Test Id : LEGI
Legionella Culture, Varies
    
        Useful For
            
                
                
                    
                    Suggests clinical disorders or settings where the test may be helpful
                
            
    
    Diagnosis of Legionnaires disease
    
        Reflex Tests
            
                
                
                    
                    Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.
                
            
    
    | Test Id | Reporting Name | Available Separately | Always Performed | 
|---|---|---|---|
| RMALD | Ident by MALDI-TOF mass spec | No, (Bill Only) | No | 
| ISAE | Aerobe Ident by Sequencing | No, (Bill Only) | No | 
| TISSR | Tissue Processing | No, (Bill Only) | No | 
    
        Testing Algorithm
            
                
                
                    
                    Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
                
            
    
    When this test is ordered, the reflex tests may be performed at an additional charge.
    
        Method Name
            
                
                
                    
                    A short description of the method used to perform the test
                
            
    
    Conventional Culture
    
        NY State Available
            
                
                
                    
                    Indicates the status of NY State approval and if the test is orderable for NY State clients.
                
            
    
    
    
        Reporting Name
            
                
                
                    
                    Lists a shorter or abbreviated version of the Published Name for a test
                
            
    
    
    
        Aliases
            
                
                
                    
                    Lists additional common names for a test, as an aid in searching
                
            
    
    50008-LEGI
    
        Testing Algorithm
            
                
                
                    
                    Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
                
            
    
    When this test is ordered, the reflex tests may be performed at an additional charge.
    
        Specimen Type
            
                
                
                    
                    Describes the specimen type validated for testing
                
            
    
        Varies
    
        Additional Testing Requirements
    
    Because examination by rapid polymerase-chain reaction (PCR) increases sensitivity and provides faster results, it is strongly recommended to also order LEGRP / Legionella species, Molecular Detection, PCR, Varies.
    
        Necessary Information
    
    Specimen source is required.
    
        ORDER QUESTIONS AND ANSWERS
    
    | Question ID | Description | Answers | 
|---|---|---|
| Q00M0033 | Specimen Source | 
    
        Specimen Required
            
                
                
                    
                    Defines the optimal specimen required to perform the test and the preferred volume to complete testing
                
            
    
    Specimen Type: Lower respiratory
Sources: Bronchoalveolar lavage, bronchial aspirate/brushing/lavage/washing, tracheal/endotracheal secretions/aspirate, sputum
Container/Tube: Sterile container
Specimen Volume: Entire collection
Specimen type: Fresh tissue or biopsy
Sources: Lung, pleura, heart valve, pericardium
Container/Tube: Sterile container
Specimen Volume: 5 mm(3)
Collection Instructions: Aseptically collect a 1 to 2 cm(3) piece of tissue whenever possible
Specimen type: Fluid
Sources: Pericardial, pleural, chest, chest tube drainage, thoracentesis, empyema
Container/Tube: Sterile container
Specimen Volume: 2 mL
    
        Forms
    
    If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.
    
        Specimen Minimum Volume
            
                
                
                    
                    Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
                
            
    
    See Specimen Required
    
        Reject Due To
            
                
                
                    
                    Identifies specimen types and conditions that may cause the specimen to be rejected
                
            
    
    
    
        Specimen Stability Information
            
                
                
                    
                    Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
                
            
    
    | Specimen Type | Temperature | Time | Special Container | 
|---|---|---|---|
| Varies | Refrigerated | 48 hours | 
    
        Useful For
            
                
                
                    
                    Suggests clinical disorders or settings where the test may be helpful
                
            
    
    Diagnosis of Legionnaires disease
    
        Testing Algorithm
            
                
                
                    
                    Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
                
            
    
    When this test is ordered, the reflex tests may be performed at an additional charge.
    
        Clinical Information
            
                
                
                    
                    Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
                
            
    
    The Legionellaceae are ubiquitous in natural freshwater habitats, allowing them to colonize artificial water supplies (eg, reservoirs), which may then serve as the source for human infections.
 
