Polat Yusuf, Ergin Cağri, Kaleli Ilknur, Pinar Ahmet
Mikrobiyol Bul. 2007 Apr;41(2):211-7.
Contaminated water sources, reservoirs and systems such as evaporative condensers of air-conditioners are known to be the main transmission routes of Legionella spp. which are ubiquitous aquatic bacteria. By virtue of this point the aim of this study was to investigate the rate of Legionella pneumophila seropositivity in a profession considered as risky due to the direct and prolonged exposure to air-conditioning and air-circulating systems. For this purpose, in the period of February-August 2004 a total of 79 male subjects (63 were bus drivers and 16 were driver assistants) who were continously travelling to two different route (South part as hot climate and Middle/North parts as cold climate of Turkey) from Denizli province coach station (a province located in internal Aegian where accepted as crossroads), were included to the study. The mean age and mean working duration of bus drivers were 43.0 +/- 1.1 years and 20.0 +/- 1.1 years, respectively, while these values were 22.5 +/- 0.9 years and 4.0 +/- 0.6 years, respectively, for the drivers' assistants. The serum samples collected from the subjects were screened by a commercial indirect immunofluorescence method (Euroimmun, Germany) using L. pneumophila serogrup 1-14 antigens for the presence of specific antibodies. Additionally, air-conditioners' moisture exhaust samples of the busses in which seropositive subjects travelling with have been examined by culture and 5S rRNA gene targeted polymerase chain reaction (PCR) methods, for the presence of Legionella spp. The overall L. pneumophila seropositivity rate was detected as 15.2% (12/79). This rate was 19% (12/63) for bus drivers while all of the drivers' assistants were found seronegative. The seropositivity rate was found statistically higher in the personnel who were travelling to the hot climates (10/36, 27.8%) than those who travel to cold climates (2/43, 4.6%), (p < 0.05). The culture and PCR yielded negative results for Legionella spp. in the exhaust samples collected from the air-conditioners of the busses in which seropositive drivers travel. Our data indicated that long distance bus drivers were chronically exposed to this pathogen and this may be considered as an occupational risk factor for legionellosis especially for drivers who travel to the west and south parts of our country (mean temperature in August 2004: 30-35 degrees C), since the bus air-conditioning and air-circulating systems are active during the travel. Further studies on air spreading of Legionella in intercity buses can reveal how the exposure occurs for bus drivers.
已知受污染的水源、蓄水池以及诸如空调蒸发冷凝器等系统是嗜肺军团菌的主要传播途径,嗜肺军团菌是一种广泛存在于水中的细菌。基于这一点,本研究的目的是调查一个因直接和长期接触空调及空气循环系统而被视为高风险职业的群体中嗜肺军团菌血清阳性率。为此,在2004年2月至8月期间,共有79名男性受试者(63名公交车司机和16名司机助手)被纳入研究,他们从代尼兹利省汽车站(位于安纳托利亚内陆被视为交通枢纽的一个省份)持续往返于两条不同路线(土耳其南部炎热气候区和中/北部寒冷气候区)。公交车司机的平均年龄和平均工作时长分别为43.0±1.1岁和20.0±1.1年,而司机助手的这两个值分别为22.5±0.9岁和4.0±0.6年。从受试者采集的血清样本采用商业化间接免疫荧光法(德国欧蒙公司),使用嗜肺军团菌血清型1 - 14抗原检测特异性抗体的存在情况。此外,对血清阳性受试者乘坐的公交车的空调排湿样本采用培养法和靶向5S rRNA基因的聚合酶链反应(PCR)法检测嗜肺军团菌的存在情况。总体嗜肺军团菌血清阳性率检测为15.2%(12/79)。公交车司机的这一比率为19%(12/63),而所有司机助手均为血清阴性。前往炎热气候区的人员(10/36,27.8%)的血清阳性率在统计学上高于前往寒冷气候区的人员(2/43,4.6%),(p<0.05)。从血清阳性司机乘坐的公交车空调采集的排湿样本中,培养法和PCR法检测嗜肺军团菌均为阴性结果。我们的数据表明,长途公交车司机长期暴露于这种病原体,这可能被视为军团病的一个职业风险因素,特别是对于前往我国西部和南部地区(2004年8月平均气温:30 - 35摄氏度)的司机,因为公交车空调和空气循环系统在行程中处于运行状态。关于城际公交车中军团菌空气传播的进一步研究可以揭示公交车司机是如何暴露的。