Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, Australia.
UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia.
Zoonoses Public Health. 2021 May;68(3):165-181. doi: 10.1111/zph.12791. Epub 2020 Dec 14.
Q fever is a zoonotic disease caused by the intracellular bacterium, Coxiella burnetii. Its primary mode of transmission is by inhalation of aerosols originating from infected animals and contaminated environments. The organism has a very low infective dose, can persist in the environment for long periods of time and large outbreaks fuelled by windborne spread have been previously reported. Detection of C. burnetii in the environment is therefore important during human and animal outbreak investigations and for the control and prevention of Q fever. This study aimed to systematically review and critically appraise the published literature on sampling methods used to detect C. burnetii from different environmental samples. A search of four electronic databases with subsequent hand searching identified 47 eligible articles published since 1935. These articles described sampling of dust, air, soil and liquids in attempts to detect C. burnetii during 19 Q fever outbreaks and in 28 endemic settings. Environmental positivity was most commonly associated with ruminant livestock populations. Evidence describing spatio-temporal characteristics and associated geographical dispersion gradients was limited. The most commonly tested sample type was dust which also yielded the highest bacterial loads of >10 bacteria/cloth. The MD8 (Sartorius) air sampler was used widely for air sampling. Soil was the only sample type for which a validated laboratory protocol was established specifically for C. burnetii. Each environmental sample type has its advantages and limitations which are discussed in detail and a simplified framework to guide decisions around environmental sampling for C. burnetii is provided. In any type of environmental sampling, it is recommended to use standardized and validated methods and to match the most ideal sampling strategy and timing with the research context. These conditions are essential to be considered when designing future Q fever management plans that involve environmental sampling for C. burnetii.
Q 热是一种由细胞内细菌伯氏考克斯体引起的动物源性疾病。其主要传播途径是吸入来自感染动物和受污染环境的气溶胶。该病原体的感染剂量非常低，在环境中能长时间存活，并且以前曾有报道过由风传播引起的大规模暴发。因此，在人类和动物暴发调查以及 Q 热的控制和预防中，对环境中伯氏考克斯体的检测非常重要。本研究旨在系统地回顾和批判性评价已发表的文献，以了解从不同环境样本中检测伯氏考克斯体的采样方法。通过对四个电子数据库进行搜索，并随后进行手工搜索，共确定了自 1935 年以来发表的 47 篇符合条件的文章。这些文章描述了在 19 次 Q 热暴发和 28 次地方性流行期间，尝试从灰尘、空气、土壤和液体中采样以检测伯氏考克斯体。环境阳性结果最常与反刍动物牲畜群体有关。描述时空特征和相关地理扩散梯度的证据有限。测试最多的样本类型是灰尘，其细菌负荷最高，超过 10 个细菌/块。MD8（Sartorius）空气采样器被广泛用于空气采样。土壤是唯一一种专门为伯氏考克斯体建立了验证实验室方案的样本类型。每种环境样本类型都有其优点和局限性，我们对此进行了详细讨论，并提供了一个简化的框架来指导围绕伯氏考克斯体的环境采样决策。在任何类型的环境采样中，都建议使用标准化和经过验证的方法，并根据研究背景匹配最理想的采样策略和时间。在设计涉及环境采样以检测伯氏考克斯体的未来 Q 热管理计划时，这些条件是必须要考虑的。
