SynthesisJournal of clinical microbiology2016
Diagnostic Accuracy of PCR Alone and Compared to Urinary Antigen Testing for Detection of Legionella spp.: a Systematic Review.
Synthesis in Journal of clinical microbiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 2 of them syntheses that pooled it.
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Who cites it
48 citing papers in PubMed, 2 syntheses or guidelines pooled it, 97 citations in OpenAlex.
- Detection performance of PCR for Legionella pneumophila in environmental samples: a systematic review and meta-analysis.Annals of clinical microbiology and antimicrobials · 2022Pooled it
- Estimate false-negative RT-PCR rates for SARS-CoV-2. A systematic review and meta-analysis.European journal of clinical investigation · 2022Pooled it
- Can Digital PCR Enhance the Detection ofPathogens (Basel, Switzerland) · 2026Article
- Proteome-Wide Reverse Vaccinology and Immunoinformatics-Guided Design of a Multi-Epitope Vaccine AgainstInternational journal of molecular sciences · 2026Article
- Serogroup characterisation, co-pathogen causality, and environmental surveillance gaps in a cross-sectional study of Legionella pneumophila in hospital-acquired pneumonia.Lung India : official organ of Indian Chest Society · 2026Article
- Detection of L. pneumophila non-serogroup 1 in hospital-acquired pneumonia: A cross-sectional study from Eastern India.Lung India : official organ of Indian Chest Society · 2026Article
- Review
- Metagenomic next-generation sequencing reveals airway microbial dysbiosis and functional alterations inFrontiers in cellular and infection microbiology · 2026Article
- A Rapid and Sensitive CRISPR-Cas12a for the Detection ofPolish journal of microbiology · 2025Article
- How to identify respiratory pathogens in primary health care - a review on the benefits, prospects and pitfalls in using point of care tests.Infection · 2025Review
- Antimicrobial Susceptibility Determination of Less Frequently IsolatedAntibiotics (Basel, Switzerland) · 2025Article
- Diagnostic approach in acute hypoxemic respiratory failure.Journal of intensive medicine · 2025Review
- Case report: The value of early application of mNGS technology in the diagnosis and treatment of severe Legionnaires' disease: reports of two cases with different outcomes.Frontiers in medicine · 2025Article
- The Brief Case: A fatal case ofJournal of clinical microbiology · 2024Review
- Atypical pneumonia (Review).Experimental and therapeutic medicine · 2024Review
- Biomarkers in pulmonary infections: a clinical approach.Annals of intensive care · 2024Review
- Severe Legionnaires' disease.Annals of intensive care · 2024Review
- Empirical antibiotic treatment for community-acquired pneumonia and accuracy for Legionella pneumophila, Mycoplasma pneumoniae, and Clamydophila pneumoniae: a descriptive cross-sectional study of adult patients in the emergency department.BMC infectious diseases · 2023Article
- Clinical and Laboratory Diagnosis of Legionella Pneumonia.Diagnostics (Basel, Switzerland) · 2023Review
- Atraumatic Splenic Rupture inCase reports in infectious diseases · 2023Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The diagnosis of Legionnaires' disease (LD) is based on the isolation of Legionella spp., a 4-fold rise in antibodies, a positive urinary antigen (UA), or direct immunofluorescence tests. PCR is not accepted as a diagnostic tool for LD. This systematic review assesses the diagnostic accuracy of PCR in various clinical samples with a direct comparison versus UA. We included prospective or retrospective cohort and case-control studies. Studies were included if they used the Centers for Disease Control and Prevention consensus definition criteria of LD or a similar one, assessed only patients with clinical pneumonia, and reported data for all true-positive, false-positive, true-negative, and false-negative results. Two reviewers abstracted data independently. Risk of bias was assessed using Quadas-2. Summary sensitivity and specificity values were estimated using a bivariate model and reported with a 95% confidence interval (CI). Thirty-eight studies were included. A total of 653 patients had confirmed LD, and 3,593 patients had pneumonia due to other pathogens. The methodological quality of the studies as assessed by the Quadas-2 tool was poor to fair. The summary sensitivity and specificity values for diagnosis of LD in respiratory samples were 97.4% (95% CI, 91.1% to 99.2%) and 98.6% (95% CI, 97.4% to 99.3%), respectively. These results were mainly unchanged by any covariates tested and subgroup analysis. The diagnostic performance of PCR in respiratory samples was much better than that of UA. Compared to UA, PCR in respiratory samples (especially in sputum samples or swabs) revealed a significant advantage in sensitivity and an additional diagnosis of 18% to 30% of LD cases. The diagnostic performance of PCR in respiratory samples was excellent and preferable to that of the UA. Results were independent on the covariate tested. PCR in respiratory samples should be regarded as a valid tool for the diagnosis of LD.
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