scholarly journals Diagnosis of Legionella pneumonia based on Legionella urinary antigen testing of serum instead of urine in a hemodialysis patient

2017 ◽  
Vol 50 (10) ◽  
pp. 641-646 ◽  
Author(s):  
Maiko Kimura ◽  
Takehiko Kawaguchi ◽  
Moritoshi Kadomura ◽  
Satoshi Kumakura ◽  
Eri Okada ◽  
...  
Keyword(s):  
Hemodialysis Patient ◽  
Urinary Antigen ◽  
Legionella Pneumonia ◽  
Urinary Antigen Testing ◽  
Antigen Testing

scholarly journals Legionella pneumonia presenting with bilateral flank pain, hyponatraemia and acute renal failure

2013 ◽  
Vol 5 (6) ◽  
pp. 96
Author(s):  
Celia Birkin ◽  
Chandra Shekhar Biyani ◽  
Anthony J. Browning
Keyword(s):  
Gastrointestinal Symptoms ◽  
Community Acquired Pneumonia ◽  
Flank Pain ◽  
High Fever ◽  
Urinary Antigen ◽  
Legionella Pneumonia ◽  
Urinary Antigen Testing ◽  
Legionella Species ◽  
Legionnaires Disease ◽  
Antigen Testing

Legionnaires’ disease (LD) is an often overlooked but a possiblecause of sporadic community acquired pneumonia. High fever,cough and gastrointestinal symptoms are non-specific symptoms.Hyponatremia is more common in LD than pneumonia linkedwith other causes. A definitive diagnosis is usually confirmed byculture, urinary antigen testing for Legionella species. Macolideor quinolone antibiotic is the treatment of choice. We describe acase of Legionella pneumonia presenting with high fever, bilateralflank pain and oliguria. It is important for clinicians to be awareof this diagnosis when managing patients with flank pain. Thecase highlights the problems in differentiating LD from renal colicand the importance of proper history, physical examination withlaboratory tests for appropriate management.

A Recurrent Outbreak of Nosocomial Legionnaires' Disease Detected by Urinary Antigen Testing: Evidence for Long-Term Colonization of a Hospital Plumbing System

1998 ◽  
Vol 19 (12) ◽  
pp. 905-910 ◽  
Author(s):  
Lisa A. Lepine ◽  
Daniel B. Jernigan ◽  
Jay C. Butler ◽  
Janet M. Pruckler ◽  
Robert F. Benson ◽  
...  
Keyword(s):  
Plumbing System ◽  
Urinary Antigen ◽  
Urinary Antigen Testing ◽  
Legionnaires Disease ◽  
Antigen Testing

Evaluation of pneumococcal urinary antigen testing for respiratory tract infection investigations

2020 ◽  
Vol 50 (1) ◽  
pp. 57-62 ◽  
Author(s):  
F. Charton ◽  
P.L. Conan ◽  
H. Le Floch ◽  
O. Bylicki ◽  
W. Gaspard ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Urinary Antigen ◽  
Urinary Antigen Testing ◽  
Antigen Testing

scholarly journals Environmental Cultures and Hospital-Acquired Legionnaires' Disease: A 5-Year Prospective Study in 20 Hospitals in Catalonia, Spain

2004 ◽  
Vol 25 (12) ◽  
pp. 1072-1076 ◽  
Author(s):  
Miquel Sabrià ◽  
Josep M. Mòdol ◽  
Marian Garcia-Nuñez ◽  
Esteban Reynaga ◽  
Maria L. Pedro-Botet ◽  
...  
Keyword(s):  
Prospective Study ◽  
Potable Water ◽  
Environmental Study ◽  
Urinary Antigen ◽  
Hospital Acquired Pneumonia ◽  
Urinary Antigen Testing ◽  
Legionnaires Disease ◽  
Hospital Acquired ◽  
Antigen Testing

