller PH,, Butler JC. 2001. Pontiac fever due to Legionella micdadei from a whirlpool spa: possible role of bacterial endotoxin. J Infect Dis 184:12891292.
39. Gotz HM,, Tegnell A,, De J,, Broholm KA,, Kuusi M,, Kallings I,, Ekdahl K. 2001. A whirlpool associated outbreak of Pontiac fever at a hotel in Northern Sweden. Epidemiol Infect 126:241247.
40. Ferrer A,, Bellver P,, Royo P. 1995. Screening quality of respiratory samples and Legionella pneumoniae [sic]. J Clin Microbiol 33:1971.
41. Ingram JG,, Plouffe JF. 1994. Danger of sputum purulence screens in culture of Legionella species. J Clin Microbiol 32:209210.
42. Edelstein PH,. 2010. Urinary antigen detection for Legionella spp., p 17. In Garcia LS (ed), Clinical Microbiology Procedures Handbook, 3rd ed. ASM Press, Washington, DC.
43. Rigby EW,, Plouffe JF,, Hackman BA,, Hill DS,, Benson RF,, Breiman RF. 1997. Stability of Legionella urinary antigens over time. Diagn Microbiol Infect Dis 28:13.
44. Edelstein PH,. 2006. Detection of antibodies to Legionella, p 468476. In Detrick B,, Hamilton RG,, Folds JD (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th ed. ASM Press, Washington, DC.
45. Faine S,, Edelstein P,, Kirby BD,, Finegold SM. 1979. Rapid presumptive bacteriological diagnosis of Legionnaires disease. J Clin Microbiol 10:104105.
46. Winn WCJr. 1985. Legionella and Legionnaires’ disease: a review with emphasis on environmental studies and laboratory diagnosis. Crit Rev Clin Lab Sci 21:323381.
47. Bentz JS,, Carroll K,, Ward JH,, Elstad M,, Marshall CJ. 2000. Acid-fast-positive Legionella pneumophila: a possible pitfall in the cytologic diagnosis of mycobacterial infection in pulmonary specimens. Diagn Cytopathol 22:4548.
48. Hilton E,, Freedman RA,, Cintron F,, Isenberg HD,, Singer C. 1986. Acid-fast bacilli in sputum: a case of Legionella micdadei pneumonia. J Clin Microbiol 24:11021103.
49. Edelstein PH,, Meyer RD,, Finegold SM. 1980. Laboratory diagnosis of Legionnaires’ disease. Am Rev Respir Dis 121:317327.
50. Edelstein PH,. 2004. Detection of Legionella antigen by direct immunofluorescence, p 11.3.111.3.7. In Isenberg HD (ed), Clinical Microbiology Procedures Handbook, 2nd ed. ASM Press, Washington, DC.
51. She RC,, Billetdeaux E,, Phansalkar AR,, Petti CA. 2007. Limited applicability of direct fluorescent-antibody testing for Bordetella sp. and Legionella sp. specimens for the clinical microbiology laboratory. J Clin Microbiol 45:22122214.
52. Helbig JH,, Uldum SA,, Lück PC,, Harrison TG,. 2003. Detection of Legionella pneumophila antigen in urine samples: recognition of serogroups and monoclonal serogroups, p 204206. In Marre R,, Abu Kwaik Y,, Bartlett C,, Cianciotto NP,, Fields BS,, Frosch M,, Hacker J,, Lück PC (ed), Legionella. ASM Press, Washington, DC.
53. Bruin JP,, Diederen BM. 2013. Evaluation of Meridian TRU Legionella®, a new rapid test for detection of Legionella pneumophila serogroup 1 antigen in urine samples. Eur J Clin Microbiol Infect Dis 32:333334.
54. Svarrer CW,, Luck C,, Elverdal PL,, Uldum SA. 2012. Immunochromatic kits Xpect Legionella and BinaxNOW Legionella for detection of Legionella pneumophila urinary antigen have low sensitivities for the diagnosis of Legionnaires’ disease. J Med Microbiol 61:27.
55. Domínguez JA,, Galí N,, Pedroso P,, Fargas A,, Padilla E,, Manterola JM,, Matas L. 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.
