Biomedical subjects
Publications and source records attributed to W H Abraham.
The mip gene of Legionella pneumophila was demonstrated by PCR and probing in paired acute-phase and convalescent-phase sera from five patients with Legionnaires' disease but not in the acute-phase sera of 100 patients with pneumonia that showed no serological evidence of Legionella infection. PCR may help in cases presenting diagnostic difficulty.
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Sera from 1384 individuals were examined with a trivalent antigen composed of Legionella longbeachae serogroups 1 and 2 and L. jordanis. One hundred and twenty nine (9.3%) showed a reaction on screening. Thirty-six (2.6%) had a titre of greater than or equal to 64 with monovalent antigens. Ten (0.7%) had a high (greater than or equal to 256) or greater than or equal to fourfold rising titre of antibody to one or more antigens and six of these patients had a severe chest infection. No correlation was apparent between the presence of low level antibodies and disease.
A polyvalent antigen composed of heat-killed agar-grown Legionella pneumophila serogroups 1-4 suspended in a suspension of yolk-sac from embryonated hens' eggs has been examined for use in the indirect fluorescent antibody test for Legionella infection. The serological response detected by monovalent antigen correlated well with that detected by polyvalent antigen. The use of polyvalent antigen forms a useful screening test for the detection of antibody to L pneumophila, but positive results must be confirmed by test using monovalent antigen.
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Four-hundred fifty-nine sera from 342 persons were examined at Ruchill Hospital, Glasgow, using an agar-grown heat-killed, ether-treated antigen derived from the Philadelphia 1 strain of the Legionnaires' disease bacterium. They were examined, in parallel, at the Center for Disease Control (CDC), Atlanta. Overall agreement (results agreeing +/- one twofold dilution) was reached with 90% of sera. Important differences were obtained with 10 (2.2%) sera. With three of these 10 sera the CDC alone obtained a significant titre (256) whereas with the other seven the Glasgow laboratory alone obtained a titre of 256. Altogether 28 persons (8.2%) with an agreed titre of 256 or higher were identified. However, some of these people had been ill 4 years before serum was obtained for examination. These persistent high titres make the serologic diagnosis of Legionnaires' disease difficult.
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