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Medicina
Croatian Medical Association - Rijeka branch
ISSN: 0025-7729
Vol. 45, No. 1, 2009, pp. 78-86 		Bioline Code: me09011
Full paper language: Croatian
Document type: Research Article
Document available free of charge

Medicina, Vol. 45, No. 1, 2009, pp. 78-86

 en Legionella pneumophila check for this species in other resources infections in Primorsko-goranska county
Tićac, Brigita; Žižić, Igor; Kesovija, Palmira; Farkaš, Maja; Pahor, Đana & Rukavina, Tomislav

Abstract

Aim: Bacteria of the genus Legionella check for this species in other resources are important causes of both community-acquired and nosocomial pneumonia. However, the majority of cases are clinically indistinguishable from other causes of pneumonia and it cannot be reliably diagnosed on clinical grounds alone. The etiological diagnosis depends mostly on culture, antigen detection, serological or molecular tests. Methods: Present paper represents the results of retrospective analysis of tests performed at the Department of Microbiology the Teaching Institute of Public Health in Rijeka between 2003 to 2008. In our laboratories most of the cases were diagnosed by the detection of Legionella antigen in urine and/or serological determination with enzyme immunoassay (EIA) test of the anti-Legionella IgM fraction as the most recent answer to infection.
Results: Overall 97 urine samples and 112 sera of patients from Primorsko-Goranska County were analysed. L. pneumophila O1 antigen in urine was detected in 5 (5 %) of 97 samples. Serologically EIA detected IgM in overall 13 (12 %) of all samples tested. IgM only was found in 4 (21 %) samples, IgM plus IgA and IgG in 5 (26 %), IgM plus IgA in 3 (16 %), IgM plus IgG in 1 (5 %), and IgG alone was found in 6 (32 %) of 19 positive samples. Overall, from 2003 to 2008 L. pneumophila positive results were found in samples from 8 patients.
Discussion and Conclusions: Detection of IgM using a sensitive technique such as EIA seems to be a suitable complement to antigenuria detection for the diagnosis of legionellosis. EIA for the detection of L. pneumophila serogroup O1 antigen in urine specimens is a specific assay which is of great importance in providing a rapid diagnosis of Legionnaires’ disease.

Keywords
anti-Legionella antibodies; diagnosis; Legionella O1 antigen; Legionella pneumophila

 
 hr Infekcije vrstom Legionella pneumophila check for this species in other resources u Primorsko-goranskoj županiji
Tićac, Brigita; Žižić, Igor; Kesovija, Palmira; Farkaš, Maja; Pahor, Đana & Rukavina, Tomislav


Cilj: Bakterije roda Legionella check for this species in other resources značajni su uzročnici nozokomijalnih pneumonija, kao i pneumonija koje se javljaju u zajednici. U većini slučajeva klinički nije moguće razlikovati pneumonije uzrokovane legionelama od onih nastalih ostalim atipičnim uzročnicima. Etiološka dijagnoza zasniva se prije svega na kultivaciji, detekciji antigena, serodijagnostici i molekularnim testovima.
Metode: U radu smo retrospektivno analizirali rezultate pretraga izvršenih na Mikrobiološkom odjelu Nastavnog zavoda za javno zdravstvo u Rijeci od 2003. do 2008. godine. U našim laboratorijima u većini slučajeva legioneloza je dijagnosticirana detekcijom Legionella antigena u urinu i/ili imunoenzimskim (EIA) anti Legionella IgM pretragama kao najranijim serološkim pokazateljem infekcije.
Rezultati: Sveukupno je obrađeno 97 uzoraka urina i 112 seruma prikupljenih od bolesnika s područja Primorsko-goranske županije. L. pneumophila O1 antigen otkriven je u 5 (5 %) od 97 uzoraka urina. Serološki je EIA metodom utvrđena prisutnost IgM protutijela u ukupno 13 obrađenih uzoraka (12 %). Samo IgM detektiran je u 4 (21 %), IgM plus IgA i IgG u 5 (26 %), IgM i IgA u 3 (16 %), IgM i IgG u 1 (5 %), i samo IgG protutijela u 6 (32 %) od 19 pozitivnih uzoraka seruma. U konačnici, u razdoblju od 2003. do 2008. godine pozitivni nalazi na bakteriju L. pneumophila utvrđeni su u uzorcima od ukupno 8 bolesnika.
Rasprava i zaključci: Detekcija IgM protutijela primjenom osjetljive metode kao što je imunoenzimski test – EIA pokazala se pogodnom u kombinaciji s detekcijom antigena u urinu za dijagnostiku legioneloza. EIA za otkrivanje L. pneumophila seroskupine O1 antigena u urinu predstavlja specifičnu metodu koja je osobito značajna za brzu dijagnostiku legionarske bolesti.


anti Legionella protutijela; dijagnostika; Legionella O1 antigen; Legionella pneumophila

 
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