Triassi M, Di Popolo A, Ribera D'Alcalà G, Albanese Z, Cuccurullo S, Montegrosso S, Crispino M, Borella P, Zarrilli R
Dipartimento di Scienze Mediche Preventive, Sezione di Igiene, Università di Napoli Federico II, Napoli, Italy.
J Hosp Infect. 2006 Apr;62(4):494-501. doi: 10.1016/j.jhin.2005.09.029. Epub 2006 Feb 7.
The molecular epidemiology of Legionella pneumophila in the 'V. Monaldi' University Hospital was studied. Seven cases of nosocomial Legionnaires' disease were diagnosed between 1999 and 2003. Two clinical legionella strains obtained from two patients in the adult cardiac surgery unit (CSU) and 30 environmental legionella strains from the paediatric and adult CSUs, neonatal intensive care unit (NICU) and the cardiorespiratory intensive care unit (CR-ICU) were serotyped and genotyped. L. pneumophila serogroup 1/Philadelphia with an identical pulsed-field gel electrophoresis (PFGE) profile A was isolated from two patients in the adult CSU, and from three and one water samples taken in the adult CSU and the paediatric CSU, respectively, from 2001 to 2002. Furthermore, L. pneumophila serogroup 3 with an identical PFGE profile B was identified in 20 environmental strains from all wards, L. pneumophila serogroup 3 with PFGE profile C was identified in a single environmental strain from the CR-ICU, and non-pneumophila Legionella with identical PFGE profile D was identified in five environmental strains from the adult CSU, paediatric CSU and NICU. Ultraviolet irradiation was effective in disinfection of the hospital water supplies in the adult and paediatric CSUs contaminated by L. pneumophila clone associated with nosocomial Legionnaires' disease. In conclusion, these data demonstrate that two cases of nosocomial legionellosis were caused by the persistence of a single clone of L. pneumophila serogroup 1/Philadelphia in the hospital environment, and that disinfection by ultraviolet irradiation may represent an effective measure to prevent nosocomial Legionnaires' disease.
对“V. Monaldi”大学医院嗜肺军团菌的分子流行病学进行了研究。1999年至2003年间诊断出7例医院获得性军团病病例。对从成人心脏外科病房（CSU）的两名患者分离出的2株临床嗜肺军团菌菌株以及来自儿科和成人CSU、新生儿重症监护病房（NICU）和心肺重症监护病房（CR - ICU）的30株环境嗜肺军团菌菌株进行了血清分型和基因分型。从成人CSU的两名患者以及分别于2001年至2002年在成人CSU和儿科CSU采集的3份和1份水样中分离出具有相同脉冲场凝胶电泳（PFGE）图谱A的嗜肺军团菌血清型1/费城型。此外，在所有病房的20株环境菌株中鉴定出具有相同PFGE图谱B的嗜肺军团菌血清型3，在CR - ICU的1株环境菌株中鉴定出具有PFGE图谱C的嗜肺军团菌血清型3，在成人CSU、儿科CSU和NICU的5株环境菌株中鉴定出具有相同PFGE图谱D的非嗜肺军团菌。紫外线照射对医院成人和儿科CSU中被与医院获得性军团病相关的嗜肺军团菌克隆污染的供水系统具有消毒效果。总之，这些数据表明，两例医院获得性军团菌病是由医院环境中嗜肺军团菌血清型1/费城型的单一克隆持续存在引起的，并且紫外线照射消毒可能是预防医院获得性军团病的有效措施。
