Legionella species Culture

CPT: 87070
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Test Details

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.

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 to 7 days after onset, 16%; 0 to 14 days, 52%; 0 to 21 days, 66%; 0 to 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.2-4 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

Specimen Requirements

Specimen

Lung tissue, other body tissue, pleural fluid, transtracheal aspiration, lung exudate, lung biopsy, bronchial washing, or 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. Maintain specimens at 2°C to 8°C and transport 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

Clinical Information

Footnotes

1. Harrison TG, Taylor AG. Timing of seroconversion in Legionnaires' disease. Lancet. 1988 Oct 1; 2(8614):795. 2901634
2. Hoge CW, Breiman RF. Advances in the epidemiology and control of Legionella infections. Epidemiol Rev 1991; 13:329-340. 1765117
3. Hart CA, Makin T. Legionella in hospitals: A review. J Hosp Infect. 1991 Jun; 18(Suppl A):481-489. 1679819
4. Nguyen ML, Yu VL. Legionella infection. Clin Chest Med. 1991 Jun; 12(2):257-268. 1855370
5. Fang GD, Yu VL, Vickers RM. Disease due to the Legionellaceae (other than Legionella pneumophila). Historical, microbiological, clinical, and epidemiological review. Medicine (Baltimore). 1989 Mar; 68(2):116-132. 2646508

References

Winn WC Jr. Legionnaires' disease: Historical perspective. Clin Microbiol Rev. 1988 Jan; 1(1):60-81 (review). 3060246

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
086868 Legionella Species Culture 593-4 086868 Legionella Species Culture 593-4
Reflex Table for Legionella Species Culture
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 080271 Result 080272 Result 1 593-4
Reflex Table for Legionella Species Culture
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 080271 Result 080273 Result 2 N/A
Reflex Table for Legionella Species Culture
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 080271 Result 080274 Result 3 N/A
Reflex Table for Legionella Species Culture
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 080271 Result 080275 Result 4 N/A
Reflex Table for Legionella Species Culture
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 080271 Result 080276 Antimicrobial Susceptibility N/A

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