Research – Emerging Legionella species data

In July 2021, the Legionella Control Association (LCA), in conjunction with the Health and Safety Executive (HSE), Public Health England (PHE) and local authorities, held a webinar aimed at raising awareness of increasing Legionella positivity rates post lockdown.  The data demonstrated that the average positive rate in the UK had increased by around 2% following the lockdowns in response to COVID-19.

To investigate if there were particular species that could have led to this increase, LCA approached the three commercial laboratories in the UK that use MALDI-ToF to confirm down to species level, and asked if they would share their data. This information has now been returned by some laboratories, with findings from over 70,000 positive result samples in a two-year period revealing:

• over 53% of the results were L.anisa
• over 32% of the positives were L. pneumophilia, both SeroGroup 1 and SeroGroup 2-15
• nearly 1% of positives were for L. rubilucens
• over 6.5% of the results did not confirm a species type
• there were over a dozen other species identified in results that accounted for less than 1% of the data set

The first line clinical diagnostic tool used to confirm Legionnaire’s disease in the UK is commonly a urinary antigen test (UAT), and this method looks predominantly for L. pneumophilia SeroGroup 1. Given the data LCA has provided so far, this could potentially mean missing over 70% of Legionella infections in patients. It should be highlighted that this data is in its infancy, and LCA state that further research needs to take place before any significant changes are considered or undertaken.

Source: LCA, January 2022