<i>Legionella</i> Species Culture
| Legionella Species Culture | | | |
| Number | | 086868 |
| CPT | | 87070 |
| Related Information | | Legionella Culture and Legionella pneumophila, DFA Legionella pneumophila, DFA Legionella pneumophila Urinary Antigen |
| Synonyms | | Culture, Legionella sp |
| Test Includes | | Culture for Legionella spp; isolation and identification if culture results warrant (additional charges/CPT code[s] may apply). CPT coding for microbiology and virology procedures often cannot be determined before the culture is performed. |
| Specimen | | Lung tissue, other body tissue, pleural fluid, transtracheal aspiration, lung exudate, lung biopsy, water from air conditioning/cooling towers |
| Volume | | 1 mL lung exudate, 1 cc lung biopsy, or 50 mL minimum water from air conditioning/cooling towers |
| Container | | Sterile container |
| Collection | | Contamination with normal flora from respiratory tract should be avoided. Transport to the laboratory within 24 hours of collection. |
| Storage Instructions | | Refrigerate, specimens should be kept at 4°C and transported to the laboratory within 24 hours of collection. |
| Causes for Rejection | | Swab specimen; inappropriate specimen transport device; improper labeling; specimen received after prolonged delay (usually more than 72 hours); specimen received in expired transport |
| Use | | Isolate and identify Legionella sp |
| Limitations | | Sputum (expectorated), bronchial aspirates, and other specimens having normal flora are subject to bacterial overgrowth and are not as desirable as transtracheal aspirates, pleural fluid, and biopsy material for culture. Sensitivity of cultures is relatively low (50% to 80%); however, specificity is 100%. A direct fluorescent antibody smear without culture can be done to detect Legionella. |
| Methodology | | Culture on selective and nonselective media |
| Additional Information | | Acute and convalescent sera for Legionella antibodies should also be considered to increase the chance of documenting the diagnosis. A fourfold rise to a titer of 1:128 is a diagnostic standard criterion. Seroconversion may be detected in many patients in the first weeks. Seroconversion 0-7 days after onset, 16%; 0-14 days, 52%; 0-21 days, 66%; 0-28 days, 71%. Twenty-five percent of patients did not have diagnostic titers.1 Consult the laboratory regarding availability and selection of the most appropriate method. Nosocomial infections have been recognized with reservoirs in the water distribution systems, cooling systems, and hot water systems of hospitals being reported.2,3,4 Twenty species in the Legionellaceae family of bacteria have been discovered since Legionella pneumophila was first recognized. Thirteen species have been implicated as causes of human pneumonia.5 |
| Footnotes | | - Harrison TG and Taylor AG, “Timing of Seroconversion in Legionnaires' Disease,” Lancet, 1988, 2(8614):795.
- Hoge CW and Brieman RF, “Advances in the Epidemiology and Control of Legionella Infections,” Epidemiol Rev, 1991, 13:329-40.
- Hart CA and Makin T, “Legionella in Hospitals: A Review,” J Hosp Infect, 1991, 18(Suppl A):481-9.
- Nguyen ML and Yu VL, “Legionella Infection,” Clin Chest Med, 1991, 12(2):257-68.
- Fang GD, Yu VL, and Vickers RM, “Disease Due to the Legionellaceae (Other Than Legionella pneumophila). Historical, Microbiological, Clinical, and Epidemiological Review,” Medicine (Baltimore), 1989, 68(2):116-32
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| References | | Winn WC Jr, “Legionnaires' Disease: Historical Perspective,” Clin Microbiol Rev, 1988, 1(1):60-81 (review). |
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