Borella P, Bargellini A, Pergolizzi S, Aggazzotti G, Curti C, Nizzero P, Stancanelli G, Vaiani R, Gesù G, Mazzuconi R
Dip. di Scienze Igienistiche, Microbiologiche e Biostatistiche, Università di Modena e Reggio Emilia.
Ann Ig. 2000 Jul-Aug;12(4):287-96.
An outbreak of nosocomial legionnaires' disease in a hospital of Northern Italy is described, together with the epidemiological survey and the control measures adopted. Two patients developed Legionella pneumophila (serogroup 1) pneumonia, one (immunodepressed) died. The Task Group organised by the Health Service excluded other previous nosocomial infections, and made controls on patients and personnel of at risk units (all negative). An intensive programme of environmental sampling and educational activities on personnel have been carried out. The environmental surveillance revealed that the centralised hot water distribution system of the hospital was colonised with Legionella. Shock heating and hyperchlorination of water were applied, which reduced the number of contaminated sites short term, but recolonisation took place two months later. We underline the difficulties encountered to control Legionella by active surveillance of water quality; once the system is contamined, Legionella eradication may be difficult and expensive, and cases of hospital-acquired legionnaieres' disease are likely to occur.
本文描述了意大利北部一家医院发生的医院内军团病暴发事件，以及所开展的流行病学调查和采取的控制措施。两名患者感染嗜肺军团菌（血清型1）肺炎，其中一名（免疫功能低下）死亡。卫生服务部门组建的任务组排除了此前其他医院感染的可能性，并对高危科室的患者和工作人员进行了检查（结果均为阴性）。已开展了一项密集的环境采样计划和针对工作人员的教育活动。环境监测显示，医院的集中式热水分配系统中存在军团菌。对水进行了冲击加热和超氯化处理，短期内减少了污染部位的数量，但两个月后又重新出现了定植。我们强调了通过对水质进行主动监测来控制军团菌所遇到的困难；一旦系统受到污染，根除军团菌可能既困难又昂贵，并且很可能会发生医院获得性军团病病例。
