Abstract
Sera from six outbreaks of legionellosis and four outbreaks of pneumonia of other etiologies were tested with the indirect immunofluorescence assay (IFA) as currently performed. The current IFA is at least as sensitive as the original test in detecting cases of Legionnaires disease (78 to 91%). By using Center for Disease Control criteria for a positive (fourfold increase in titer during convalescence to greater than or equal to 128) or presumptive (single titer greater than or equal to 256) serological test, the specificity exceeded 99%. No cross-reactions against Legionella pneumophila antigens were observed among sera from epidemic cases of Q fever, tularemia, and psittacosis; the only positive L. pneumophila IFA titer among the epidemic Mycoplasma pneumonia sera was reduced to a negative titer with an immunosorbent extracted from Escherichia coli strain O13:K92:H4. The slight increase in specificity (to 100%), however, was offset by a slight decrease in sensitivity. The sensitivity of the IFA was maximal when a conjugate that detected immunoglobulins G, M, and A was used. IFA titers were not significantly altered by replacing the monovalent serogroup 1 antigen with a polyvalent antigen (serogroups 1 through 4) nor by the presence of rheumatoid factor or heat-labile serum factors.
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- Broome C. V., Goings S. A., Thacker S. B., Vogt R. L., Beaty H. N., Fraser D. W. The Vermont epidemic of Legionnaires' disease. Ann Intern Med. 1979 Apr;90(4):573–577. doi: 10.7326/0003-4819-90-4-573. [DOI] [PubMed] [Google Scholar]
- Cordes L. G., Fraser D. W., Skaliy P., Perlino C. A., Elsea W. R., Mallison G. F., Hayes P. S. Legionnaires' disease outbreak at an Atlanta, Georgia, Country Club: evidence for spread from an evaporative condenser. Am J Epidemiol. 1980 Apr;111(4):425–431. doi: 10.1093/oxfordjournals.aje.a112917. [DOI] [PubMed] [Google Scholar]
- Cordes L. G., Wilkinson H. W., Gorman G. W., Fikes B. J., Fraser D. W. Atypical Legionella-like organisms: fastidious water-associated bacteria pathogenic for man. Lancet. 1979 Nov 3;2(8149):927–930. doi: 10.1016/s0140-6736(79)92623-0. [DOI] [PubMed] [Google Scholar]
- Dondero T. J., Jr, Clegg H. W., 2nd, Tsai T. F., Weeks R. M., Duncan E., Strickler J., Chapman C., Mallison G. F., Politi B., Potter M. E. Legionnaires' disease in Kingport, Tennessee. Ann Intern Med. 1979 Apr;90(4):569–573. doi: 10.7326/0003-4819-90-4-569. [DOI] [PubMed] [Google Scholar]
- Dondero T. J., Jr, Rendtorff R. C., Mallison G. F., Weeks R. M., Levy J. S., Wong E. W., Schaffner W. An outbreak of Legionnaires' disease associated with a contaminated air-conditioning cooling tower. N Engl J Med. 1980 Feb 14;302(7):365–370. doi: 10.1056/NEJM198002143020703. [DOI] [PubMed] [Google Scholar]
- Edelstein P. H., McKinney R. M., Meyer R. D., Edelstein M. A., Krause C. J., Finegold S. M. Immunologic diagnosis of Legionnaires' disease: cross-reactions with anaerobic and microaerophilic organisms and infections caused by them. J Infect Dis. 1980 May;141(5):652–655. doi: 10.1093/infdis/141.5.652. [DOI] [PubMed] [Google Scholar]
- Edelstein P. H., Meyer R. D., Finegold S. M. Laboratory diagnosis of Legionnaires' disease. Am Rev Respir Dis. 1980 Feb;121(2):317–327. doi: 10.1164/arrd.1980.121.2.317. [DOI] [PubMed] [Google Scholar]
- England A. C., 3rd, McKinney R. M., Skaliy P., Gorman G. W. A fifth serogroup of Legionella pneumophila. Ann Intern Med. 1980 Jul;93(1):58–59. doi: 10.7326/0003-4819-93-1-58. [DOI] [PubMed] [Google Scholar]