56. Horn J,. 2002. Comparison of non-serogroup 1 detection by Biotest and Binax Legionella urinary antigen enzyme immunoassays, p 207210. In Marre R,, Abu Kwaik Y,, Bartlett C,, Cianciotto NP,, Fields BS,, Frosch M,, Hacker J,, Lück PC (ed), Legionella. ASM Press, Washington, DC.
57. Domínguez JA,, Manterola JM,, Blavia R,, Sopena N,, Belda FJ,, Padilla E,, Gimenez M,, Sabria M,, Morera J,, Ausina V. 1996. Detection of Legionella pneumophila serogroup-1 antigen in nonconcentrated urine and urine concentrated by selective ultrafiltration. J Clin Microbiol 34:23342336.
58. Guerrero C,, Toldos CM,, Yagüe G,, Ramírez C,, Rodríguez T,, Segovia M. 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 Microbiol 42:467468.
59. Diederen BM,, Peeters MF. 2007. Evaluation of the SAS Legionella Test, a new immunochromatographic assay for the detection of Legionella pneumophila serogroup 1 antigen in urine. Clin Microbiol Infect 13:8688.
60. Mentasti M,, Fry NK,, Afshar B,, Palepou-Foxley C,, Naik FC,, Harrison TG. 2012. Application of Legionella pneumophila-specific quantitative real-time PCR combined with direct amplification and sequence-based typing in the diagnosis and epidemiological investigation of Legionnaires’ disease. Eur J Clin Microbiol Infect Dis 31:20172028.
61. Jespersen S,, Sogaard OS,, Fine MJ,, Ostergaard L. 2009. The relationship between diagnostic tests and case characteristics in Legionnaires’ disease. Scand J Infect Dis 41:425432.
62. Murdoch DR. 2003. Diagnosis of Legionella infection. Clin Infect Dis 36:6469.
63. Bencini MA,, van den Brule AJ,, Claas EC,, Hermans MH,, Melchers WJ,, Noordhoek GT,, Salimans MM,, Schirm J,, Vink C,, van der Zee A,, Jansen R. 2007. Multicenter comparison of molecular methods for detection of Legionella spp. in sputum samples. J Clin Microbiol 45:33903392.
64. Herpers BL,, de Jongh BM,, van der Zee K,, van Hannen EJ. 2003. Real-time PCR assay targets the 23S-5S spacer for direct detection and differentiation of Legionella spp. and Legionella pneumophila. J Clin Microbiol 41:48154816.
65. Nazarian EJ,, Bopp DJ,, Saylors A,, Limberger RJ,, Musser KA. 2008. Design and implementation of a protocol for the detection of Legionella in clinical and environmental samples. Diagn Microbiol Infect Dis 62:125132.
66. Mérault N,, Rusniok C,, Jarraud S,, Gomez-Valero L,, Cazalet C,, Marin M,, Brachet E,, Aegerter P,, Gaillard JL,, Etienne J,, Herrmann JL,, DELPH-I Study Group,, Lawrence C,, Buchrieser C. 2011. Specific real-time PCR for simultaneous detection and identification of Legionella pneumophila serogroup 1 in water and clinical samples. Appl Environ Microbiol 77:17081717.
67. Benitez AJ,, Winchell JM. 2013. Clinical application of a multiplex real-time PCR assay for simultaneous detection of Legionella species, Legionella pneumophila, and Legionella pneumophila serogroup 1. J Clin Microbiol 51:348351.
68. Templeton KE,, Scheltinga SA,, Sillekens P,, Crielaard JW,, van Dam AP,, Goossens H,, Claas EC. 2003. Development and clinical evaluation of an internally controlled, single-tube multiplex real-time PCR assay for detection of Legionella pneumophila and other Legionella species. J Clin Microbiol 41:40164021.
69. Loens K,, Beck T,, Ursi D,, Overdijk M,, Sillekens P,, Goossens H,, Ieven M. 2008. Evaluation of different nucleic acid amplification techniques for the detection of M. pneumoniae, C. pneumoniae and Legionella spp. in respiratory specimens from patients with community-acquired pneumonia. J Microbiol Methods 73:257262.
