Kohler R B, Winn W C, Wheat L J
J Clin Microbiol. 1984 Oct;20(4):605-7. doi: 10.1128/jcm.20.4.605-607.1984.
The purposes of this study were to determine whether antigen is excreted by patients with Legionnaires disease early enough after the onset of symptoms to be useful for making therapeutic decisions and whether antigen excretion ends when successful treatment is concluded. Specific antigen was detected in the urine of 14 (88%) of 16 patients with Legionnaires disease during days 1 to 3 of symptoms, 33 (80%) of 41 patients during days 4 to 7, 25 (89%) of 28 patients during days 8 to 14, and 11 of 11 patients after day 14, by solid-phase immunoassays for serogroup 1 Legionella pneumophila antigen. Antigen excretion persisted for 42 days or longer after the onset of treatment in at least 15 patients. The longest documented duration of excretion was 326 days. We conclude that antigen can be detected approximately as often early after symptoms begin as later, allowing meaningful therapeutic decisions to be made, but that prolonged antigen excretion may negate the diagnostic value of urinary antigen detection for relapsing or recurrent L. pneumophila pneumonia.
本研究的目的是确定军团病患者在症状出现后是否足够早地排出抗原，以便用于做出治疗决策，以及抗原排出是否在成功治疗结束时终止。通过针对嗜肺军团菌血清群1抗原的固相免疫测定，在症状出现第1至3天，16例军团病患者中有14例（88%）尿液中检测到特异性抗原；在第4至7天，41例患者中有33例（80%）；在第8至14天，28例患者中有25例（89%）；在第14天之后，11例患者中的11例。至少15例患者在治疗开始后抗原排出持续42天或更长时间。记录到的最长排出持续时间为326天。我们得出结论，症状开始后早期检测到抗原的频率与后期大致相同，这使得能够做出有意义的治疗决策，但抗原排出时间延长可能会使尿液抗原检测对嗜肺军团菌肺炎复发或再发的诊断价值失效。
