{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T18:31:01Z","timestamp":1787941861100,"version":"build-2784847793"},"reference-count":22,"publisher":"BMJ","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2013,4,18]]},"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>\n                      A positive urinary antigen test for\n                      <jats:italic>Legionella<\/jats:italic>\n                      spp. (Legionella urinary antigen test; LUAT) allows an early switch from empiric to targeted treatment (TT) in hospitalised, community-acquired pneumonia (CAP) patients. We aimed to evaluate the diagnostic, therapeutic and economic consequences of this frequently used test 7\u2005years after its implementation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively evaluated LUATs performed between 2005 and 2011 in two teaching hospitals. All tests performed in hospitalised CAP patients were used in the economic evaluation and positive tests were included in the treatment evaluation. Data on patient characteristics, admission and outcome were retrieved from the patients\u2019 files. The number of days gained by making a rapid aetiological diagnosis, the number of days TT could be provided and their costs were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 4485 LUATs, 2504 (56%) were performed for CAP including 55 (1%) positive tests (\u20ac1041\/positive test). In 26 (60%) of the 43 included positive tests, LUAT was the only test showing\n                      <jats:italic>Legionella<\/jats:italic>\n                      spp. Subsequently, earlier TT was possible in the remaining cases during 209 cumulative admission days (\u20ac274\/TT day). LUAT led to detection of\n                      <jats:italic>Legionella<\/jats:italic>\n                      spp. 13\u2005days earlier per case (\u20ac203\/day) as compared with culture\/serology alone.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Timely LUAT use in accordance with current guidelines allows early detection and treatment of CAP caused by\n                      <jats:italic>Legionella<\/jats:italic>\n                      spp. at considerable expense.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jclinpath-2012-201209","type":"journal-article","created":{"date-parts":[[2013,6,17]],"date-time":"2013-06-17T23:05:29Z","timestamp":1371510329000},"page":"797-802","source":"Crossref","is-referenced-by-count":22,"title":["Diagnostic, therapeutic and economic consequences of a positive urinary antigen test for\n                    <i>Legionella<\/i>\n                    spp. in patients admitted with community-acquired pneumonia: a 7-year retrospective evaluation"],"prefix":"10.1136","volume":"66","author":[{"given":"M F","family":"Engel","sequence":"first","affiliation":[{"name":"Department of internal medicine and infectious diseases, University Medical Centre Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"van Manen","sequence":"additional","affiliation":[{"name":"Department of internal medicine and infectious diseases, University Medical Centre Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A I M","family":"Hoepelman","sequence":"additional","affiliation":[{"name":"Department of internal medicine and infectious diseases, University Medical Centre Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Thijsen","sequence":"additional","affiliation":[{"name":"Department of medical microbiology, Diakonessen hospital, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J J","family":"Oosterheert","sequence":"additional","affiliation":[{"name":"Department of internal medicine and infectious diseases, University Medical Centre Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2013,6,17]]},"reference":[{"key":"2025112109072890000_66.9.797.1","first-page":"90","article-title":"SWAB\/NVALT (Dutch Working Party on Antibiotic Policy and Dutch Association of Chest Physicians) Guidelines on the management of community-acquired pneumonia in adults","volume":"2","author":"Wiersinga","year":"2012","journal-title":"Neth J Med"},{"key":"2025112109072890000_66.9.797.2","unstructured":"Centres for Disease Control and Prevention; National Center for Immunization and Respiratory Diseases. Patient Facts: Learn More about Legionnaires\u2019 disease. Jun 2011. http:\/\/www.cdc.gov\/legionella\/patient_facts.htm (accessed 30 Dec 2012)."},{"key":"2025112109072890000_66.9.797.3","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2008.104778"},{"key":"2025112109072890000_66.9.797.4","doi-asserted-by":"publisher","DOI":"10.1086\/511159"},{"key":"2025112109072890000_66.9.797.5","first-page":"323","article-title":"Revised SWAB guidelines for antimicrobial therapy of community-acquired pneumonia","volume":"8","author":"Schouten","year":"2005","journal-title":"Neth J Med"},{"key":"2025112109072890000_66.9.797.6","doi-asserted-by":"publisher","DOI":"10.1136\/thx.44.12.1031"},{"key":"2025112109072890000_66.9.797.7","doi-asserted-by":"publisher","DOI":"10.1378\/chest.113.5.1195"},{"key":"2025112109072890000_66.9.797.8","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2004.018861"},{"key":"2025112109072890000_66.9.797.9","doi-asserted-by":"crossref","unstructured":"Engel MF Postma DF Hulscher ME . Barriers to an early switch from intravenous to oral antibiotic therapy in hospitalised patients with community-acquired pneumonia. Eur Respir J 2013 Jan;41(1):123\u201330. doi: 10.1183\/09031936.00029412. 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SWAB\/NVALT (Dutch Working Party on Antibiotic Policy and Dutch Association of Chest Physicians) guidelines on the management of community-acquired pneumonia in adults. Neth J Med 2012;70(2): 90\u2013101."},{"key":"2025112109072890000_66.9.797.19","first-page":"85","article-title":"Clinical utility of a Legionella pneumophila urinary antigen test in a large university teaching hospital","volume":"2","author":"Dionne","year":"2003","journal-title":"Can J Infect Dis"},{"key":"2025112109072890000_66.9.797.20","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.118588"},{"key":"2025112109072890000_66.9.797.21","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.3201\/eid0812.020035","article-title":"Legionnaires\u2019 disease at a Dutch flower show: prognostic factors and impact of therapy","volume":"8","author":"Lettinga","year":"2002","journal-title":"Emerg Infect Dis"},{"key":"2025112109072890000_66.9.797.22","doi-asserted-by":"publisher","DOI":"10.1080\/00365540802014864"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jclinpath-2012-201209","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T17:07:40Z","timestamp":1763744860000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jclinpath-2012-201209"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,6,17]]},"references-count":22,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2013,8,16]]},"published-print":{"date-parts":[[2013,9]]}},"alternative-id":["10.1136\/jclinpath-2012-201209"],"URL":"https:\/\/doi.org\/10.1136\/jclinpath-2012-201209","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,6,17]]}}}