- Fraser D. W., Deubner D. C., Hill D. L., Gilliam D. K. Nonpneumonic, short-incubation-period Legionellosis (Pontiac fever) in men who cleaned a steam turbine condenser. Science. 1979 Aug 17;205(4407):690–691. doi: 10.1126/science.462175. [DOI] [PubMed] [Google Scholar]
- Fraser D. W., Tsai T. R., Orenstein W., Parkin W. E., Beecham H. J., Sharrar R. G., Harris J., Mallison G. F., Martin S. M., McDade J. E. Legionnaires' disease: description of an epidemic of pneumonia. N Engl J Med. 1977 Dec 1;297(22):1189–1197. doi: 10.1056/NEJM197712012972201. [DOI] [PubMed] [Google Scholar]
- Grady G. F., Gilfillan R. F. Relation of Mycoplasma pneumoniae seroreactivity, immunosuppression, and chronic disease to Legionnaires' disease. A twelve-month prospective study of sporadic cases in Massachusetts. Ann Intern Med. 1979 Apr;90(4):607–610. doi: 10.7326/0003-4819-90-4-607. [DOI] [PubMed] [Google Scholar]
- McDade J. E., Shepard C. C., Fraser D. W., Tsai T. R., Redus M. A., Dowdle W. R. Legionnaires' disease: isolation of a bacterium and demonstration of its role in other respiratory disease. N Engl J Med. 1977 Dec 1;297(22):1197–1203. doi: 10.1056/NEJM197712012972202. [DOI] [PubMed] [Google Scholar]
- McKinney R. M., Thacker L., Harris P. P., Lewallen K. R., Hebert G. A., Edelstein P. H., Thomason B. M. Four serogroups of Legionnaires' disease bacteria defined by direct immunofluorescence. Ann Intern Med. 1979 Apr;90(4):621–624. doi: 10.7326/0003-4819-90-4-621. [DOI] [PubMed] [Google Scholar]
- McKinney R. M., Wilkinson H. W., Sommers H. M., Fikes B. J., Sasseville K. R., Yungbluth M. M., Wolf J. S. Legionella pneumophila serogroup six: isolation from cases of legionellosis, identification by immunofluorescence staining, and immunological response to infection. J Clin Microbiol. 1980 Sep;12(3):395–401. doi: 10.1128/jcm.12.3.395-401.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Morris G. K., Steigerwalt A., Feeley J. C., Wong E. S., Martin W. T., Patton C. M., Brenner D. J. Legionella gormanii sp. nov. J Clin Microbiol. 1980 Nov;12(5):718–721. doi: 10.1128/jcm.12.5.718-721.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ormsbee R. A., Peacock M. G., Lattimer G. L., Page L. A., Fiset P. Legionnaires' disease: antigenic peculiarities, strain differences, and antibiotic sensitivities of the agent. J Infect Dis. 1978 Aug;138(2):260–264. doi: 10.1093/infdis/138.2.260. [DOI] [PubMed] [Google Scholar]
- Reimer C. B., Black C. M., Phillips D. J., Logan L. C., Hunter E. F., Pender B. J., McGrew B. E. The specificity of fetal IgM: antibody or anti-antibody? Ann N Y Acad Sci. 1975 Jun 30;254:77–93. doi: 10.1111/j.1749-6632.1975.tb29159.x. [DOI] [PubMed] [Google Scholar]
- Scales R. W., Jacobs N. F., Jr, Skaggs R. Use of immunoglobulin coupled to agarose beads for examining the specificity of conjugates. J Clin Microbiol. 1975 Oct;2(4):292–295. doi: 10.1128/jcm.2.4.292-295.1975. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wilkinson H. W., Farshy C. E., Fikes B. J., Cruce D. D., Yealy L. P. Measure of immunoglobulin G-, M-, and A-specific titers against Legionella pneumophila and inhibition of titers against nonspecific, gram-negative bacterial antigens in the indirect immunofluorescence test for legionellosis. J Clin Microbiol. 1979 Nov;10(5):685–689. doi: 10.1128/jcm.10.5.685-689.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wilkinson H. W., Fikes B. J., Cruce D. D. Indirect immunofluorescence test for serodiagnosis of Legionnaires disease: evidence for serogroup diversity of Legionnaires disease bacterial antigens and for multiple specificity of human antibodies. J Clin Microbiol. 1979 Mar;9(3):379–383. doi: 10.1128/jcm.9.3.379-383.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]