70. Diederen BM,, Kluytmans JA,, Vandenbroucke-Grauls CM,, Peeters MF. 2008. Utility of real-time PCR for diagnosis of Legionnaires’ disease in routine clinical practice. J Clin Microbiol 46:671677.
71. Luck PC,, Ecker C,, Reischl U,, Linde HJ,, Stempka R. 2007. Culture-independent identification of the source of an infection by direct amplification and sequencing of Legionella pneumophila DNA from a clinical specimen. J Clin Microbiol 45:31433144.
72. Ginevra C,, Lopez M,, Forey F,, Reyrolle M,, Meugnier H,, Vandenesch F,, Etienne J,, Jarraud S,, Molmeret M. 2009. Evaluation of a nested-PCR-derived sequence-based typing method applied directly to respiratory samples from patients with Legionnaires’ disease. J Clin Microbiol 47:981987.
73. van der Zee A,, Peeters M,, de Jong C,, Verbakel H,, Crielaard JW,, Claas EC,, Templeton KE. 2002. Qiagen DNA extraction kits for sample preparation for Legionella PCR are not suitable for diagnostic purposes. J Clin Microbiol 40:1126.
74. Evans GE,, Murdoch DR,, Anderson TP,, Potter HC,, George PM,, Chambers ST. 2003. Contamination of Qiagen DNA extraction kits with Legionella DNA. J Clin Microbiol 41:34523453. (Letter.)
75. Shen H,, Rogelj S,, Kieft TL. 2006. Sensitive, real-time PCR detects low-levels of contamination by Legionella pneumophila in commercial reagents. Mol Cell Probes 20:147153.
76. Schuetz AN,, Hughes RL,, Howard RM,, Williams TC,, Nolte FS,, Jackson D,, Ribner BS. 2009. Pseudo-outbreak of Legionella pneumophila serogroup 8 infection associated with a contaminated ice machine in a bronchoscopy suite. Infect Control Hosp Epidemiol 30:461466.
77. Mitchell DH,, Hicks LJ,, Chiew R,, Montanaro JC,, Chen SC. 1997. Pseudoepidemic of Legionella pneumophila serogroup 6 associated with contaminated bronchoscopes. J Hosp Infect 37:1923.
78. Descours G,, Suet A,, Ginevra C,, Campese C,, Slimani S,, Ader F,, Che D,, Lina G,, Jarraud S. 2012. Contribution of amoebic coculture to recovery of Legionella isolates from respiratory samples: prospective analysis over a period of 32 months. J Clin Microbiol 50:17251726.
79. Edelstein PH,, Snitzer JB,, Bridge JA. 1982. Enhancement of recovery of Legionella pneumophila from contaminated respiratory tract specimens by heat. J Clin Microbiol 16:10611065.
80. Edelstein PH,, Finegold SM. 1979. Use of a semiselective medium to culture Legionella pneumophila from contaminated lung specimens. J Clin Microbiol 10:141143.
81. Morrill WE,, Barbaree JM,, Fields BS,, Sanden GN,, Martin WT. 1990. Increased recovery of Legionella micdadei and Legionella bozemanii on buffered charcoal yeast extract agar supplemented with albumin. J Clin Microbiol 28:616618.
82. Steele TW,, Lanser J,, Sangster N. 1990. Isolation of Legionella longbeachae serogroup 1 from potting mixes. Appl Environ Microbiol 56:4953.
83. Edelstein PH,, Edelstein MA. 2010. Comparison of the plating efficiencies and shelf lives of three different commercial buffered charcoal yeast extract media supplemented with alpha-ketoglutaric acid. J Clin Microbiol 48:18821883.
84. Edelstein PH,. 1999. The guinea-pig model of Legionnaires’ disease, p 303314. In Zak O,, Sande MA (ed), Handbook of Animal Models of Infection. Academic Press, London, United Kingdom.
85. Dennis PJ,, Taylor JA,, Barrow GI. 1981. Phosphate buffered, low sodium chloride blood agar medium for Legionella pneumophila. Lancet ii:636.
86. Westerman EL,, McDonald J. 1983. Tularemia pneumonia mimicking legionnaires’ disease: isolation of organism on CYE agar and successful treatment with erythromycin. South Med J 76:11691170.
