title: Pan-European study on culture-proven Legionnaires' disease: distribution of Legionella pneumophila serogroups and monoclonal subgroups.
abstract: This pan-European study included unrelated strains of Legionella pneumophila obtained from 1335 cases of Legionnaires' disease. The isolates were serotyped into the serogroups 1 to 15 by monoclonal antibodies (MAb) and/or rabbit antisera. Additionally, MAb subgrouping was undertaken for isolates belonging to serogroups 1, 4, and 5. Monoclonal types of serogroup 1 were subdivided as having, or not having, the virulence-associated epitope recognized by the MAb 3/1 (Dresden Panel). This epitope is not present on strains belonging to any other serogroups. Taking all Legionella incidents together, MAb 3/1-positive cases were most frequent (66.8%); 11.7% of the isolates belonged to MAb 3/1-negative serogroup 1 subgroups and 21.5% to other serogroups, with serogroups 3 and 6 predominating. Among all serotypes discriminated in this study, monoclonal subtype Philadelphia was the most frequent. If categories of infection were considered, the proportion of MAb 3/1-negative strains differed significantly ( P<0.0005) between community-acquired cases (139/510; 27.3%) and travel-associated (42/295; 14.2%) or hospital-acquired infections (176/329; 53.5%). Moreover, taking distribution in different European areas into account, the proportion of MAb 3/1-negative strains was significantly higher in the Scandinavian region than in the Mediterranean countries or the UK for both community-acquired (48.7% vs. 18.6% or 12.0%; P<0.0005) and nosocomial cases (87.7% vs. 32.6% or 52.6%; P</=0.0007).
authors.affiliation: Institut Medizinische Mikrobiologie und Hygiene, Medizinische Fakultät TU Dresden, Fetscherstrasse 74, 01307 Dresden, Germany. Juergen.Helbig@mailbox.tu-dresden.de
authors.forename: J H
authors.initials: JH
authors.lastname: Helbig
authors.forename: S
authors.initials: S
authors.lastname: Bernander
authors.forename: M
authors.initials: M
authors.lastname: Castellani Pastoris
authors.forename: J
authors.initials: J
authors.lastname: Etienne
authors.forename: V
authors.initials: V
authors.lastname: Gaia
authors.forename: S
authors.initials: S
authors.lastname: Lauwers
authors.forename: D
authors.initials: D
authors.lastname: Lindsay
authors.forename: P C
authors.initials: PC
authors.lastname: Lück
authors.forename: T
authors.initials: T
authors.lastname: Marques
authors.forename: S
authors.initials: S
authors.lastname: Mentula
authors.forename: M F
authors.initials: MF
authors.lastname: Peeters
authors.forename: C
authors.initials: C
authors.lastname: Pelaz
authors.forename: M
authors.initials: M
authors.lastname: Struelens
authors.forename: S A
authors.initials: SA
authors.lastname: Uldum
authors.forename: G
authors.initials: G
authors.lastname: Wewalka
authors.forename: T G
authors.initials: TG
authors.lastname: Harrison
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000032:analysis*; D000918:Antibody Specificity; D018604:Epitope Mapping; D005060:Europe / Q000453:epidemiology; D005798:Genes, Bacterial; D006801:Humans; D015994:Incidence; D016952:Legionella pneumophila / Q000145:classification* / Q000235:genetics*; D007877:Legionnaires' Disease / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D011336:Probability; D011817:Rabbits; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012703:Serotyping
chemical_list: D000911:Antibodies, Monoclonal