Culture for Legionella pneumophila

CERNER / EPIC MNEMONIC: C LEGIONSM
POE DESCRIPTION: CU LEGIONELLA AND SMEAR; C LEGIONSM
CPT CODE: 87077; 87278; 87081
TEST INFORMATION: The test includes culture and direct fluorescent antibody (DFA) smear for Legionella pneumophila.
DAYS PERFORMED: Daily, 24 hours
TURNAROUND TIME: DFA smear results are available Monday-Friday. Specimens received by 0900 will have the DFA results reported the same day. Preliminary cultures reports are available after 48 hours. Culture reports of no growth will be issued after 5 days. Completion of culture reports may take 6-7 days after receipt of the specimen, depending upon the nature of the microorganisms isolated.
CONTAINER TYPE: Sealed sterile container; Leuken`s tube
COLLECTION: Specimens are to be collected from a site prepared utilizing aseptic technique. Non-bacteriostatic sterile saline should be used when obtaining washings and/or lavage specimens. Material obtained by needle aspiration (transbronchial lung biopsy) is injected into a sealed sterile container.
SPECIMEN REQUIREMENTS: Lung tissue, other body tissue, pleural fluid, other body fluid, transtracheal aspiration, bronchoalveolar lavage, BAL, and bronchial brushing.
REJECTION CRITERIA: Inappropriate specimen container, insufficient specimen volume.
MINIMUM VOLUME: 2 mL
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, refrigerate.
REFERENCE RANGE: DFA: No Legionella pneumophila detected

Culture: No Legionella species isolated

LIMITATIONS OF TEST: The sensitivity of the DFA smear is relatively low (25-70%); however, the specificity is >95%. Not all serogroups of Legionella pneumophila are detected by DFA. The sensitivity of the culture is 50-80%; however, the specificity is 100%.
METHODOLOGY: Smear: direct fluorescent antibody.

Culture: conventional culture using routine media and media selective for Legionella isolation.

ADDITIONAL INFORMATION: If clinical suspicion of Legionella is high, several specimens may need to be submitted since small numbers of organisms may be present. Legionella species are widespread in the environment and are associated almost exclusively with surface and potable waters or moist environments. Click here for more information about Legionnaire's disease.