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Mayo Test ID LEGI Legionella Culture, Varies


Additional Testing Requirements


Because examination by rapid polymerase-chain reaction (PCR) increases sensitivity and provides faster results, it is strongly recommended to also order LEGRP / Legionella species, Molecular Detection, PCR, Varies.



Necessary Information


Specimen source is required.



Specimen Required


Specimen Type: Lower respiratory

Sources: Bronchoalveolar lavage, bronchial aspirate/brushing/lavage/washing, tracheal/endotracheal secretions/aspirate, sputum

Container/Tube: Sterile container

Specimen Volume: Entire collection

 

Specimen type: Fresh tissue or biopsy

Sources: Lung, pleura, heart valve, pericardium

Container/Tube: Sterile container

Specimen Volume: 5 mm(3)

Collection Instructions: Aseptically collect a 1 to 2 cm(3) piece of tissue whenever possible

 

Specimen type: Fluid

Sources: Pericardial, pleural, chest, chest tube drainage, thoracentesis, empyema

Container/Tube: Sterile container

Specimen Volume: 2 mL


Useful For

Diagnosis of Legionnaires disease

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
RMALD Ident by MALDI-TOF mass spec No, (Bill Only) No
ISAE Aerobe Ident by Sequencing No, (Bill Only) No
TISSR Tissue Processing No, (Bill Only) No

Testing Algorithm

When this test is ordered, the reflex tests may be performed at an additional charge.

Method Name

Conventional Culture Technique

Reporting Name

Legionella Culture

Specimen Type

Varies

Specimen Minimum Volume

See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time
Varies Refrigerated 48 hours

Reject Due To

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Clinical Information

The Legionellaceae are ubiquitous in natural freshwater habitats, allowing them to colonize artificial water supplies (eg, reservoirs), which may then serve as the source for human infections.

 

Legionella pneumophila and the related species, Legionella bozemanii, Legionella dumoffii, Legionella gormanii, Legionella micdadei, Legionella longbeachae, and Legionella jordanis have been isolated from patients with pneumonia (Legionnaires disease). The organism has been isolated from lung tissue, bronchoalveolar lavage, pleural fluid, and sputum. The signs, symptoms, and radiographic findings of Legionnaires disease are generally nonspecific.

Reference Values

No growth of Legionella species after 7 days of incubation

Interpretation

Identification of Legionella species from respiratory specimens provides a definitive diagnosis of Legionnaires disease.

 

Organisms isolated are identified as Legionella species via matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry and/or 16S ribosomal RNA (rRNA) gene sequencing.

Cautions

Although semi-selective media is utilized, recovery of Legionella in specimens heavily contaminated with indigenous microbiota (ie, sputum) may be difficult.

Clinical Reference

1. Edelstein PH. Legionella In: Carroll KC, Pfaller MA, eds. Manual of Clinical Microbiology. 12th ed. ASM Press; 2019:905-920

2. Clinical and Laboratory Standards Institute. Interpretive Criteria for Identification of Bacteria and Fungi by Targeted DNA Sequencing. 2nd ed. CLSI Guideline MM18. CLSI; 2018

3. Rucinski SL, Murphy MP, Kies KD, Cunningham SA, Schuetz AN, Patel R. Eight years of clinical Legionella PCR testing illustrates a seasonal pattern. J Infect Dis. 2018;218(4):669-670. doi:10.1093/infdis/jiy201

Method Description

Specimens are cultured on buffered charcoal-yeast extract-based media. Colonies may appear within a few days; however, cultures are incubated for 7 days before issuing a negative report. Positive specimens will be identified via matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry and/or 16S ribosomal RNA (rRNA) gene sequencing.(Edelstein PH. Improved semi-selective medium for isolation of Legionella pneumophila from contaminated clinical and environmental specimens. J Clin Microbiol. 1981;14:298-303; CLSI. Interpretive Criteria for Identification of Bacteria and Fungi by Targeted DNA Sequencing. 2nd ed. CLSI Guideline MM18. Clinical and Laboratory Standards Institute; 2018)

Day(s) Performed

Monday through Sunday

Report Available

7 to 10 days

Specimen Retention Time

2 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

87081-Legionella culture

87077-Ident by MALDI-TOF mass spec (if appropriate)

87153-Aerobe ident by sequencing (if appropriate)

87176-Tissue processing (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
LEGI Legionella Culture 593-4

 

Result ID Test Result Name Result LOINC Value
LEGI Legionella Culture 593-4