Engelhart Steffen, Pleischl Stefan, Lück Christian, Marklein Günter, Fischnaller Edith, Martin Sybille, Simon Arne, Exner Martin
Institute of Hygiene and Public Health, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany.
Int J Hyg Environ Health. 2008 Jul;211(3-4):235-40. doi: 10.1016/j.ijheh.2007.07.022. Epub 2007 Sep 17.
A case of hospital-acquired legionellosis occurred in a 75-year-old male patient who underwent surgery due to malignant melanoma. Legionellosis was proven by culture of Legionella pneumophila serogroup 1 from bronchoalveolar lavage (BAL) fluid. Being a chronic smoker the patient used to visit the sickroom balcony that was located about 90 m to the west of a hospital cooling tower. Routine cooling tower water samples drawn during the presumed incubation period revealed 1.0x10(4) CFU/100 ml (L. pneumophila serogroup 1). One of three isolates from the cooling tower water matched the patient's isolate by monoclonal antibody (mab)- and genotyping (sequence-based typing). Horizontal transport of cooling tower aerosols probably was favoured by meteorological conditions with thermal inversion. The case report stresses the importance of routine maintenance and microbiological control of hospital cooling towers.
一名75岁男性患者因恶性黑色素瘤接受手术，发生了医院获得性军团病。通过对支气管肺泡灌洗（BAL）液进行嗜肺军团菌血清1型培养，确诊为军团病。该患者为长期吸烟者，常去病房阳台，该阳台位于医院冷却塔以西约90米处。在假定的潜伏期采集的冷却塔常规水样显示，嗜肺军团菌血清1型为1.0x10(4) CFU/100 ml。冷却塔水样的三个分离株之一通过单克隆抗体（mab）和基因分型（基于序列的分型）与患者的分离株匹配。冷却塔气溶胶的水平传播可能受到逆温气象条件的影响。该病例报告强调了医院冷却塔常规维护和微生物控制的重要性。
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