The Adequacy of Current Legionnaires’ Disease Diagnostic Practices in Capturing the Epidemiology of Clinically Relevant Legionella: A Scoping Review

Ryan Ha; Ashley Heilmann; Sylvain A. Lother; Christine Turenne; David Alexander; Yoav Keynan; Zulma Vanessa Rueda

doi:10.3390/pathogens13100857

journal article Open Access Oct 01, 2024

The Adequacy of Current Legionnaires’ Disease Diagnostic Practices in Capturing the Epidemiology of Clinically Relevant Legionella: A Scoping Review

Ryan Ha Ashley Heilmann Sylvain A. Lother Christine Turenne David Alexander

Yoav Keynan

Zulma Vanessa Rueda

Pathogens Vol. 13 No. 10 pp. 857 · MDPI AG

View at Publisher Save 10.3390/pathogens13100857

Abstract

Legionella is an underdiagnosed and underreported etiology of pneumonia. Legionella pneumophila serogroup 1 (LpSG1) is thought to be the most common pathogenic subgroup. This assumption is based on the frequent use of a urinary antigen test (UAT), only capable of diagnosing LpSG1. We aimed to explore the frequency of Legionella infections in individuals diagnosed with pneumonia and the performance of diagnostic methods for detecting Legionella infections. We conducted a scoping review to answer the following questions: (1) “Does nucleic acid testing (NAT) increase the detection of non-pneumophila serogroup 1 Legionella compared to non-NAT?”; and (2) “Does being immunocompromised increase the frequency of pneumonia caused by non-pneumophila serogroup 1 Legionella compared to non-immunocompromised individuals with Legionnaires’ disease (LD)?”. Articles reporting various diagnostic methods (both NAT and non-NAT) for pneumonia were extracted from several databases. Of the 3449 articles obtained, 31 were included in our review. The most common species were found to be L. pneumophila, L. longbeachae, and unidentified Legionella species appearing in 1.4%, 0.9%, and 0.6% of pneumonia cases. Nearly 50% of cases were caused by unspecified species or serogroups not detected by the standard UAT. NAT-based techniques were more likely to detect Legionella than non-NAT-based techniques. The identification and detection of Legionella and serogroups other than serogroup 1 is hampered by a lack of application of broader pan-Legionella or pan-serogroup diagnostics.

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Details

Published: Oct 01, 2024
Vol/Issue: 13(10)
Pages: 857
License: View

Authors

R

Ryan Ha

Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 745 Bannatyne Ave., Winnipeg, MB R3E 0J9, Canada

A

Ashley Heilmann

Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 745 Bannatyne Ave., Winnipeg, MB R3E 0J9, Canada

S

Sylvain A. Lother

Department of Internal Medicine, University of Manitoba, 750 Bannatyne Ave., Winnipeg, MB R3A 1R9, Canada

C

Christine Turenne

Shared Health, Diagnostic Services, 1502-155 Carlton St, Winnipeg, MB R3C 3H8, Canada

D

David Alexander

Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 745 Bannatyne Ave., Winnipeg, MB R3E 0J9, Canada; Cadham Provincial Laboratory, Shared Health, 750 William Ave., Winnipeg, MB R3E 3J7, Canada

Y

Yoav Keynan

Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 745 Bannatyne Ave., Winnipeg, MB R3E 0J9, Canada; Department of Internal Medicine, University of Manitoba, 750 Bannatyne Ave., Winnipeg, MB R3A 1R9, Canada; Department of Community Health Sciences, University of Manitoba, 750 Bannatyne Ave., Winnipeg, MB R3E 0J9, Canada

Z

Zulma Vanessa Rueda

Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 745 Bannatyne Ave., Winnipeg, MB R3E 0J9, Canada; School of Medicine, Universidad Pontificia Bolivariana, Circular 1ª 70-01, Barrio Laureles, Medellín 050031, Colombia

Funding

Christopher Spitzke Critical Illness Research Endowment Fund Award: 950-232963

Canada Research Chairs Program Award: 950-232963

University of Manitoba Rady Faculty of Health Sciences Graduate Studentship Award: 950-232963

Cite This Article

Ryan Ha, Ashley Heilmann, Sylvain A. Lother, et al. (2024). The Adequacy of Current Legionnaires’ Disease Diagnostic Practices in Capturing the Epidemiology of Clinically Relevant Legionella: A Scoping Review. Pathogens, 13(10), 857. https://doi.org/10.3390/pathogens13100857

The Adequacy of Current Legionnaires’ Disease Diagnostic Practices in Capturing the Epidemiology of Clinically Relevant Legionella: A Scoping Review

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