2013年俄亥俄州一家使用自动消毒系统的冷却塔导致长期护理机构发生军团病疫情

Legionnaires' Disease Outbreak at a Long-Term Care Facility Caused by a Cooling Tower Using an Automated Disinfection System--Ohio, 2013.

作者信息

Quinn Celia, Demirjian Alicia, Watkins Louise Francois, Tomczyk Sara, Lucas Claressa, Brown Ellen, Kozak-Muiznieks Natalia, Benitez Alvaro, Garrison Laurel E, Kunz Jasen, Brewer Scott, Eitniear Samantha, DiOrio Mary

出版信息

J Environ Health. 2015 Dec;78(5):8-13.

PMID:26738313

Abstract

On July 9, 2013, an outbreak of Legionnaires' disease (LD) was identified at Long-Term Care Facility A in central Ohio. This article describes the investigation of the outbreak and identification of the outbreak source, a cooling tower using an automated biocide delivery system. In total, 39 outbreak LD cases were identified; among these, six patients died. Water samples from a cooling tower were positive for Legionella pneumophila serogroup 1, reactive to monoclonal antibody 2, with matching sequence type to a patient isolate. An electronic control system turned off cooling tower pumps during low-demand periods, preventing delivery of disinfectant by a timed-release system, and leading to amplification of Legionella in the cooling tower. Guidelines for tower maintenance should address optimal disinfection when using automated systems.

摘要

2013年7月9日，俄亥俄州中部的长期护理机构A发现了一起军团病（LD）疫情。本文描述了对此次疫情的调查以及疫情源头的确定，源头是一座使用自动杀菌剂输送系统的冷却塔。总共确定了39例疫情相关的军团病病例；其中6名患者死亡。冷却塔的水样中嗜肺军团菌血清1型呈阳性，与单克隆抗体2发生反应，序列类型与一名患者的分离株匹配。电子控制系统在需求较低期间关闭了冷却塔水泵，阻止了定时释放系统输送消毒剂，导致冷却塔中军团菌大量繁殖。冷却塔维护指南应涉及使用自动化系统时的最佳消毒方法。