Development of a TLDA card for Legionella diagnostics and typing

  • Research type

    Research Study

  • Full title

    Development of a TLDA card for the simultaneous diagnosis and subtyping of Legionella

  • IRAS ID

    214744

  • Contact name

    Vicki Chalker

  • Contact email

    vicki.chalker@phe.gov.uk

  • Sponsor organisation

    UKHSA

  • Duration of Study in the UK

    1 years, 4 months, 31 days

  • Research summary

    Research Summary
    Legionnaires’ disease is a severe pneumonia and a significant public health concern. Detection of infection and
    source identification requires analysis of patient and environmental samples. Clinical samples and environmental
    isolates are referred to the Public Health England Respiratory and Vaccine Preventable Bacteria Reference Unit
    (RVPBRU) where several diagnostic tests are used to confirm infection and link patients to environmental sources.
    Techniques are time consuming, largely limited to Legionella pneumophila and expensive. Reliance on some current
    assays for primary testing may not detect infection with unusual Legionella types and these infections may go undiagnosed.
    The majority of detected human infections and point source outbreaks are caused by a limited number of
    specific types of Legionella pneumophila serogroup 1 called sequence types. The researchers in this study will use
    unique data on Legionella genetic content to design novel diagnostic tests that can differentiate all clinically relevant
    Legionella and the most common Legionella pneumophila serogroup 1 sequence types. These tests will be
    combined into a single format called a Taqman Array Card. These can produce results in approximately 90 minutes
    compared to several days by traditional methods. The new Taqman array card will be evaluated on both primary
    clinical samples (obtained from NHS laboratories for diagnostic purposes), stored Legionella grown from historical
    patient samples and environmental water samples. Sensitivity and specificity of the new assay will be determined and
    compared to existing traditional techniques. A beta trial involving European Reference lab partners will follow.
    Following successful validation, implementation of such an assay will bring several benefits, significantly reducing
    time to results, improving PHE response to incidents providing a diagnostic service for all Legionella infections (not
    just Legionella pneumophila) and substantially reducing overall testing costs.

    Summary of Results
    • This study was initiated to develop a multiplex PCR for the detection and typing of legionella.
    • The test was developed to detect legionella and other water pathogens, subtypes of legionella. Validation was partially completed.
    • Insufficient staffing and funding prevented completion of the validation of the study.
    • The main investigator left the organisation in June 2022
    • No pharmaceutical formulation was used in the study.

  • REC name

    Wales REC 4

  • REC reference

    16/WA/0329

  • Date of REC Opinion

    28 Nov 2016

  • REC opinion

    Further Information Favourable Opinion