Sensitivity of urinary antigen test in relation to clinical severity in a large outbreak of Legionella pneumonia in Spain
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- Blázquez, R.M., Espinosa, F.J., Martínez-Toldos, C.M. et al. Eur J Clin Microbiol Infect Dis (2005) 24: 488. doi:10.1007/s10096-005-1361-3
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Presented here are the results of Legionella urinary antigen testing correlated with patient characteristics and severity of pneumonia (Fine score) in 295 patients diagnosed with Legionella pneumonia in connection with a large outbreak in Murcia, Spain. Overall, the sensitivity of the urinary antigen test was 47.7% (141/295). A statistically significant association was found between the clinical severity of pneumonia and test sensitivity; 85.7% for patients with severe pneumonia versus 37.9% for patients with mild pneumonia (risk ratio, 2.3). Variables significantly associated with test positivity in multivariate analysis were as follows: pre-existing pulmonary disease, body temperature >40°C, leukocytosis and multilobar infiltrates. Patients with mild pneumonia may go undiagnosed if the urinary antigen test is used alone.