87. Thacker L,, McKinney RM,, Moss CW,, Sommers HM,, Spivack ML,, O’Brien TF. 1981. Thermophilic sporeforming bacilli that mimic fastidious growth characteristics and colonial morphology of legionella. J Clin Microbiol 13:794797.
88. Ng V,, Weir L,, York MK,, Hadley WK. 1992. Bordetella pertussis versus non-L. pneumophila Legionella spp.: a continuing diagnostic challenge. J Clin Microbiol 30:33003301.
89. Kerr E,, Snell H,, Black BL,, Storey M,, Colby WD. 1992. Isolation of Nocardia asteroides from respiratory specimens by using selective buffered charcoal-yeast extract agar. J Clin Microbiol 30:13211322.
90. Vickers RM,, Rihs JD,, Yu VL. 1992. Clinical demonstration of isolation of Nocardia asteroides on buffered charcoal-yeast extract media. J Clin Microbiol 30:227228.
91. Pasculle AW,, McDevitt D,. 2004. Legionella cultures, p 3.11.4.13.11.4.14. In Isenberg HD (ed), Clinical Microbiology Procedures Handbook, 2nd ed. ASM Press, Washington, DC.
92. Dowling JN,, Kroboth FJ,, Karpf M,, Yee RB,, Pasculle AW. 1983. Pneumonia and multiple lung abscesses caused by dual infection with Legionella micdadei and Legionella pneumophila. Am Rev Respir Dis 127:121125.
93. Meyer RD,, Edelstein PH,, Kirby BD,, Louie MH,, Mulligan ME,, Morgenstein AA,, Finegold SM. 1980. Legionnaires’ disease: unusual clinical and laboratory features. Ann Intern Med 93:240243.
94. Luck PC,, Wenchel HM,, Helbig JH. 1998. Nosocomial pneumonia caused by three genetically different strains of Legionella pneumophila and detection of these strains in the hospital water supply. J Clin Microbiol 36:11601163.
95. Thacker WL,, Wilkinson HW,, Benson RF. 1983. Comparison of slide agglutination test and direct immunofluorescence assay for identification of Legionella isolates. J Clin Microbiol 18:11131118.
96. Edelstein PH,, Edelstein MAC. 1989. Evaluation of the Merifluor-Legionella immunofluorescent reagent for identifying and detecting 21 Legionella species. J Clin Microbiol 27:24552458.
97. Wilkinson HW,, Thacker WL,, Steigerwalt AG,, Brenner DJ,, Ampel NM,, Wing EJ. 1985. Second serogroup ofLegionella hackeliae isolated from a patient with pneumonia. J Clin Microbiol 22:488489.
98. Thacker WL,, Benson RF,, Wilkinson HW,, Ampel NM,, Wing EJ,, Steigerwalt AG,, Brenner DJ. 1986. 11th serogroup of Legionella pneumophila isolated from a patient with fatal pneumonia. J Clin Microbiol 23:11461147.
99. Pelaz C,, García Albert L,, Bourgon CM. 1987. Cross-reactivity among Legionella species and serogroups. Epidemiol Infect 99:641646.
100. Richardson IR,, Lightfoot NF. 1992. Legionella pneumophila species identification using a commercial latex agglutination kit: a potential cross-reaction problem with serogroup 12. Med Lab Sci 49:144146.
101. Tateyama M. 1992. Misleading serological identification of Legionella anisa as Legionella bozemanii. Kansenshogaku Zasshi 66:149155.
102. Thacker WL,, Benson RF,, Schifman RB,, Pugh E,, Steigerwalt AG,, Mayberry WR,, Brenner DJ,, Wilkinson HW. 1989. Legionella tucsonensis sp. nov. isolated from a renal transplant recipient. J Clin Microbiol 27:18311834.
103. Benson RF,, Thacker WL,, Lanser JA,, Sangster N,, Mayberry WR,, Brenner DJ. 1991. Legionella adelaidensis, a new species isolated from cooling tower water. J Clin Microbiol 29:10041006.
104. Thacker WL,, Dyke JW,, Benson RF,, Havlichek DH,Jr,, Robinson-Dunn B,, Stiefel H,, Schneider W,, Moss CW,, Mayberry WR,, Brenner DJ. 1992. Legionella lansingensis sp. nov. isolated from a patient with pneumonia and underlying chronic lymphocytic leukemia. J Clin Microbiol 30:23982401.
