Sabria M, Alvarez J, Dominguez A, Pedrol A, Sauca G, Salleras L, Lopez A, Garcia-Nuñez M A, Parron I, Barrufet M P
Hospital Universitario Germans Trias I Pujol, Infectious Diseases, Badalona, Barcelona, Spain.
Clin Microbiol Infect. 2006 Jul;12(7):642-7. doi: 10.1111/j.1469-0691.2006.01447.x.
A community outbreak of Legionella pneumonia in the district of Cerdanyola, Mataró (Catalonia, Spain) was investigated in an epidemiological, environmental and molecular study. Each patient was interviewed to ascertain personal risk-factors and the clinical and epidemiological data. Isolates of Legionella from patients and water samples were subtyped by pulsed-field gel electrophoresis. Between 7 August and 25 August 2002, 113 cases of Legionella pneumonia fulfilling the outbreak case definition criteria were reported, with 84 (74%) cases being located within a 500-m radius of the suspected cooling tower source. In this area, the relative risk of being infected was 54.6 (95% CI 25.3-118.1) compared with individuals living far from the cooling tower. Considering the population residing in the Cerdanyola district (28,256 inhabitants) as a reference population, the attack rate for the outbreak was 399.9 cases/100,000 inhabitants, and the case fatality rate was 1.8%. A single DNA subtype was observed among the ten clinical isolates, and one of the subtypes from the cooling tower matched exactly with the clinical subtype. Nine days after closing the cooling tower, new cases of pneumonia caused by Legionella ceased to appear. The epidemiological features of the outbreak, and the microbiological and molecular investigations, implicated the cooling tower as the source of infection.
在一项流行病学、环境和分子研究中，对西班牙加泰罗尼亚马塔罗市塞尔达尼奥拉区军团菌肺炎的社区暴发进行了调查。对每位患者进行访谈，以确定个人风险因素以及临床和流行病学数据。通过脉冲场凝胶电泳对患者和水样中的军团菌分离株进行亚型分析。2002年8月7日至8月25日期间，报告了113例符合暴发病例定义标准的军团菌肺炎病例，其中84例（74%）位于疑似冷却塔源半径500米范围内。在该区域，与居住在远离冷却塔的个体相比，感染的相对风险为54.6（95%可信区间25.3 - 118.1）。以塞尔达尼奥拉区的居民（28,256人）作为参考人群，此次暴发的发病率为399.9例/10万居民，病死率为1.8%。在10株临床分离株中观察到单一的DNA亚型，冷却塔分离出的一种亚型与临床亚型完全匹配。关闭冷却塔9天后，由军团菌引起的肺炎新病例不再出现。此次暴发的流行病学特征以及微生物学和分子学调查表明，冷却塔是感染源。
