Evaluation of a novel urinary antigen test kit for diagnosing Legionella pneumonia

Akihiro Ito; Yoshihiro Yamamoto; Yoshikazu Ishii; Akihito Okazaki; Yoshihisa Ishiura; Yukio Kawagishi; Yasuo Takiguchi; Kazuma Kishi; Yoshio Taguchi; Takashi Shinzato; Yasumi Okochi; Ryuji Hayashi; Yoshitaka Nakamori; Yoshiko Kichikawa; Kengo Murata; Hiroaki Takeda; Futoshi Higa; Takayuki Miyara; Keisuke Saito; Takeo Ishikawa; Tadashi Ishida; Kazuhiro Tateda

doi:10.1016/j.ijid.2020.10.106

Evaluation of a novel urinary antigen test kit for diagnosing Legionella pneumonia

Int J Infect Dis. 2021 Feb:103:42-47. doi: 10.1016/j.ijid.2020.10.106. Epub 2020 Nov 8.

Authors

Akihiro Ito¹, Yoshihiro Yamamoto², Yoshikazu Ishii³, Akihito Okazaki⁴, Yoshihisa Ishiura⁵, Yukio Kawagishi⁶, Yasuo Takiguchi⁷, Kazuma Kishi⁸, Yoshio Taguchi⁹, Takashi Shinzato¹⁰, Yasumi Okochi¹¹, Ryuji Hayashi¹², Yoshitaka Nakamori¹³, Yoshiko Kichikawa¹⁴, Kengo Murata¹⁵, Hiroaki Takeda¹⁶, Futoshi Higa¹⁷, Takayuki Miyara¹⁸, Keisuke Saito¹⁹, Takeo Ishikawa²⁰, Tadashi Ishida²¹, Kazuhiro Tateda²²

Affiliations

¹ Department of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan. Electronic address: ai12306@kchnet.or.jp.
² Department of Clinical Infectious Diseases, Toyama University Hospital, 2630 Sugitani, Toyama, Toyama 930-0194, Japan. Electronic address: yamamoto@med.u-toyama.ac.jp.
³ Department of Microbiology and Infectious Diseases, Toho University School of Medicine, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan. Electronic address: yishii@med.toho-u.ac.jp.
⁴ Department of Respiratory Medicine, Koseiren Takaoka Hospital, 5-10 Eirakumachi, Takaoka, Toyama 933-8555, Japan. Electronic address: okazaki03325@kouseiren-ta.or.jp.
⁵ First Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi, Osaka 570-8507, Japan. Electronic address: ishiuray@takii.kmu.ac.jp.
⁶ Department of Internal Medicine, Kurobe City Hospital, 1108-1 Mikkaichi, Kurobe, Toyama 938-8502, Japan. Electronic address: kawagishi-tym@umin.ac.jp.
⁷ Department of Respiratory Medicine, Chiba Aoba Municipal Hospital, 1273-2 Aoba-chou, Chuo-ku, Chiba, Chiba 260-0852, Japan. Electronic address: takiguchi@ninus.ocn.ne.jp.
⁸ Department of Respiratory Medicine, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan. Electronic address: kazuma.kishi@med.toho-u.ac.jp.
⁹ Department of Respiratory Medicine, Tenri Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan. Electronic address: ytaguchi@tenriyorozu.jp.
¹⁰ Department of Infectious Diseases and Internal Medicine, Nakagami General Hospital, 610 Noborikawa, Okinawa, Okinawa 904-2195, Japan. Electronic address: takashinzato@nakagami.or.jp.
¹¹ Department of Respiratory Medicine, Japan Community Health Care Organization, Tokyo Yamate Medical Center, 3-22-1 Hyakunin-cho, Shinjuku-ku, Tokyo 169-0073, Japan. Electronic address: okochi@mac.com.
¹² Clinical Oncology, Toyama University Hospital, 2630 Sugitani, Toyama, Toyama 930-0194, Japan. Electronic address: hsayaka@med.u-toyama.ac.jp.
¹³ Division of Respiratory Medicine, Mishuku Hospital, 5-33-12 Kamimeguro, Meguro-ku, Tokyo 153-0051, Japan. Electronic address: nakamori@toranomon.or.jp.
¹⁴ Division of Respiratory Medicine, Mishuku Hospital, 5-33-12 Kamimeguro, Meguro-ku, Tokyo 153-0051, Japan. Electronic address: ykichi@mishuku.gr.jp.
¹⁵ Department of Respiratory Medicine, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo 183-8524, Japan. Electronic address: kengo_murata@tmhp.jp.
¹⁶ Department of Respiratory Medicine, Yamagata Saisei Hospital, 79-1 Okimachi, Yamagata, Yamagata 990-8545, Japan. Electronic address: takeda@ameria.org.
¹⁷ Department of Internal Medicine, National Hospital Organization Okinawa Hospital, 3-20-14 Ganeko, Ginowan, Okinawa 901-2214, Japan. Electronic address: fhiga-ok@umin.ac.jp.
¹⁸ Department of Infection Prevention and Control, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan. Electronic address: miyarat@med.kobe-u.ac.jp.
¹⁹ Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, Japan. Electronic address: keisuke@jikei.ac.jp.
²⁰ Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan Hospital, 4-11-1 Izumihoncho, Komae, Tokyo 201-8601, Japan. Electronic address: takeo-i@fa2.so-net.ne.jp.
²¹ Department of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan. Electronic address: ishidat@kchnet.or.jp.
²² Department of Microbiology and Infectious Diseases, Toho University School of Medicine, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan. Electronic address: kazu@med.toho-u.ac.jp.

PMID: 33176204
DOI: 10.1016/j.ijid.2020.10.106

Abstract

Objectives: The aim of this study was to evaluate the diagnostic utility of a novel test kit that could theoretically detect all serogroups of Legionella pneumophila for diagnosing Legionella pneumonia, in comparison with existing kits.

Methods: This study was conducted in 16 hospitals in Japan from April 2016 to December 2018. Three urinary antigen test kits were used: the novel kit (LAC-116), BinaxNOW Legionella (Binax), and Q-line Kyokutou Legionella (Q-line). In addition, sputum culture and nucleic acid detection tests and serum antibody tests were performed where possible. The diagnostic accuracy and correlations of the novel kit with the two existing kits were analyzed.

Results: In total, 56 patients were diagnosed with Legionella pneumonia. The sensitivities of LAC-116, Binax, and Q-line were 79%, 84%, and 71%, respectively. The overall match rate between LAC-116 and Binax was 96.8% and between LAC-116 and Q-line was 96.4%. One patient had L. pneumophila serogroup 2, and only LAC-116 showed a positive result, whereas Binax and Q-line did not.

Conclusions: The novel Legionella urinary antigen test kit was useful for diagnosing Legionella pneumonia. In addition, it could detect Legionella pneumonia caused by non-L. pneumophila serogroup 1.

Keywords: Diagnosis; Immunoassay; Legionella pneumophila; Pneumonia; Urinary antigen test.

Publication types

Evaluation Study

MeSH terms

Aged
Antigens, Bacterial / analysis*
Antigens, Bacterial / urine
Female
Humans
Japan
Legionella pneumophila / classification*
Legionella pneumophila / immunology
Legionella pneumophila / isolation & purification
Legionnaires' Disease / diagnosis*
Male
Middle Aged
Reagent Kits, Diagnostic
Sensitivity and Specificity
Serogroup

Substances

Antigens, Bacterial
Reagent Kits, Diagnostic