Legionella pneumophila and the related species, Legionella bozemanii, Legionella dumoffii, Legionella gormanii, Legionella micdadei, Legionella longbeachae, and Legionella jordanis have been isolated from patients with pneumonia (Legionnaires disease). The organism has been isolated from lung tissue, bronchoalveolar lavage, pleural fluid, and sputum. The signs, symptoms, and radiographic findings of Legionnaires disease are generally nonspecific.
    
        Reference Values
            
                
                
                    
                    Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
                
            
    
    No growth of Legionella species after 7 days of incubation
    
        Interpretation
            
                
                
                    
                    Provides information to assist in interpretation of the test results
                
            
    
    Identification of Legionella species from respiratory specimens provides a definitive diagnosis of Legionnaires disease.
Organisms isolated are identified as Legionella species via matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry and/or 16S ribosomal RNA (rRNA) gene sequencing.
    
        Cautions
            
                
                
                    
                    Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
                
            
    
    Although semi-selective media is utilized, recovery of Legionella in specimens heavily contaminated with indigenous microbiota (ie, sputum) may be difficult.
    
        Clinical Reference
            
                
                
                    
                    Recommendations for in-depth reading of a clinical nature
                
            
    
    1. Edelstein PH. Legionella In: Carroll KC, Pfaller MA, eds. Manual of Clinical Microbiology. 12th ed. ASM Press; 2019:905-920
2. Clinical and Laboratory Standards Institute. Interpretive Criteria for Identification of Bacteria and Fungi by Targeted DNA Sequencing. 2nd ed. CLSI Guideline MM18. CLSI; 2018
3. Rucinski SL, Murphy MP, Kies KD, Cunningham SA, Schuetz AN, Patel R. Eight years of clinical Legionella PCR testing illustrates a seasonal pattern. J Infect Dis. 2018;218(4):669-670. doi:10.1093/infdis/jiy201
    
        Method Description
            
                
                
                    
                    Describes how the test is performed and provides a method-specific reference
                
            
    
    Specimens are cultured on buffered charcoal-yeast extract-based media. Colonies may appear within a few days; however, cultures are incubated for 7 days before issuing a negative report. Positive specimens will be identified via matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry and/or 16S ribosomal RNA (rRNA) gene sequencing.(Edelstein PH. Improved semi-selective medium for isolation of Legionella pneumophila from contaminated clinical and environmental specimens. J Clin Microbiol. 1981;14:298-303; CLSI. Interpretive Criteria for Identification of Bacteria and Fungi by Targeted DNA Sequencing. 2nd ed. CLSI Guideline MM18. Clinical and Laboratory Standards Institute; 2018)
    
        PDF Report
            
                
                
                    
                    Indicates whether the report includes an additional document with charts, images or other enriched information
                
            
    
    
    
        Day(s) Performed
            
                
                
                    
                    Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
                
            
    
    Monday through Sunday
    
        Report Available
            
                
                
                    
                    The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
                
            
    
    
    
        Specimen Retention Time
            
                
                
                    
                    Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
                
            
    
    
    
        Performing Laboratory Location
            
                
                
                    
                    Indicates the location of the laboratory that performs the test
                
            
    
    
    
        Fees :
            
                
                
                    
                    Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
                
            
    
    - Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
    
        Test Classification
            
                
                
                    
                    Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
                
            
    
    This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
    
        CPT Code Information
            
                
                
                    
                    Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
                
            
    
    CPT codes are provided by the performing laboratory.
87081
87077-Ident by MALDI-TOF mass spec
    
        LOINC® Information
            
                
                
                    
                    Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
                
            
    
    | Test Id | Test Order Name | Order LOINC Value | 
|---|---|---|
| LEGI | Legionella Culture | 593-4 | 
| Result Id | Test Result Name | Result LOINC Value 
                                        
                                        Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
                                     | 
|---|---|---|
| LEGI | Legionella Culture | In Process |