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Chapter 35 : Human Leukocyte Antigen Typing in Legionella-Positive Transplant Patients
This chapter compares human leukocyte antigen (HLA) frequency and HLA haplotype frequency in Legionella-positive patients with frequencies in healthy individuals from a local panel (control group). Sputum, bronchoalveolar lavage (BAL), or urine obtained from 114 patients after solid organ (heart, kidney, liver, pancreas) transplantation were examined for the presence of Legionella by using the culture method (sputum, BAL), and the direct fluorescent antibody assay method (sputum, BAL), and by the detection of urinary antigen (urine) during the 4 months after transplantation. A buffered charcoal-yeast extract medium (OXOID) was the culture method used in parallel with BMPA and GVPC selective supplements. Legionella serotypes were determined by using microagglutination test. The monoclonal antibody of MONOFLUO L. pneumophila IFA test kit was used for the direct fluorescent-antibody assay method. The urinary antigen was detected by using Legionella Urin antigen enzyme immunoassay. Differences were found in HLA-A antigen frequencies and HLA-B antigen frequencies between Legionella-positive patients and a control group. Differences in HLA A-B haplotypes and HLA A-B-DR haplotypes were not statistically significant between healthy individuals and Legionella-positive patients. Several published reports suggest that natural resistance or susceptibility to infection with Legionella might be genetically determined. However, no significant difference in HLA class II antigens and the frequencies of haplotypes HLA A-B and HLA A-B-DR was found between both defined groups.