Thouverez M, Godard C, Leprat R, Talon D
Service d'Hygiène Hospitalière, Hôpital Jean Minjoz, Besançon, France.
J Hosp Infect. 2003 Dec;55(4):254-9. doi: 10.1016/j.jhin.2003.08.009.
Pulsed-field gel electrophoresis (PFGE) was used to type Legionella pneumophila isolates collected from the water systems of Besançon University Hospital and other hospitals in Franche-Comté region between January 2001 and December 2002 and compare them with patient isolates to identify hospital-acquired pneumonia. Genomic DNA was digested with SfiI and subjected to PFGE in a clamped, homogeneous electric field apparatus. Two of 11 Legionella infections were hospital-acquired. Both were with the same type, also present in the ward water. An environmental strain isolated from the water system of Vesoul Hospital, exhibited DNA pattern 6, also found in three patients with community-acquired pneumonia, who had never been in Vesoul hospital and lived in different towns located >60 km away. Patient 11, who lived in Besançon, was infected with a DNA pattern 12 strain. This patient had never been to the Besançon swimming pool, from which a similar strain was collected. Subtype matching of patient and environmental isolates should be interpreted with caution, and it is important to combine a molecular typing method with sound epidemiological data to ensure that the most stringent criteria are used to determine whether a hospital-reservoir is responsible for nosocomial pneumonia.
2001年1月至2002年12月期间，采用脉冲场凝胶电泳（PFGE）技术对从贝桑松大学医院及弗朗什 - 孔泰地区其他医院的水系统中分离出的嗜肺军团菌菌株进行分型，并将其与患者分离株进行比较，以确定医院获得性肺炎。用SfiI酶消化基因组DNA，并在钳位均匀电场装置中进行PFGE分析。11例军团菌感染中有2例为医院获得性感染。两者感染的是同一类型菌株，该菌株也存在于病房用水中。从韦苏尔医院水系统分离出的一株环境菌株，其DNA图谱为6型，在3例社区获得性肺炎患者中也发现了相同图谱，这些患者从未去过韦苏尔医院，且居住在距离韦苏尔医院60多公里外的不同城镇。居住在贝桑松的患者11感染了DNA图谱为12型的菌株。该患者从未去过贝桑松游泳池，但从该游泳池收集到了类似菌株。患者与环境分离株的亚型匹配结果应谨慎解读，将分子分型方法与可靠的流行病学数据相结合很重要，以确保使用最严格的标准来确定医院储水系统是否是医院获得性肺炎的病因。
