Bornstein N, Marmet D, Surgot M, Nowicki M, Arslan A, Esteve J, Fleurette J
Centre National de Référence des Légionelloses, Faculté de Médecine Alexis Carrel, Lyon.
Epidemiol Infect. 1989 Feb;102(1):31-6. doi: 10.1017/s0950268800029654.
Following the occurrence of five cases of Legionnaires' disease among patients and therapists at a French hot spring spa, a series of cleansing procedures and an epidemiological study were undertaken. During a 3-month period, the spring water was repeatedly sampled. Serum samples were taken from 689 randomly selected patients, 230 therapists, 134 administrative staff and a control group of 904 blood donors. Legionellaceae were present in the spring water at concentrations of 10(3)-10(5) colony forming units/l. Fifteen different species or serogroups were isolated with Legionella pneumophila serogroups 3 and 1 predominating. No clinical cases of Legionnaires disease were observed during the study. However, 11% of the therapists and 5% of the patients either had a high titre of antibody (greater than or equal to 256) to at least one species or serogroup or seroconverted during the study. Mean antibody titres in the three study groups were significantly higher than those in the blood donors against 11 of the 32 legionella antigens tested. Nine of these 11 antigens corresponded to species or serogroups isolated from the spring water. The highest mean antibody titres in all three study groups were against L. pneumophila serogroup 3, the most common legionella in the spring water. These findings have important implications for the maintenance of adequate standards of hygiene, bacteriological sampling and clinical surveillance in this and similar establishments.
在法国一家温泉浴场的患者和治疗师中出现5例军团病病例后，开展了一系列清洁程序和一项流行病学研究。在3个月期间，对泉水进行了多次采样。从689名随机挑选的患者、230名治疗师、134名行政人员以及904名献血者组成的对照组中采集了血清样本。泉水中存在嗜肺军团菌科，浓度为10³-10⁵菌落形成单位/升。分离出15种不同的菌种或血清群，其中嗜肺军团菌血清群3和1占主导。研究期间未观察到军团病临床病例。然而，11%的治疗师和5%的患者在研究期间要么对至少一种菌种或血清群有高滴度抗体（大于或等于256），要么发生了血清转化。在测试的32种军团菌抗原中，三个研究组的平均抗体滴度显著高于献血者针对其中11种抗原的滴度。这11种抗原中的9种与从泉水中分离出的菌种或血清群相对应。所有三个研究组中平均抗体滴度最高的是针对嗜肺军团菌血清群3，它是泉水中最常见的军团菌。这些发现对于在该机构及类似场所维持适当的卫生标准、细菌学采样和临床监测具有重要意义。
