Correction: First Case of Legionnaire's Disease Caused by Legionella anisa in Spain and the Limitations on the Diagnosis of Legionella non-pneumophila Infections

Vaccaro, Lucianna; Izquierdo, F.; Magnet, Ángela; Hurtado, Carolina; Salinas, Mireya; Gomes, Thiago Santos; Angulo, Santiago; Salso, Santiago; Pelaez, Jesús; Tejeda, Maria Isabel; Alhambra, Almudena; Gómez, Carmen; Enríquez, Ana; Estirado, Eva; Fenoy, S.; Águila, C. del

doi:10.1371/journal.pone.0162934

Cited by 7 publications

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“…The reliability of PCR in diagnosing LD is more and more recognised by the scientific community and recent studies demonstrated a better performance of PCR compared with other diagnostic assays, regardless of the type of respiratory sample (bronchoalveolar lavage or sputum) [9,13]. Moreover, PCR can also detect the presence of all Legionella species some of which are notoriously difficult to isolate by culture [19].…”

Section: Discussionmentioning

confidence: 99%

Improvement of Legionnaires’ disease diagnosis using real-time PCR assay: a retrospective analysis, Italy, 2010 to 2015

Ricci

Grottola

Serpini³

et al. 2018

Eurosurveillance

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AimTo evaluate real-time PCR as a diagnostic method for Legionnaires’ disease (LD). Detection of Legionella DNA is among the laboratory criteria of a probable LD case, according to the European Centre for Disease Prevention and Control, although the utility and advantages, as compared to culture, are widely recognised.MethodsTwo independent laboratories, one using an in-house and the other a commercial real-time PCR assay, analysed 354 respiratory samples from 311 patients hospitalised with pneumonia between 2010–15. The real-time PCR reliability was compared with that of culture and urinary antigen tests (UAT). Concordance, specificity, sensitivity and positive and negative predictive values (PPV and NPV, respectively) were calculated.ResultsOverall PCR detected eight additional LD cases, six of which were due to Legionella pneumophila (Lp) non-serogroup 1. The two real-time PCR assays were concordant in 99.4% of the samples. Considering in-house real-time PCR as the reference method, specificity of culture and UAT was 100% and 97.9% (95% CI: 96.2–99.6), while the sensitivity was 63.6% (95%CI: 58.6–68.6) and 77.8% (95% CI: 72.9–82.7). PPV and NPV for culture were 100% and 93.7% (95% CI: 91.2-96.3). PPV and NPV for UAT were 87.5% (95% CI: 83.6-91.4) and 95.8% (95% CI: 93.5-98.2).ConclusionRegardless of the real-time PCR assay used, it was possible to diagnose LD cases with higher sensitivity than using culture or UAT. These data encourage the adoption of PCR as routine laboratory testing to diagnose LD and such methods should be eligible to define a confirmed LD case.

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Section: Discussionmentioning

confidence: 99%

Improvement of Legionnaires’ disease diagnosis using real-time PCR assay: a retrospective analysis, Italy, 2010 to 2015

Ricci

Grottola

Serpini³

et al. 2018

Eurosurveillance

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Enumeration and characterization of five pathogenic Legionella species from large research and educational buildings

Logan-Jackson

Flood

Rose

2021

Environ. Sci.: Water Res. Technol.

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The Contribution of Legionella anisa to Legionella Contamination of Water in the Built Environment

Crook,

Young,

Rideout

et al. 2024

IJERPH

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Legionella bacteria can proliferate in poorly maintained water systems, posing risks to users. All Legionella species are potentially pathogenic, but Legionella pneumophila (L. pneumophila) is usually the primary focus of testing. However, Legionella anisa (L. anisa) also colonizes water distribution systems, is frequently found with L. pneumophila, and could be a good indicator for increased risk of nosocomial infection. Anonymized data from three commercial Legionella testing laboratories afforded an analysis of 565,750 water samples. The data covered July 2019 to August 2021, including the COVID-19 pandemic. The results confirmed that L. anisa commonly colonizes water distribution systems, being the most frequently identified non-L. pneumophila species. The proportions of L. anisa and L. pneumophila generally remained similar, but increases in L. pneumophila during COVID-19 lockdown suggest static water supplies might favor its growth. Disinfection of hospital water systems was effective, but re-colonization did occur, appearing to favor L. pneumophila; however, L. anisa colony numbers also increased as a proportion of the total. While L. pneumophila remains the main species of concern as a risk to human health, L. anisa’s role should not be underestimated, either as a potential infection risk or as an indicator of the need to intervene to control Legionella’s colonization of water supplies.

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Correction: First Case of Legionnaire's Disease Caused by Legionella anisa in Spain and the Limitations on the Diagnosis of Legionella non-pneumophila Infections

Cited by 7 publications

References 1 publication

Improvement of Legionnaires’ disease diagnosis using real-time PCR assay: a retrospective analysis, Italy, 2010 to 2015

Improvement of Legionnaires’ disease diagnosis using real-time PCR assay: a retrospective analysis, Italy, 2010 to 2015

Enumeration and characterization of five pathogenic Legionella species from large research and educational buildings

The Contribution of Legionella anisa to Legionella Contamination of Water in the Built Environment

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