Concordance between IDEXX Legiolert® (liquid culture assay) and plate culture (ISO 11731:2017) for the detection and quantification of Legionella pneumophila in water samples

K Karia; S Yui; M Muzslay; S Ali

doi:10.1016/j.jhin.2023.10.019

Concordance between IDEXX Legiolert® (liquid culture assay) and plate culture (ISO 11731:2017) for the detection and quantification of Legionella pneumophila in water samples

J Hosp Infect. 2023 Nov 8:S0195-6701(23)00354-7. doi: 10.1016/j.jhin.2023.10.019. Online ahead of print.

Authors

K Karia¹, S Yui², M Muzslay², S Ali²

Affiliations

¹ Environmental Research Laboratory, University College London Hospitals NHS Foundation Trust, London, UK. Electronic address: kush.karia@nhs.net.
² Environmental Research Laboratory, University College London Hospitals NHS Foundation Trust, London, UK.

PMID: 37949373
DOI: 10.1016/j.jhin.2023.10.019

Abstract

Background: Legionella pneumophila is a water-borne bacterium that can cause Legionnaires' disease. Legiolert® (IDEXX, USA) is a low-labour liquid culture assay for the detection and enumeration of L. pneumophila (SG1-15) from water.

Aim: To analyse concordance between Legiolert and ISO 11731:2017 plate culture method (membrane filtration and culture on selective agars) using hospital water samples (N = 100).

Methods: Incubation was at 39 °C and 36 °C, respectively, for seven days, followed by most-probable enumeration for Legiolert and subculturing and serogrouping of suspected Legionella colonies, with plate culture.

Findings: L. pneumophila (SG1-15) was isolated from 25 out of 100 samples when using Legiolert or plate culture. Fourteen additional Legiolert samples tested positive for L. pneumophila; analysis of the same samples by plate culture was negative (12 out of 14) or yielded only Legionella rubrilucens (two out of 14; confirmed via matrix-assisted ionization/desorption time-of-flight mass spectrometry). L. pneumophila was not captured from Quanti-Tray/Legiolert pouch wells of these positive samples after subculture of puncture aliquots on buffered charcoal yeast-extract agar. Both methods in concordance did not detect L. pneumophila in 61 out of 100 samples.

Conclusion: Legiolert and plate culture are both satisfactory methods to detect L. pneumophila from water samples, and both to detect isolated L. pneumophila in 25% of the sample population. Legiolert provides a faster time to result, and is less resource-demanding and labour-intensive; however, there may be a low risk of cross-reactivity with other organisms. Both methods are suitable for the analysis of water in healthcare settings, where the monitoring of L. pneumophila is imperative in preventing cases of Legionnaires' disease.

Keywords: Culture; IDEXX; Legiolert®; Legionella pneumophila; Water.