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Chapter 37 : Detection of Antigen in Urine Samples: Recognition of Serogroups and Monoclonal Subgroups

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Detection of Antigen in Urine Samples: Recognition of Serogroups and Monoclonal Subgroups, Page 1 of 2

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Abstract:

A study by Benson et al. compared the usefulness of urinary antigen detection for diagnosing Legionnaires’ disease caused by serogroup 1 of different monoclonal subgroups in addition to cases caused by other serogroups. A total of 152 urine samples from 152 patients with culture-proven legionellosis were tested. Urine samples were tested simultaneously using Binax urinary enzyme immunoassay (EIA) and Biotest Urin Antigen enzyme immunoassay (EIA). Taking all cases of legionellosis into account, a sensitivity of 77% for both Binax EIA and Biotest EIA was found. This is in good agreement with other studies. In addition, the authors demonstrated that the sensitivities for infections caused by monoclonal antibody (MAb) 3/1- and MAb 2-positive strains are much higher, exceeding 95%; thus, urinary antigen detection is the best method for diagnosing community-acquired as well as travel-associated cases. Diagnosis of such infections has especially far-reaching implications for nosocomially acquired legionellosis, which is significantly more often caused by strains belonging to monoclonal subgroups OLDA/Oxford and Bellingham or to serogroups 2 to 15 than are community-acquired infections.

Citation: Helbig J, Lück C, Uldum S, Harrison T. 2002. Detection of Antigen in Urine Samples: Recognition of Serogroups and Monoclonal Subgroups, p 204-206. In Marre R, Abu Kwaik Y, Bartlett C, Cianciotto N, Fields B, Frosch M, Hacker J, Lück P (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555817985.ch37

Key Concept Ranking

Legionella pneumophila
0.6923077
Enzyme Immunoassay
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References

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1. Aguero-Rosenfeld, M. E.,, and P. H. Edelstein. 1988. Retrospective evaluation of the Du Pont radioimmunoassay kit for detection of Legionella pneumophila serogroup 1 antigenuria in humans. J. Clin. Microbiol. 26:17751778.
2. Benson, R. F.,, P. W. Tang,, and B. S. Fields. 2000. Evaluation of the Binax and Biotest urinary antigen kits for the detection of Legionnaires' disease due to multiple serogroups and species of Legionella. J. Clin. Microbiol. 38:27632765.
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7. Joly, J. R.,, R. M. McKinney,, O. J. Tobin,, W. F. Bibb,, I. D. Watkins,, and D. Ramsay. 1986. Development of a standardized subgrouping scheme for Legionella pneumophila serogroup 1 using monoclonal antibodies. J. Clin. Microbiol. 23:768771.
8. Joseph, C. A.,, J. M. Watson,, T. G. Harrison,, and C. L. R. Bartlett. 1994. Nosocomial Legionnaires' disease in England and Wales, 19801992. Epidemiol. Infect. 112:329345.
9. Kazandjian, D.,, R. Chiew,, and G. L. Gilbert. 1997. Rapid diagnosis of Legionella pneumophila serogroup 1 infections with the Binax enzyme immunoassay urinary antigen test. J. Clin. Microbiol. 35:954956.
10. Plouffe, J. F.,, T. M. Mile,, R. F. Breiman,, B. A. Hackmann,, 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.
11. Ruf, B.,, D. Schürmann,, I. Horbach,, F. J. Fehrenbach,, and H. D. Pohle. 1990. Prevalence and diagnosis of Legionella pneumonia: a 3-year prospective study with emphasis on application of urinary antigen detection. J. Infect. Dis. 162:13411348.

Tables

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TABLE 1

Urinary antigen detection in specimens from culture-proven legionellosis

Citation: Helbig J, Lück C, Uldum S, Harrison T. 2002. Detection of Antigen in Urine Samples: Recognition of Serogroups and Monoclonal Subgroups, p 204-206. In Marre R, Abu Kwaik Y, Bartlett C, Cianciotto N, Fields B, Frosch M, Hacker J, Lück P (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555817985.ch37

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