Production of monoclonal antibodies to Legionella pneumophila serogroups 1 and 6

To better define the surface antigens of Legionella pneumophila for clinical and experimental purposes, we have produced monoclonal antibodies to L. pneumophila serogroups 1 and 6. Two hybridomas were produced in serogroup 1. One antibody, LP-I-17, recognized a serogroup-common antigen. The second antibody, LP-I-81, was specific for serogroup 1. This antibody was able to agglutinate bacterial cells belonging to the serogroup 1 reference strains. Philadelphia and Knoxville. Microagglutination assays of environmental and clinical isolates revealed a subgroup of serogroup 1 environmental isolates which were not agglutinated by LP-I-81. This subset of isolates was segregated to certain buildings in the medical complex. Immunodiffusion studies showed identity between the LP-I-81 antigen and the serogroup-specific antigen of serogroup 1 organisms. This antigen could be absorbed out of the serogroup 1 organism extract with LP-I-81-coated Staphylococcus aureus, leaving the serogroup-common antigens. Three hybridomas were produced to serogroup 6. All three produced antibodies which were serogroup 6 specific and agglutinated serogroup 6 bacteria.     

Cross-reacting lipopolysaccharide antigens in Legionella pneumophila serogroups 1 to 14.

Immunological cross-reactions among Legionella species were investigated with sonicated, proteinase K-digested cell lysates. The antigens separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis were either analyzed for lipopolysaccharides (LPSs) by silver staining or transferred to nitrocellulose membranes for serological characterization with rabbit antibodies directed against Legionella pneumophila serogroups 1 and 5. When antiserum prepared against serogroup 5 was used to probe the LPSs from L. pneumophila serogroups 1 to 14, the antibodies recognized a common epitope harbored by all L. pneumophila serogroups but not by other Legionella species or by the gram-negative bacteria tested as controls. Hence, the serogroup 5 antiserum correctly identified all serogroups of L. pneumophila tested in the LPS immunoblot assay. Moreover, the silver-stained profiles of the isolated LPSs revealed characteristic patterns allowing the identification of the individual serogroups of L. pneumophila.     

Background prevalence of microagglutination antibodies to Legionella pneumophila serogroups 1, 2, 3, and 4.

The background prevalence of microagglutination antibodies to Legionella pneumophila was determined by testing the sera of 517 individuals who lived or worked in a small Iowa town. In this population, the upper limit of normal microagglutination titer for serogroups 1, 3, and 4 was 1:16, and that for serogroup 2 was 1:8. The prevalence of microagglutination titers of greater than or equal to 1:32 against any serogroup of L. pneumophila was only 7.4% and did not vary significantly with age or sex.     

Evaluation of an indirect hemagglutination test for the diagnosis of human leptospirosis.

A presumptive hemagglutination test for the serological diagnosis of leptospirosis in humans is described. The antigen was prepared from a soluble alcohol extract of an andamana strain sorbed to human O-negative erythrocytes and preserved by pyruvic aldehyde fixation. In this study, the overall sensitivity of the hemagglutination test was 92% in contrast to 69% for the presumptive slide agglutination test. The specificity was 95% for the hemagglutination test in comparison with 83% for the slide test.     

Outer membrane proteins from Legionella pneumophila serogroups and other Legionella species.

Outer membranes were isolated from eight serogroups of L. pneumophila and five other Legionella species. The protein composition of the membranes was characterized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. A single, disulfide stabilized protein with a molecular size of 29,000 to 30,000 daltons was found to be the major outer membrane protein (MOMP) of all the serogroups. The equivalent of the L. pneumophila MOMP was not observed in any of the other Legionella species examined. Silver staining of sodium dodecyl sulfate-polyacrylamide gel electrophoresis gels revealed distinctive patterns for each serogroup and other Legionella species that were not observed by staining with Coomassie blue and may result from the presence of lipopolysaccharide in the membrane preparations. The MOMP from serogroup 1 was isolated by exposing crude peptidoglycan to detergent in the presence of heat and reducing agent and was found to be tightly associated with lipopolysaccharide. Antibodies to this complex were used to probe the outer membranes of the remaining, L. pneumophila serogroups and other Legionella species by Western blotting. Serogroup 1 anti-MOMP antibodies were found to react with the MOMP from the remaining seven serogroups examined, whereas antibodies directed against the lipopolysaccharide of serogroup 1 only reacted with lipopolysaccharide from two of the remaining seven serogroups.     

