Isolation of Legionella pneumophila serogroup 1 from blood with nonsupplemented blood culture bottles

Abstract

Legionella pneumophila serogroup 1 was isolated from antemortem aerobic blood culture bottles not supplemented with L-cysteine or ferric pyrophosphate and from the postmortem lung tissue of a 72-year-old man. We recommend that aerobic blood culture bottles (Johnston Laboratories, Cockeysville, Md.) of BACTEC be subcultured to an agar that supports the growth of L. pneumophila when growth indexes range from 30 to 60 but fail to increase further.

Legionnaires disease: historical perspective.

“…pneumophila was initially isolated from blood by using a biphasic medium (74). This species has been recovered by using a commercial radiometric blood culture system (43,216). In one case, a low positive growth indicator suggested the possibility of legionellae; in the other, daily blind subculture was required.…”

Update on detection of bacteremia and fungemia.

“…Single isolations have been reported by using biphasic blood culture media and supplemented proteose peptone broth (45,101,105,106). The BACTEC 460 instrument recovered isolates variably: in one study, aerobic 6B bottles were positive by growth index and subculture whereas the anaerobic 7D bottles were negative (32); in another study, the 7D bottles were positive by blind subculture whereas the aerobic bottles were negative (145). In this prospective study of 16 patients with Legionnaires' disease, 6 had positive BACTEC blood cultures, all determined by blind subculture of the anaerobic bottles (145).…”

Isolation of Legionella pneumophila from blood with the BACTEC system: a prospective study yielding positive results

“…At day 7 of the incubation, both aerobic and anaerobic bottles were subcultured to BCYE agar; two of the three aerobic bottles yielded L. pneumophila. As a result, Chester et al recommended that aerobic blood culture bottles be subcultured to Legionella media when BACTEC growth indices rise to the 30 to 60 range (1). We instituted a prospective search for L. pneumophila in BACTEC blood culture bottles taken from pneumonia patients in whom respiratory tract cultures yielded L. pneumophila.…”

“…Thus, the first clinical isolation of L. pneumophila was from blood. Since the American Legion Convention outbreak, there have been a few anecdotal reports of isolation from blood (1,4,5,7,9). In two of the reports, blood culture bottles supplemented with L-cysteine and ferric pyrophosphate were used (4, 7).…”