105. Edelstein PH,, McKinney RM,, Meyer RD,, Edelstein MAC,, Krause CJ,, Finegold SM. 1980. Immunologic diagnosis of Legionnaires’ disease: cross-reactions with anaerobic and microaerophilic organisms and infections caused by them. J Infect Dis 141:652655.
106. Klein GC. 1980. Cross-reaction to Legionella pneumophila antigen in sera with elevated titers to Pseudomonas pseudomallei. J Clin Microbiol 11:2729.
107. Collins MT,, Espersen F,, Høiby N,, Cho SN,, Friss-Møller A,, Reif JS. 1983. Cross-reactions between Legionella pneumophila (serogroup 1) and twenty-eight other bacterial species, including other members of the family Legionellaceae. Infect Immun 39:14411456.
108. Glupczynski Y,, Labbe M,, Yourassowsky E. 1984. Cross-reactivity of environmental bacteria with fluorescent-antibody conjugates for Legionella pneumophila. Eur J Clin Microbiol Infect Dis 3:215.
109. Benson RF,, Thacker WL,, Plikaytis BB,, Wilkinson HW. 1987. Cross-reactions in Legionella antisera with Bordetella pertussis strains. J Clin Microbiol 25:594596.
110. Chen S,, Hicks L,, Yuen M,, Mitchell D,, Gilbert GL. 1994. Serological cross-reaction between Legionella spp. and Capnocytophaga ochracea by using latex agglutination test. J Clin Microbiol 32:30543055.
111. Jimenez-Lucho V,, Shulman M,, Johnson J. 1994. Bordetella bronchiseptica in an AIDS patient cross-reacts with Legionella antisera. J Clin Microbiol 32:30953096.
112. Cercenado E,, Edelstein PH,, Gosting LH,, Sturge JC. 1987. Legionella micdadei and Legionella dumoffii monoclonal antibodies for laboratory diagnosis of Legionella infections. J Clin Microbiol 25:21632167.
113. Edelstein PH,, Beer KB,, Sturge JC,, Watson AJ,, Goldstein LC. 1985. Clinical utility of a monoclonal direct fluorescent reagent specific for Legionella pneumophila: comparative study with other reagents. J Clin Microbiol 22:419421.
114. Helbig JH,, Luck PC,, Witzleb W. 1994. Serogroup-specific and serogroup-cross-reactive epitopes of Legionella pneumophila. Int J Med Microbiol Virol Parasitol Infect Dis 281:1623.
115. Tenover FC,, Edelstein PH,, Goldstein LC,, Sturge JC,, Plorde JJ. 1986. Comparison of cross-staining reactions by Pseudomonas spp. and fluorescein-labeled polyclonal and monoclonal antibodies directed against Legionella pneumophila. J Clin Microbiol 23:647649.
116. Brenner DJ. 1987. Classification of the legionellae. Semin Respir Infect 2:190205.
117. Svarrer CW,, Uldum SA. 2012. The occurrence of Legionella species other than Legionella pneumophila in clinical and environmental samples in Denmark identified by mip gene sequencing and matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Clin Microbiol Infect 18:10041009.
118. Liu H,, Li Y,, Huang X,, Kawamura Y,, Ezaki T. 2003. Use of the dnaJ gene for the detection and identification of all Legionella pneumophila serogroups and description of the primers used to detect 16S rDNA gene sequences of major members of the genus Legionella. Microbiol Immunol 47:859869.
119. Ratcliff RM,, Lanser JA,, Manning PA,, Heuzenroeder MW. 1998. Sequence-based classification scheme for the genus Legionella targeting the mip gene. J Clin Microbiol 36:15601567.
120. Riffard S,, Vandenesch F,, Reyrolle M,, Etienne J. 1996. Distribution of mip-related sequences in 39 species (48 serogroups) of Legionellaceae. Epidemiol Infect 117:501506.
121. La Scola B,, Birtles RJ,, Greub G,, Harrison TJ,, Ratcliff RM,, Raoult D. 2004. Legionella drancourtii sp. nov., a strictly intracellular amoebal pathogen. Int J Syst Evol Microbiol 54:699703.