Comparison of phenol- and heat-killed antigens in the indirect immunofluorescence test for serodiagnosis of Legionella pneumophila group 1 infections.

An antigen prepared with agar-grown Legionella pneumophila group 1 killed by 0.5% phenol and suspended in 0.5% yolk sac was examined for use in the indirect immunofluorescence test for legionellosis and compared with a heat-killed antigen. The serological results of the two antigens for single and paired sera agreed well. Morphological and staining characteristics were better for phenol-treated organisms. Electron microscopy observation showed an apparently well-preserved cell surface. The background antibody level among a healthy control population was very low (3.4% with titers of greater than or equal to 16). Sera of patients with gram-negative bacteria infections (Yersinia enterocolytica, Campylobacter jejuni, Salmonella typhimurium, Escherichia coli, Brucella melitensis, Pseudomonas aeruginosa, Mycoplasma pneumoniae, Coxiella burnetti, and Chlamydia psittaci) showed no cross-reactions with the phenol-killed antigen. The data suggest that phenol-killed antigen is sensitive and specific. This antigen is stable for at least 1 year.     

Detection of cell-associated or soluble antigens of Legionella pneumophila serogroups 1 to 6, Legionella bozemanii, Legionella dumoffii, Legionella gormanii, and Legionella micdadei by staphylococcal coagglutination tests.

Current methods used for the detection of whole-cell isolates of Legionella or for the detection of Legionella soluble antigens are technically impractical for many clinical laboratories. The purpose of this study was to explore practical alternatives. The results showed that whole cell isolates of Legionella pneumophila serogroups 1 to 6, Legionella bozemanii, Legionella dumoffii, Legionella gormanii, and Legionella micdadei were identified specifically by a simple slide agglutination test or slide coagglutination test in which the reagent antisera are first bound to staphylococcal protein A. Soluble antigens were also identified specifically by the slide coagglutination test and by a sandwich immunofluorescence assay. The latter test may be useful in detecting antigen in body fluids of patients with legionellosis or in environmental samples.     

Simple immunodiffusion test for detecting antibodies against Legionella pneumophila serotype 1.

A simple immunodiffusion test for investigation of antibodies against Legionella pneumophila serotype 1 was developed. The comparison between the indirect immunofluorescence assay and the immunodiffusion technique gave a 98.6% correlation. All of the patients studied were serologically diagnosed by both procedures.     

Freeze-dried erythrocytes for an indirect hemagglutination test for detection of cytomegalovirus antibodies.

An indirect hemagglutination test with lyophilized, fixed, tanned, and cytomegalovirus (CMV)-sensitized sheep erythrocytes for the detection of CMV antibodies is reported. To avoid nonspecific hemagglutination, cells were fixed with glutaraldehyde or Formalin directly in whole blood. The lyophilized, CMV-sensitized erythrocytes obtained by this technique were stable up to 9 months at 37 degrees C and retained the same reactivity at fresh, CMV-sensitized cells. Indirect hemagglutination performed with lyophilized, sensitized cells was highly efficient in detecting CMV-antibodies as compared with complement fixation and enzyme immunoassay.     

Whole-cell peroxidase test for identification of Legionella pneumophila.

A simple combined peroxidase-catalase test has been developed which is applicable to live bacterial cells. Known strains of Legionella pneumophila were differentiated from other species of Legionella by being peroxidase positive and catalase negative.     

