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In a recently published report, we assessed the performance of PCR as a diagnostic method and compared the performance of different PCR assays of serum samples from patients with Legionnaires’ disease (LD) (Diederen et al., 2007). Among the patients with proven LD, 54.4 % tested positive in 5S rRNA PCR, 52.9 % in mip gene PCR and 30.9 % in 16S rRNA PCR in the first available serum sample. We were not able to investigate the relationship between test sensitivity and severity of disease. However, the association between Ct value in 5S PCR positive serum samples (n549) and C-reactive protein value was determined, and showed a strong negative correlation (Pearson correlation coefficient r520.63; P ,0.0001). As the urinary antigen test is less reliable in milder cases of LD, it would be plausible that the same holds true for the detection of Legionella DNA in serum (Yzerman et al., 2002). The aim of the described study was to assess the sensitivity of PCR as a diagnostic method and to investigate a possible relationship between test sensitivity and the severity of disease.

Sensitivity of Legionella pneumophila DNA detection in serum samples in relation to disease severity