First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, Japan.
National Hospital Organization Okinawa National Hospital, Japan.
J Infect Chemother. 2020 May;26(5):411-417. doi: 10.1016/j.jiac.2019.12.016. Epub 2020 Feb 18.
Legionella species are consistently identified as some of the most common causative agents of severe community-acquired pneumonia (CAP) or nosocomial pneumonia. Although the number of reported Legionella infection cases is gradually increasing in Japan, most cases are diagnosed by a urinary antigen test, which identifies only L. pneumophila serogroup 1. Therefore, assessment of pneumonia-causing Legionella species and serogroups would be important. The Japan Society for Chemotherapy Legionella committee has collected the isolates and clinical information on cases of sporadic community-acquired Legionella pneumonia throughout Japan. Between December 2006 and March 2019, totally 140 sporadic cases were identified, in which L. pneumophila was the most frequently isolated species (90.7%) followed by L. bozemanae (3.6%), L. dumofii (3.6%), L. micdadei (1.4%), and L. longbeachae (0.7%). Among 127 isolates of L. pneumophila, 111 isolates were of serogroup 1, two of serogroup 2, four of serogroup 3, one of serogroup 4, one of serogroup 5, seven of serogroup 6, and one was of serogroup 10. We also assessed in vitro activity of antibiotics against these isolates and showed that quinolones and macrolides have potent anti-Legionella activity. Our study showed that pneumonia-causing Legionella species and serogroup distribution was comparable to that reported in former surveillances. L. pneumophila was the most common etiologic agent in patients with community-acquired Legionella pneumonia, and L. pneumophila serogroup 1 was the predominant serogroup.
嗜肺军团菌属是引起严重社区获得性肺炎（CAP）或医院获得性肺炎的常见病原体之一。尽管日本报告的军团菌感染病例数量逐渐增加，但大多数病例是通过尿抗原检测诊断的，该检测只能识别嗜肺军团菌血清群 1。因此，评估引起肺炎的军团菌种类和血清群很重要。日本化疗学会军团菌委员会收集了日本各地散发性社区获得性军团菌肺炎的分离株和临床资料。2006 年 12 月至 2019 年 3 月，共发现 140 例散发性病例，其中嗜肺军团菌是最常见的分离株（90.7%），其次是博兹曼军团菌（3.6%）、杜姆菲军团菌（3.6%）、米氏军团菌（1.4%）和长滩军团菌（0.7%）。在 127 株嗜肺军团菌分离株中，111 株为血清群 1，2 株为血清群 2，4 株为血清群 3，1 株为血清群 4，1 株为血清群 5，7 株为血清群 6，1 株为血清群 10。我们还评估了这些分离株对抗生素的体外活性，表明喹诺酮类和大环内酯类具有很强的抗军团菌活性。我们的研究表明，引起肺炎的军团菌种类和血清群分布与以前的监测报告相似。嗜肺军团菌是社区获得性军团菌肺炎患者最常见的病原体，血清群 1 是主要的血清群。