Evaluation of two new immunochromatographic assays (Rapid U Legionella antigen test and SD Bioline Legionella antigen test) for detection of Legionella pneumophila serogroup 1 antigen in urine

We evaluated two new immunochromatographic assays for their abilities to detect Legionella pneumophila serogroup 1 antigen in urine. The results were compared with those obtained by the Binax NOW urinary antigen test. The sensitivities and specificities were estimated to be 71.2% and 96.6%, respectively, for the Rapid U test; 31.5% and 98.9%, respectively, for the SD Bioline test; and 91.8% and 100%, respectively, for the Binax NOW test.     

Similar DNA restriction endonuclease profiles in strains of Legionella pneumophila from different serogroups

DNA of strains of Legionella pneumophila serogroups 1, 3, 4, and 6, isolated from patients and environmental sources, was examined by restriction endonuclease analysis (REA). Major differences in profiles enabled subtyping in many strains with the same serogroup antigen. However, a cluster of L. pneumophila strains, originating from all the examined serogroups, had similar restriction endonuclease profiles, sometimes with minor differences. This suggests that the genetic similarity between strains of L. pneumophila of different serogroups is sometimes closer than in strains with the same serogroup antigen. Seven environmental sources harbored two L. pneumophila strains with various serogroup antigens; six sources had similar restriction endonuclease profiles. The resolution of small differences in profiles is hampered in REA by the great magnitude of DNA fragments; even upon extensive analysis, these differences are not always readily visualized. Double digestions with the restriction enzymes HpaI and HpaII showed the best results and sometimes revealed differences not evident by digestions with a single endonuclease. REA has a great capacity for accurate epidemiological typing of L. pneumophila, in addition to classical serogrouping; it appeared that the results of the two techniques do not necessarily correlate. On the other hand, it should be stressed that small differences in profiles are not easily detected by REA.     

Evaluation of a modified complement fixation test and an indirect hemagglutination test for the serodiagnosis of melioidosis in pigs.

A complement fixation test modified by the addition of porcine serum and an indirect hemagglutination test were used to detect antibodies to Pseudomonas pseudomallei in pigs. These tests together with cultural examinations were carried out with 250 pigs. The sensitivity and specificity values were 79.3 and 99.5% and 82.8 and 93.2% for the modified complement fixation and hemagglutination tests, respectively. When results from the combination of both tests were considered, the values were 86.2 and 92.8%, respectively.     

Detection of antibodies against Legionella pneumophila serogroups 1 to 6 and the Leiden-1 strain by micro ELISA and immunofluorescence assay

One hundred and seventy-five human sera were tested for the presence of type-specific antibodies against L pneumophila serogroups 1 to 6 and the Leiden-1 strain by means of an enzyme linked immunosorbent assay (ELISA) and compared with the results obtained by the indirect immunofluorescence assay (IFA). A high correlation (correlation coefficient 0.92) between both methods was found. No consistent pattern of IgG, IgA and IgM classes of antibody titres against L pneumophila were found. In the sera of 15 of 17 patients with a proven L pneumophila pneumonia, IgM class antibodies against L pneumophila could be detected. A "polyvalent" ELISA was developed which permits rapid routine screening of human sera for antibodies against L pneumophila serogroups 1 to 6 and the Leiden-1 strain.     

An ELISA test for the detection of antibodies to Legionella pneumophila.

An enzyme-linked immunosorbent assay (ELISA) test has been developed to detect antibodies to Legionella pneumophila serogroup 1. There is good correlation between indirect fluorescent antibody (IFA) and ELISA titres but ELISA is more sensitive.     

