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False positive legionella serology in campylobacter infection: campylobacter serotypes, duration of antibody response and elimination of cross-reactions in the indirect fluorescent antibody test

Published online by Cambridge University Press:  15 May 2009

L. E. Marshall
Affiliation:
Public Health Laboratory, Northern General Hospital, Herries Road, Sheffield S5 7BQ
T. C. J. Boswell*
Affiliation:
Department of Microbiology, Selly Oak Hospital, Raddlebarn Road, Birmingham B29 6JD
G. Kudesia
Affiliation:
Public Health Laboratory, Northern General Hospital, Herries Road, Sheffield S5 7BQ
*
*Correspondence and reprint requests to: Dr T. Boswell, Public Health Laboratory, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5ST.
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Sera from 83 patients with campylobacter gastroenteritis were examined for the presence of legionella antibodies by indirect immunofluorescence. Twenty–one patients (25%) had positive titres (≥ 16) including 11 patients with titres of ≥ 128. Legionella seropositivity persisted in 5 of 9 patients (55%) studied for 6–9 months. Campylobacter isolates were serotyped by the Penner scheme. Isolates associated with legionella seropositivity included Penner types 1, 2 and 4, the common endemic serotypes in England. Campylobacter blocking fluids were prepared from a range of Penner reference strains. The blocking fluid prepared from Penner type 11 was the most efficient at inhibiting the false-positive legionella titres. Using this absorption step legionella titres were inhibited from 24 of 26 patients (92%) with campylobacter but not from 8 patients with cultureproven legionnaires' disease. We recommend that this method is incorporated into routine diagnostic legionella serology in order to eliminate false-positive reactions due to campylobacter.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1994

References

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