{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T15:42:33Z","timestamp":1776872553038,"version":"3.51.2"},"reference-count":33,"publisher":"American Society for Microbiology","issue":"4","license":[{"start":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T00:00:00Z","timestamp":1712707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T00:00:00Z","timestamp":1712707200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2024,4,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>\n              Many\n              <jats:italic>Legionella<\/jats:italic>\n              pneumonia patients do not produce sputum, and it is unknown whether purulent sputum is required for the identification of\n              <jats:italic>Legionella<\/jats:italic>\n              species. This study aimed to evaluate the identification rate of\n              <jats:italic>Legionella<\/jats:italic>\n              species based on sputum quality and the factors predictive of\n              <jats:italic>Legionella<\/jats:italic>\n              infection. This study included\n              <jats:italic>Legionella<\/jats:italic>\n              pneumonia patients at Kurashiki Central Hospital from November 2000 to December 2022. Sputum quality, based on gram staining, was classified as the following: Geckler 1\/2, 3\/6 and 4\/5. Geckler 4\/5 was defined as purulent sputum. The sputa of 104 of 124\n              <jats:italic>Legionella<\/jats:italic>\n              pneumonia patients were cultured. Fifty-four patients (51.9%) were identified with\n              <jats:italic>Legionella<\/jats:italic>\n              species, most of which were\n              <jats:italic>Legionella pneumophila<\/jats:italic>\n              serogroup 1 (81.5%). The identification rates of\n              <jats:italic>Legionella<\/jats:italic>\n              species according to sputum quality were 57.1% (16\/28) in Geckler 1\/2 sputum, 50.0% (34\/68) in Geckler 3\/6 sputum, and 50.0% (4\/8) in Geckler 4\/5 sputum, which were not significantly different (\n              <jats:italic>P<\/jats:italic>\n              = 0.86). On multivariate analysis, pre-culture treatment with anti-\n              <jats:italic>Legionella<\/jats:italic>\n              antimicrobials (odds ratio [OR] 0.26, 95% confidence interval [CI] 0.06\u20130.91), Pneumonia Severity Index class \u2265IV (OR 2.57 [95% CI 1.02\u20136.71]), and intensive care unit admission (OR 3.08, 95% CI 1.06\u201310.09) correlated with the ability to identify\n              <jats:italic>Legionella<\/jats:italic>\n              species, but sputum quality did not (OR 0.88, 95% CI 0.17\u20134.41). The identification rate of\n              <jats:italic>Legionella<\/jats:italic>\n              species in non-purulent sputum was similar to that in purulent sputum. For the diagnosis of\n              <jats:italic>Legionella<\/jats:italic>\n              pneumonia, sputum should be collected before administering anti-\n              <jats:italic>Legionella<\/jats:italic>\n              antibiotics and cultured regardless of sputum quality.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/jcm.01665-23","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T12:00:50Z","timestamp":1710849650000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":2,"title":["Identification rate of\n            <i>Legionella<\/i>\n            species in non-purulent sputum culture is comparable to that in purulent sputum culture in\n            <i>Legionella<\/i>\n            pneumonia"],"prefix":"10.1128","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7508-0442","authenticated-orcid":true,"given":"Akihiro","family":"Ito","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadashi","family":"Ishida","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromasa","family":"Tachibana","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, National Hospital Organization, Minami Kyoto Hospital, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yosuke","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanori","family":"Kawataki","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akio","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuyoshi","family":"Washio","sequence":"additional","affiliation":[{"name":"Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.114.6.1588"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10156-005-0425-8"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.56.4.296"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1086\/586741"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.143982"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.52.8830"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13-0162"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2014.04.005"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01695659"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60078-2"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00029-14"},{"key":"e_1_3_3_13_2","first-page":"66","article-title":"Questionnaire survey results on diagnosis and treatment of Legionella. 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Comparative study of the detection rates of the urinary antigen test and the LAMP method for Legionella species. 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