Evaluation of Vircell enzyme-linked immunosorbent assay and indirect immunofluorescence assay for detection of antibodies against Legionella pneumophila

We evaluated the abilities of the Vircell immunoglobulin G (IgG) and IgM indirect immunofluorescence assay (IFA) for Legionella pneumophila serogroup 1, the IgM and IgG enzyme-linked immunosorbent assay (ELISA) for Legionella pneumophila serogroup 1, and the IgM-plus-IgG ELISA for Legionella pneumophila serogroups 1 to 6 to diagnose Legionnaires' disease (LD) in a well-described sample of patients with and without LD. Also, we determined the agreements, sensitivities, and specificities of the different Vircell assays in comparison to a validated ELISA (Serion classic ELISA). Clinical sensitivity and specificity were 74.6% and 96.6%, respectively, for the IgM IFA, 65.1% and 88.0% for the IgG IFA, 92.3% and 100% for the IgM ELISA, 43.3% and 96.6% for the IgG ELISA, and 90.8% and 100% for the IgM-plus-IgG ELISA. Compared to Serion classic ELISA, agreement, sensitivity, and specificity were 80.0%, 83.1%, and 78.4%, respectively, for the IgM IFA, 75.2%, 66.0%, and 79.5% for the IgG IFA, 89.5%, 82.0%, and 97.6% for the IgM ELISA, 81.9%, 88.9%, and 78.0% for the IgG ELISA, and 93.5%, 90.0%, and 96.6% for the IgM-plus-IgG ELISA. The value of a positive diagnostic result obtained by the Vircell IgM IFA, the Vircell IgG IFA, and the Vircell IgG ELISA might not be acceptable for a diagnostic assay. Both the high specificities and sensitivities of the Vircell IgM ELISA and the IgM-plus-IgG ELISA and the high correlation with the Serion classic ELISA indicate that they are useful in the diagnosis of LD.     

Serum antibodies to Legionella pneumophila by indirect immunofluorescent antibody test in 269 hemodialysis patients and 353 healthy subjects

Serum antibodies to Legionella pneumophila serogroup I-VI were determined by indirect immunofluorescent antibody test in 269 hemodialysis patients and compared to 353 so called healthy subjects. Antigen suspension was prepared by incubation on B-CYE agar and adding formalin solution, then fixed on a micro slide glass, and reacted with serial serum dilutions. FITC-labeled goat antihuman immunoglobulin was added as a second antibody. 273 (77.3%) cases of control group had a titer of less than 1:4, 6 (1.7%) cases had a titer of 1: 32, and none had a titer of greater than or equal to 1: 64. There was no significant difference in sex and age. 173 (64.3%) hemodialysis patients had a titer of less than 1: 4, 13 (4.9%) cases had a titer of greater than or equal to 1: 64, and 5 (1.9%) cases had a titer of 1: 128, 42 (43.8%) of 96 cases who showed a titer of greater than or equal to 1: 4 had antibodies to Legionella pneumophila serogroup I. The titer in hemodialysis patients were higher than control group (p less than 0.005). The results of this study suspected that acute feverish disease and pneumonia of compromised host such as hemodialysis patients should be always thought of Legionnaires' infection.     

Evaluation of urinary antigen ELISA for diagnosing Legionella pneumophila serogroup 1 infection.

The enzyme linked immunosorbent assay (ELISA) described was developed to detect a soluble antigen in the urine of patients with Legionnaires' disease caused by Legionella pneumophila serogroup 1 (L.pn 1). The assay was evaluated and showed good specificity (100%) and intra-assay reproducibility. Antigen was detected in the urine of 93 (77%) of 120 patients, overall, and in 86% of patients from whom a specimen obtained within seven days of onset of illness was available. On all but one occasion the first urine sample taken from a patient for whom a positive ELISA result was obtained, was itself positive. In one case antigen was not detected at four days but was present on the fifth day after onset of symptoms. In two patients urinary antigen was detectable as early as two days after onset of symptoms. In another the antigen persisted for at least 60 days. More than half the patients, however, had stopped producing detectable antigen within 14 days of onset of symptoms. It is therefore important that where Legionnaires' disease is suspected urine is collected as early as possible in the course of the disease.