Laussucq S, Schuster D, Alexander W J, Thacker W L, Wilkinson H W, Spika J S
Division of Bacterial Diseases, Centers for Disease Control, Atlanta, Georgia 30333.
J Clin Microbiol. 1988 Aug;26(8):1442-4. doi: 10.1128/jcm.26.8.1442-1444.1988.
Between 11 November 1986 and 28 February 1987, legionellosis was diagnosed in 23 patients at one hospital with a recently marketed Legionella-specific DNA probe for respiratory secretions. Only 10 of the 23 probe-positive patients showed findings typical of Legionella pneumonia, including a temperature of greater than or equal to 100.5 degrees F (approximately 38.1 degrees C) and radiographic evidence of pneumonia. No differences were found in the results of laboratory studies, demographic features, or underlying risk factors for these 10 probe-positive patients when compared with the 13 probe-positive patients with nonpneumonic illnesses. A case-control study comparing probe-positive and -negative patients failed to identify any different features of disease or epidemiologic characteristics. Probes of repeat specimens of sputum were still positive 2 to 13 weeks after the initial test in 5 (50%) of the 10 probe-positive patients. The clinical features in most patients were atypical for legionellosis, and the diagnosis could not be confirmed by traditional laboratory tests performed on duplicate specimens processed at the Centers for Disease Control. This report emphasizes the need for clinical microbiology laboratories to confirm test results from new procedures by accepted diagnostic methods.
1986年11月11日至1987年2月28日期间,一家医院使用一种新上市的针对呼吸道分泌物的军团菌特异性DNA探针,确诊了23例军团菌病患者。23例探针检测呈阳性的患者中,只有10例表现出典型的军团菌肺炎症状,包括体温大于或等于100.5华氏度(约38.1摄氏度)以及肺炎的影像学证据。与13例患有非肺炎性疾病的探针检测呈阳性患者相比,这10例探针检测呈阳性的肺炎患者在实验室检查结果、人口统计学特征或潜在风险因素方面未发现差异。一项比较探针检测呈阳性和阴性患者的病例对照研究未能确定任何疾病特征或流行病学特征的差异。10例探针检测呈阳性患者中的5例(50%),其痰液重复标本的探针在初次检测后2至13周仍呈阳性。大多数患者的临床特征不符合军团菌病的典型表现,且通过疾病控制中心对重复标本进行的传统实验室检测无法确诊。本报告强调临床微生物实验室需要通过公认的诊断方法来确认新检测程序的结果。