122. Fry NK,, Rowbotham TJ,, Saunders NA,, Embley TM. 1991. Direct amplification and sequencing of the 16S ribosomal DNA of an intracellular Legionella species recovered by amoebal enrichment from the sputum of a patient with pneumonia. FEMS Microbiol Lett 67:165168.
123. Park MY,, Ko KS,, Lee HK,, Park MS,, Kook YH. 2003. Legionella busanensis sp. nov., isolated from cooling tower water in Korea. Int J Syst Evol Microbiol 53:7780.
124. LoPresti F,, Riffard S,, Meugnier H,, Reyrolle M,, Lasne Y,, Grimont PA,, Grimont F,, Vandenesch F,, Etienne J,, Fleurette J,, Freney J. 1999. Legionella taurinensis sp. nov., a new species antigenically similar to Legionella spiritensis. Int J Syst Bacteriol 49:397403.
125. Wilson DA,, Reischl U,, Hall GS,, Procop GW. 2007. Use of partial 16S rRNA gene sequencing for identification of Legionella pneumophila and non-pneumophila Legionella spp. J Clin Microbiol 45:257258.
126. Ko KS,, Lee HK,, Park MY,, Lee KH,, Yun YJ,, Woo SY,, Miyamoto H,, Kook YH. 2002. Application of RNA polymerase beta-subunit gene (rpoB) sequences for the molecular differentiation of Legionella species. J Clin Microbiol 40:26532658.
127. Riffard S,, LoPresti F,, Normand P,, Forey F,, Reyrolle M,, Etienne J,, Vandenesch F. 1998. Species identification of Legionella via intergenic 16S-23S ribosomal spacer PCR analysis. Int J Syst Bacteriol 48:723730.
128. Thürmer A,, Helbig JH,, Jacobs E,, Lück PC. 2009. PCR-based ‘serotyping’ of Legionella pneumophila. J Med Microbiol 58:588595.
129. Harrison TG,, Saunders NA,, Haththotuwa A,, Doshi N,, Taylor AG. 1992. Further evidence that genotypically closely related strains of Legionella pneumophila can express different serogroup specific antigens. J Med Microbiol 37:155161.
130. Luck PC,, Birtles RJ,, Helbig JH. 1995. Correlation of MAb subgroups with genotype in closely related Legionella pneumophila serogroup 1 strains from a cooling tower. J Med Microbiol 43:5054.
131. Brenner DJ,, Steigerwalt AG,, Epple P,, Bibb WF,, McKinney RM,, Starnes RW,, Colville JM,, Selander RK,, Edelstein PH,, Moss CW. 1988. Legionella pneumophila serogroup Lansing 3 isolated from a patient with fatal pneumonia, and descriptions of L. pneumophila subsp. pneumophila subsp. nov., L. pneumophila subsp. fraseri subsp. nov., and L. pneumophila subsp. pascullei subsp. nov. J Clin Microbiol 26:16951703.
132. Kool JL,, Buchholz U,, Peterson C,, Brown EW,, Benson RF,, Pruckler JM,, Fields BS,, Sturgeon J,, Lehnkering E,, Cordova R,, Mascola LM,, Butler JC. 2000. Strengths and limitations of molecular subtyping in a community outbreak of Legionnaires’ disease. Epidemiol Infect 125:599608.
133. Heath TC,, Roberts C,, Jalaludin B,, Goldthrope I,, Capon AG. 1998. Environmental investigation of a legionellosis outbreak in western Sydney: the role of molecular profiling. Aust N Z J Public Health 22:428431.
134. Lawrence C,, Reyrolle M,, Dubrou S,, Forey F,, Decludt B,, Goulvestre C,, Matsiota-Bernard P,, Etienne J,, Nauciel C. 1999. Single clonal origin of a high proportion of Legionella pneumophila serogroup 1 isolates from patients and the environment in the area of Paris, France, over a 10-year period. J Clin Microbiol 37:26522655.
135. Huang B,, Heron BA,, Gray BR,, Eglezos S,, Bates JR,, Savill J. 2004. A predominant and virulent Legionella pneumophila serogroup 1 strain detected in isolates from patients and water in Queensland, Australia, by an amplified fragment length polymorphism protocol and virulence gene-based PCR assays. J Clin Microbiol 42:41644168.
