A retrospective data analysis of Legionella pneumophila diagnostic procedures and their impact on patients' management: the experience of a rapid point-of-care test

We compare a conventional and a rapid point of care test (POCT) for the diagnosis of Legionella pneumophila, considering various performance criteria. We used data of patients with positive test for L. pneumophila (confirmed cases), registered by the microbiology laboratories of two hospitals in Crete, Greece. Hospital A adopts a conventional, indirect fluorescent-antibody technique and Hospital B uses a urinary antigen POCT. The mean laboratory turnaround time was 4.45 days for the conventional test and 0.11 days for POCT. A total of 24 laboratory positive cases (11 inpatients, 13 outpatients) were identified out of 905 samples taken from 751 people. The mean daily hospitalisation cost per inpatient was €79.86 for Hospital B and €127.45 for Hospital A; for the latter a much higher antibiotic treatment cost/patient was recorded. The analysis suggests that a rapid POCT for L. pneumophila could significantly decrease time to diagnosis, improve treatment and reduce hospitalisation charges.