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Identification of legionella in clinical samples.
[legionellosis]
Currently
,
several
methods
are
used
for
the
detection
of
Legionella
in
clinical
samples
,
and
these
methods
constitute
part
of
the
criteria
for
defining
legionellosis
cases
.
Urinary
antigen
detection
is
the
first
-line
diagnostic
test
,
although
this
test
is
limited
to
L
.
pneumophila
serogroup
1
(
Lp
1
)
(
Helbig
et
al
.
,
J
Clin
Microbiol
41
:
838
-
840
,
2003
)
.
The
use
of
molecular
techniques
can
improve
Legionaire
's
disease
(
LD
)
diagnosis
by
detecting
other
serogroups
and
species
(
Diederen
et
al
.
,
J
Clin
Microbiol
46
:
671
-
677
,
2008
)
.
The
isolation
of
Legionella
strains
from
pulmonary
samples
by
axenic
culture
is
still
required
to
perform
further
epidemiological
investigations
(
Blyth
et
al
.
,
N
S
W
Public
Health
Bull
20
:
157
-
161
,
2009
;
Fields
et
al
.
,
Clin
Microbiol
Rev
15
:
506
-
526
,
2002
)
but
demonstrates
various
sensitivities
.
Amoebic
coculture
has
been
described
as
a
method
to
recover
Legionella
from
clinical
culture-negative
specimens
(
La
Scola
et
al
.
,
J
Clin
Microbiol
39
:
365
-
366
,
2001
;
Rowbotham
,
J
Clin
Pathol
36
:
978
-
986
,
1983
)
and
can
be
proposed
for
optimizing
Legionella
strain
isolation
from
samples
contaminated
by
oropharyngeal
flora
.
Identification
of
Legionella
isolates
is
based
on
serological
characterization
,
genotypic
methods
(
with
sequencing
of
the
mip
gene
as
the
standard
method
)
and
,
more
recently
,
the
Matrix-assisted
laser
desorption
/
ionization
time-of-flight
mass
spectrometry
(
MALDI-TOF
MS
)
method
.
This
chapter
is
limited
to
the
identification
of
Legionella
in
clinical
samples
;
antibody
detection
in
human
serum
will
not
be
discussed
.
Diseases
Validation
Diseases presenting
"although this test is limited to l"
symptom
legionellosis
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