136. Pruckler JM,, Mermel LA,, Benson RF,, Giorgio C,, Cassiday PK,, Breiman RF,, Whitney CG,, Fields BS. 1995. Comparison of Legionella pneumophila isolates by arbitrarily primed PCR and pulsed-field gel electrophoresis: analysis from seven epidemic investigations. J Clin Microbiol 33:28722875.
137. Aurell H,, Etienne J,, Forey F,, Reyrolle M,, Girardo P,, Farge P,, Decludt B,, Campese C,, Vandenesch F,, Jarraud S. 2003. Legionella pneumophila serogroup 1 strain Paris: endemic distribution throughout France. J Clin Microbiol 41:33203322.
138. Drenning SD,, Stout JE,, Joly JR,, Yu VL. 2001. Unexpected similarity of pulsed-field gel electrophoresis patterns of unrelated clinical isolates of Legionella pneumophila, serogroup 1. J Infect Dis 183:628632.
139. Gaia V,, Fry NK,, Afshar B,, Luck PC,, Meugnier H,, Etienne J,, Peduzzi R,, Harrison TG. 2005. Consensus sequence-based scheme for epidemiological typing of clinical and environmental isolates of Legionella pneumophila. J Clin Microbiol 43:20472052.
140. Fry NK,, Bangsborg JM,, Bernander S,, Etienne J,, Forsblom B,, Gaia V,, Hasenberger P,, Lindsay D,, Papoutsi A,, Pelaz C,, Struelens M,, Uldum SA,, Visca P,, Harrison TG. 2000. Assessment of intercentre reproducibility and epidemiological concordance of Legionella pneumophila serogroup 1 genotyping by amplified fragment length polymorphism analysis. Eur J Clin Microbiol Infect Dis 19:773780.
141. Ratzow S,, Gaia V,, Helbig JH,, Fry NK,, Luck PC. 2007. Addition of neuA, the gene encoding N-acylneuraminate cytidylyl transferase, increases the discriminatory ability of the consensus sequence-based scheme for typing Legionella pneumophila serogroup 1 strains. J Clin Microbiol 45:19651968.
142. Reuter S,, Harrison TG,, Koser CU,, Ellington MJ,, Smith GP,, Parkhill J,, Peacock SJ,, Bentley SD,, Torok ME. 9 January 2013. A pilot study of rapid whole-genome sequencing for the investigation of a Legionella outbreak. BMJ Open 3:e002175. 10.1136/bmjopen-2012-00217.
143. Nagington J,, Wreghitt TG,, Tobin JO,, Macrae AD. 1979. The antibody response in Legionnaires’ disease. J Hyg (Lond) 83:377381.
144. Bruin JP,, Koshkolda T,, IJzerman EP,, Luck C,, Diederen BM,, den Boer JW,, Mouton JW. 2014. Isolation of ciprofloxacin-resistant Legionella pneumophila in a patient with severe pneumonia. J Antimicrob Chemother 69:28692871.
145. Edelstein PH,, Edelstein MAC,, Ren JJ,, Polzer R,, Gladue RP. 1996. Activity of trovafloxacin (cp-99,219) against Legionella isolates: in-vitro activity, intracellular accumulation and killing in macrophages, and pharmacokinetics and treatment of guinea-pig with L. pneumophila pneumonia. Antimicrob Agents Chemother 40:314319.
146. Ogawa M,, Takade A,, Miyamoto H,, Taniguchi H,, Yoshida S. 2001. Morphological variety of intracellular microcolonies of Legionella species in Vero cells. Microbiol Immunol 45:557562.
147. Muder RR,, Yu VL. 2002. Infection due to Legionella species other than L. pneumophila. Clin Infect Dis 35:990998.

Tables

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TABLE 1

Selected characteristics of the spp.

Citation: Edelstein P, LÜCK C. 2015. Legionella, p 887-904. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch49
Generic image for table
TABLE 2

Composition and selectivity of media used to grow spp. from clinical and environmental specimens

Citation: Edelstein P, LÜCK C. 2015. Legionella, p 887-904. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch49

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