| Summary: | Urinary antigen tests (UATs) are often used to diagnose Legionnaires’ disease as they are rapid and easy to perform on readily obtainable urine samples without the need for specialized skills compared to conventional methods. Recently developed automated readers for UATs may provide objective results interpretation, especially in cases of weak result bands. Using 53 defined patient urine samples, we evaluated the performance of the BinaxNOW <i>Legionella</i> Antigen Card (Abbott), ImmuView <i>S. pneumoniae</i> and <i>Legionella</i> (SSI Diagnostica), STANDARD F <i>Legionella</i> Ag FIA (SD Biosensor), and Sofia <i>Legionella</i> FIA (Quidel) simultaneously with their respective automated readers. Automatic and visual interpretation of result bands were also compared for the immunochromatography-based BinaxNOW and ImmuView UATs. Overall sensitivity and specificity of <i>Legionella</i> UATs were 53.9–61.5% and 90.0–94.9%, respectively. All four UATs successfully detected all samples from <i>L. pneumophila</i> serogroup 1-positive patients, but most failed to detect samples for <i>Legionella</i> spp., or other serogroups. Automatic results interpretation of results was found to be mostly concordant with visual results reading. In conclusion, the performance of the four UATs were similar to each other in the detection of <i>Legionella</i> urinary antigen with no major difference between automated or visual results reading.
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