Lab Guide
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Test ID: Legionella Antigen Urine
Legionella antigen in urine
Detection of urinary antigen of Legionella pneumophila serogroup 1
Useful For

Aid in the presumptive diagnosis of Legionella infection (Legionnaires’ disease) caused by L. pneumophila serogroup 1 in conjunction with culture and other methods.

Method name and description

Commercially available immunochromatographic card test

Reporting name

Urine Legionella Antigen

Clinical information

Legionnaires disease, named after the outbreak in 1976 at the American Legion convention in Philadelphia, is caused by Legionella pneumophila and is an acute febrile respiratory illness ranging in severity from mild illness to fatal pneumonia. Since that time, it has been recognized that the disease occurs in both epidemic and endemic forms, and that sporadic cases are not readily differentiated from other respiratory infections by clinical symptoms. Known risk factors for infection include immunosuppression, cigarette smoking, alcohol consumption, and concomitant pulmonary disease. The resulting mortality rate, which ranges up to 40% in untreated immunocompetent patients, can be lowered if the disease can be rapidly diagnosed and appropriate antimicrobial therapy instituted early. L pneumophila is estimated to be responsible for 80% to 85% of reported cases of Legionella infections with the majority of cases being caused by L pneumophila serogroup 1 alone.

It was shown as early as 1979 that a specific soluble antigen was present in the urine of patients with Legionnaires disease. The presence of Legionella antigen in urine makes this an ideal specimen for detection in early, as well as later, stages of the disease. The antigen may be detectable in the urine as early as 3 days after onset of symptoms

Aliases
  • Legionella Ag
  • Legionella pneumophila
  • Legionellosis
  • Legionnaires' Disease

 

Specimen type / Specimen volume / Specimen container

Specimen type: Urine

Specimen volume: Minimum volume: 0.5 ml

Specimen container: Sterile wide mouth container

 

Collection instructions / Special Precautions / Timing of collection

Collect a random urine specimen 

Relevant clinical information to be provided
  • Patient clinical condition
  • Antimicrobial therapy

 

Storage and transport instructions

 Transportation

  • Send to the laboratory at room temperature within 2 hrs of collection

Storage

  • If delay > 2 hrs, refrigerate at 2-8°C and send to the laboratory within 24 hrs of collection

 

Specimen Rejection Criteria
  • Leaking container
  • Unlabeled/mislabeled specimen
  • Duplicate samples within 72 hours
  • Urine sample submitted in boric acid urine container
  • No relevant clinical details provided with the request. (Please note that where applicable, the relevant clinical details should reflect those on the patient’s electronic record at the time the order was placed).

 

Biological reference intervals and clinical decision values

Negative result

Legionella antigen detection: negative

Positive result

Legionella antigen detection: positive

 

Factors affecting test performance and result interpretation
  • Improper collection and transport
  • Improper container
  • Improper processing technique

 

Turnaround time / Days and times test performed / Specimen retention time

Turnaround time

  • Same day if receieved before 3pm; otherwise performed the next day

Days and times performed

  • Daily 7 days a week from 7am to 3pm in the HGH microbiology laboratory. Samples received in other microbiology laboratories will be sent to the HGH microbiology laboratory for testing.

Specimen retention time

  • 48 hours after final report