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- 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.
Expected Turnaround Time
7 - 16 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Information
Related Documents
Specimen Requirements
Specimen
Lung tissue, other body tissue, pleural fluid, transtracheal aspiration, lung exudate, lung biopsy, bronchial washing
Volume
1 mL lung exudate or 1 cc lung biopsy
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; environmental water samples such as air conditioning/cooling towers
Test Details
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
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 | 88585-5 | 086868 | Legionella Species Culture | 88585-5 |
| 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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