Cross-reactive urinary antigens among patients infected with Legionella pneumophila serogroups 1 and 4 and the Leiden 1 strain.

A solid-phase radioimmunoassay was developed to detect antigens of Legionella pneumophila serogroup 4. The assay detected antigen in urine from four of seven patients with pneumonia caused by L. pneumophila serogroup 4, two of two patients with L. pneumophila Leiden 1 strain (proposed new serogroup), and 26 of 55 patients with L. pneumophila serogroup 1 (proven by culture or direct fluorescent-antibody assay). The antigen of two patients with serogroup 4, one with Leiden 1 strain, and 49 with serogroup 1 infections could be detected in a previously described assay for antigens of L. pneumophila serogroup 1. Serogroup specificity of the assays could be demonstrated if serial dilutions of urine were tested. None of 347 urine specimens used as controls were positive in the radioimmunoassay. We conclude that antigens are excreted in the urine of at least some patients with Legionnaires' disease caused by serogroup 4 and Leiden 1 strain. The urinary antigens in patients with serogroup 4 and Leiden 1 strain infections, although different from those in patients with serogroup 1 infections, serologically contain cross-reactive components.