Huang Bixing, Heron Brett A, Gray Bruce R, Eglezos Sofroni, Bates John R, Savill John
Molecular Microbiology R&D Unit, Public Health Microbiology Laboratory, Queensland Health Scientific Services, 39 Kessels Rd., Coopers Plains, QLD 4108, Australia.
J Clin Microbiol. 2004 Sep;42(9):4164-8. doi: 10.1128/JCM.42.9.4164-4168.2004.
In epidemiological investigations of community legionellosis outbreaks, knowledge of the prevalence, distribution, and clinical significance (virulence) of environmental Legionella isolates is crucial for interpretation of the molecular subtyping results. To obtain such information for Legionella pneumophila serogroup 1 isolates, we used the standardized amplified fragment length polymorphism (AFLP) protocol of the European Working Group on Legionella Infection to subtype L. pneumophila SG1 isolates obtained from patients and water sources in Queensland, Australia. An AFLP genotype, termed AF1, was predominant in isolates from both patients (40.5%) and water (49.0%). The second most common AFLP genotype found in water isolates was AF16 (36.5%), but this genotype was not identified in the patient isolates. When virulence gene-based PCR assays for lvh and rtxA genes were applied to the isolates from patients and water, nearly all (65 of 66) AF1 strains had both virulence genes, lvh and rtxA. In contrast, neither the lvh nor the rtxA gene was found in the AF16 strains, except for one isolate with the rtxA gene. It appears that this may explain the failure to find this genotype in the isolates from patients even though it may be common in the environment. In view of the evidence that the AF1 genotype is the most common genotype among strains found in patients and water sources in this region, any suggested epidemiological link derived from comparing the AF1 genotype from patient isolates with the AF1 genotype from environmental isolates must be interpreted and acted on with caution. The use of virulence gene-based PCR assays applied to environmental samples may be helpful in determining the infection potential of the isolates involved.
在社区军团菌病暴发的流行病学调查中,了解环境军团菌分离株的流行率、分布及临床意义(毒力)对于解释分子分型结果至关重要。为获取嗜肺军团菌血清型1分离株的此类信息,我们采用欧洲军团菌感染工作组的标准化扩增片段长度多态性(AFLP)方案,对从澳大利亚昆士兰州患者和水源中分离得到的嗜肺军团菌血清型1菌株进行分型。一种名为AF1的AFLP基因型在患者分离株(40.5%)和水源分离株(49.0%)中均占主导地位。在水源分离株中发现的第二常见AFLP基因型是AF16(36.5%),但在患者分离株中未鉴定出该基因型。当对患者和水源分离株进行基于毒力基因的lvh和rtxA基因PCR检测时,几乎所有(66株中的65株)AF1菌株都同时具有lvh和rtxA这两个毒力基因。相比之下,除了一株带有rtxA基因的分离株外,AF16菌株中未发现lvh基因和rtxA基因。这似乎可以解释为何尽管该基因型在环境中可能很常见,但在患者分离株中却未发现。鉴于有证据表明AF基因型是该地区患者和水源中分离出的菌株中最常见的基因型,任何通过比较患者分离株的AF1基因型与环境分离株的AF1基因型得出的流行病学关联建议都必须谨慎解释和采取行动。将基于毒力基因的PCR检测应用于环境样本可能有助于确定相关分离株的感染潜力。