Detection performance of PCR for Legionella pneumophila in environmental samples: a systematic review and meta-analysis

Ann Clin Microbiol Antimicrob. 2022 Mar 18;21(1):12. doi: 10.1186/s12941-022-00503-9.

Abstract

Background: Legionellosis remains a public health problem. The most common diagnostic method to detect Legionella pneumophila (L. pneumophila) is culture. Polymerase chain reaction (PCR) is a fast and accurate method for this detection in environmental samples.

Methods: Four databases were searched for studies that evaluated the detection efficiency of PCR in L. pneumophila. The quality evaluation was conducted using Review Manager 5.3. We used Meta-DiSc 1.4 software and the Stata 15.0 software to create forest plots, a meta-regression, a bivariate boxplot and a Deeks' funnel plot.

Results: A total of 18 four-fold tables from 16 studies were analysed. The overall pooled sensitivity and specificity of PCR was 94% and 72%, respectively. The positive likelihood ratio (RLR) and negative likelihood ratio (NLR) was 2.73 and 0.12, respectively. The result of the diagnostic odds ratio (DOR) was 22.85 and the area under the curve (AUC) was 0.7884.

Conclusion: Establishing a laboratory diagnostic tool for L. pneumophila detection is important for epidemiological studies. In this work, PCR demonstrated a promising diagnostic accuracy for L. pneumophila.

Keywords: Diagnosis; L. pneumophila; Legionella pneumophila; PCR.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Databases, Bibliographic
  • Environmental Microbiology
  • Humans
  • Legionella pneumophila* / genetics
  • Legionella pneumophila* / isolation & purification
  • Odds Ratio
  • Polymerase Chain Reaction / methods
  • Sensitivity and Specificity