Han Xiang Y, Ihegword Andrea, Evans Scott E, Zhang Jiaqi, Li Li, Cao Hongjing, Tarrand Jeffrey J, El-Kweifi Omar
Department of Laboratory Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
Department of Laboratory Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
J Clin Microbiol. 2015 Jul;53(7):2180-7. doi: 10.1128/JCM.00380-15. Epub 2015 Apr 29.
Legionella, a large group of environmental Gram-negative bacteria, represents an occasional cause of pneumonia. We analyzed the microbiological and clinical features of 33 consecutive cases of Legionella infections that occurred at the University of Texas MD Anderson Cancer Center, Houston, TX, from 2002 to 2014. The Legionella strains were isolated from bronchoscopy specimens (32 strains) and a blood culture (1 strain) and were identified by sequencing analysis of the full-length 16S rRNA gene. The 33 strains involved 12 Legionella species or subspecies: 15 strains of L. pneumophila subsp. pneumophila, 3 strains of L. pneumophila subsp. fraseri or L. pneumophila subsp. pascullei, 4 strains of "L. donaldsonii," 3 strains of L. micdadei, and one each of L. bozemanae, L. feeleii, L. gormanii, L. longbeachae, L. maceachernii, L. parisiensis, L. sainthelensi, and Legionella sp. strain D5382. All patients except one asymptomatic carrier showed pneumonia, including one with concurrent bacteremia. Nine patients died, with this infection being the immediate cause of death in six. Twenty-seven patients had underlying hematologic malignancies. Twenty-three patients were leukopenic. Six patients were recipients of allogeneic hematopoietic stem cell transplant, with their infections caused by five Legionella species. Together, these results suggest that diverse Legionella species infect patients with cancer in the Houston area and its vicinity. The five cases of pneumonia due to L. donaldsonii and Legionella sp. D5382 are likely the first reports of human infection with these organisms.
嗜肺军团菌是一大类环境革兰氏阴性菌，偶尔会引发肺炎。我们分析了2002年至2014年在德克萨斯大学MD安德森癌症中心（位于德克萨斯州休斯顿）连续发生的33例军团菌感染的微生物学和临床特征。军团菌菌株从支气管镜检查标本（32株）和一份血培养物（1株）中分离得到，并通过对全长16S rRNA基因进行测序分析来鉴定。这33株菌株涉及12种军团菌属或亚种：嗜肺军团菌嗜肺亚种15株，嗜肺军团菌弗雷泽亚种或嗜肺军团菌帕斯库莱亚种3株，“唐纳森军团菌”4株，米克戴德军团菌3株，以及博兹曼军团菌、费氏军团菌、戈尔曼军团菌、长滩军团菌、马卡切尼军团菌、巴黎军团菌、圣泰尔恩军团菌各1株，还有军团菌属菌株D5382。除一名无症状携带者外，所有患者均表现出肺炎，其中一名患者并发菌血症。9名患者死亡，6名患者直接死因是这种感染。27名患者患有潜在的血液系统恶性肿瘤。23名患者白细胞减少。6名患者是异基因造血干细胞移植受者，他们的感染由5种军团菌引起。总体而言，这些结果表明，多种军团菌属感染了休斯顿地区及其附近的癌症患者。由唐纳森军团菌和军团菌属菌株D5382引起的5例肺炎很可能是这些病原体人类感染的首次报道。
