Struelens M J, Maes N, Rost F, Deplano A, Jacobs F, Liesnard C, Bornstein N, Grimont F, Lauwers S, McIntyre M P
Hospital Epidemiology and Infection Control Unit, Hôpital Erasme, Université Libre de Bruxelles, Belgium.
J Infect Dis. 1992 Jul;166(1):22-30. doi: 10.1093/infdis/166.1.22.
To determine the source of a nosocomial outbreak of Legionella pneumophila serogroup 1 infection and the efficacy of control measures, clinical and environmental isolates were characterized by molecular subtyping and disease surveillance was conducted. The outbreak involved 32 cases (relative risk, 4.0; P less than .001 vs. previous period). Water colonization with L. pneumophila serogroup 1 and patients' exposure to faucet use incriminated the water system as the environmental source. Monoclonal antibody typing showed that patient isolates belonged mainly to type Pontiac and water isolates mainly to type Bellingham (P less than .001). By four genotypic techniques, outbreak-related isolates from patients and the water system were found to be clonally related and distinct from control strains (P less than .001). Heat and UV light treatment of the water system showed a protective efficacy of 88% (95% confidence interval, 75%-94%). These findings indicate that phenotypic variation may interfere with monoclonal antibody typing of legionellae and that waterborne legionellosis can be controlled by physical disinfection.
为确定嗜肺军团菌1血清型医院感染暴发的源头及控制措施的效果，对临床和环境分离株进行分子分型鉴定，并开展疾病监测。此次暴发涉及32例病例（相对危险度为4.0；与前期相比，P<0.001）。嗜肺军团菌1血清型在水中定殖以及患者接触水龙头用水表明水系统是环境源头。单克隆抗体分型显示，患者分离株主要属于庞蒂亚克型，水分离株主要属于贝灵汉型（P<0.001）。通过四种基因分型技术发现，来自患者和水系统的与暴发相关的分离株具有克隆相关性，且与对照菌株不同（P<0.001）。对水系统进行加热和紫外线处理显示保护效果为88%（95%置信区间为75%-94%）。这些发现表明，表型变异可能会干扰军团菌的单克隆抗体分型，且水源性军团菌病可通过物理消毒加以控制。