AbstractObjective:To determine whether environmental cultures forLegionellaincrease the index of suspicion for legionnaires' disease (LD).Design:Five-year prospective study.Setting:Twenty hospitals in Catalonia, Spain.Methods:From 1994 to 1996, the potable water systems of 20 hospitals in Catalonia were tested forLegionella, Cases of hospital-acquired LD and availability of an “in-house”Legionellatest in the previous 4 years were assessed. After the hospitals were informed of the results of their water cultures, a prospective 5-year-study was conducted focusing on the detection of new cases of nosocomial legionellosis and the availability and use of Legionella testing.Results:Before environmental cultures were started, only one hospital had conducted active surveillance of hospital-acquired pneumonia and usedLegionellatests includingLegionellaurinary antigen in all pneumonia cases. Only one other hospital had used the latter test at all. In six hospitals,Legionellatests had been completely unavailable. Cases of nosocomial LD had been diagnosed in the previous 4 years in only two hospitals. During prospective surveillance, 12 hospitals (60%) usedLegionellaurinary antigen testing in house and 11 (55%) found cases of nosocomial legionellosis, representing 64.7% (11 of 17) of those with positive water cultures. Hospitals with negative water cultures did not find nosocomial LD.Conclusions:The environmental study increased the index of suspicion for nosocomial LD. The number of cases of nosocomial LD increased significantly during the prospective follow-up period, and most hospitals began using theLegionellaurinary antigen test in their laboratories.

Rapid urinary antigen testing for the investigation of bacteraemic respiratory pneumococcal disease; underutilised and undervalued?

2017 ◽  
Vol 74 (2) ◽  
pp. 198-200 ◽  
Author(s):  
Ciara O'Connor ◽  
Fintan O'Hara ◽  
Cormac McCarthy ◽  
Ross Morgan ◽  
Hilary Humphreys
Keyword(s):  
Pneumococcal Disease ◽  
Urinary Antigen ◽  
Urinary Antigen Testing ◽  
Antigen Testing

scholarly journals Pneumococcal Urinary Antigen Testing in US Hospitals: Underutilized and Rarely Acted Upon

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S17-S17
Author(s):  
Sarah Haessler ◽  
Jennifer Schimmel ◽  
Pei-Chun Yu ◽  
Michael Rothberg
Keyword(s):  
Large Scale ◽  
Clinical Care ◽  
Urinary Antigen ◽  
Substantial Impact ◽  
Prescribing Behavior ◽  
Urinary Antigen Testing ◽  
And Performance ◽  
Antigen Testing ◽  
Culture Positive ◽  
Research Grant

Abstract Background The IDSA guideline for CAP recommends Pneumococcal urinary antigen testing (UAT) in addition to blood and sputum cultures for patients with severe CAP. In controlled settings, UAT is 50–80% sensitive and >90% specific; however, its utility and performance on a large-scale in real-world use has not been assessed. It is unclear whether UAT is clinically useful or whether the results impact prescribing behavior. Methods Retrospective cohort study of adult patients admitted with CAP or HCAP from 2010 to 2015 at 170 US hospitals that submit data to Premier. Date and time-stamped administrative and microbiologic data were assessed. Patients with a principal diagnosis of pneumonia, or sepsis with a secondary diagnosis of pneumonia plus a CXR and antibiotics within the first 24 hours, were included if they had a UAT plus either a blood or respiratory culture within the first 48 hours of admission. Results Of 159,894 eligible pneumonia patients, 24,757 (15.5%) had UAT plus either blood or respiratory cultures performed. Of 1,797 (7%) who had a positive UAT, 457 (25%) also grew S. pneumoniae (SP) from blood or respiratory cultures, 1,240 (69%) had negative cultures, and 100 (6%) an organism other than SP, with S. aureus, Pseudomonas spp., and E.coli being the most common pathogens, predominantly from respiratory cultures. Among 22,960 patients with a negative UAT, 429 (2%) had a positive blood or respiratory culture for SP and 2,653 (12%) had a culture positive for another organism. UAT was performed among 18.4% of patients admitted to the ICU, and 15.3% of those admitted to wards. Among patients empirically started on broad-spectrum antibiotics, 35% who had a positive UAT were de-escalated by Day 5, compared with 49% who grew SP in blood cultures and 24% in respiratory cultures. Conclusion In a large representative US inpatient database, there was poor concordance between UAT and cultures for SP. A positive UAT decreased the probability of having a non-SP pathogen. Antibiotic de-escalation occurred more often in association with a positive blood culture for SP than for UAT or positive respiratory culture, but occurred in less than half the patients with these markers of pneumococcal pneumonia. Overall, UAT is underutilized and does not appear to have a substantial impact on clinical care. Disclosures S. Haessler, AHRQ: Investigator, Research grant; P. C. Yu, AHRQ: Investigator, Research grant; M. Rothberg, AHRQ: Investigator, Research grant

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