Nechwatal R, Ehret W, Klatte O J, Zeissler H J, Prull A, Lutz H
Medizinische Klinik I, Klinikum Bayreuth, Germany.
Infection. 1993 Jul-Aug;21(4):235-40. doi: 10.1007/BF01728897.
Ten patients from a rehabilitation center were admitted to hospital with serious respiratory infections within ten weeks. An outbreak of Legionnaire's disease was suspected based on the epidemic and atypical manifestation of pneumonia and could be proven microbiologically. Pulmonary and extrapulmonary complications included respiratory failure, lung abscess, transitory renal impairment in five patients and acute renal failure requiring dialysis in one, tetraparesis caused by peripheral neuropathy and acute psychosis. Three patients died despite immediate institution of therapy with erythromycin. Legionella pneumophila serogroup 1 subtype Pontiac was isolated from a bronchial lavage sample of one patient and from the water supply of the rehabilitation center. Monoclonal antibody subtyping and restriction endonuclease analysis were performed on both environmental and patient isolates. Potable water was identified as the source of the outbreak based on identical patterns on restriction endonuclease analysis. Despite thermic and chemical disinfection with chlorination (up to 15 ppm) in the rehabilitation clinic, an eleventh case of Legionnaire's disease was detected 11 months later.
一家康复中心的10名患者在10周内因严重呼吸道感染入院。基于肺炎的流行情况和非典型表现，怀疑发生了军团病暴发，并且可以通过微生物学方法得到证实。肺和肺外并发症包括呼吸衰竭、肺脓肿、5名患者出现短暂性肾功能损害，1名患者出现需要透析的急性肾衰竭、周围神经病变导致的四肢轻瘫以及急性精神病。尽管立即使用红霉素进行治疗，仍有3名患者死亡。从1名患者的支气管灌洗样本以及康复中心的供水系统中分离出嗜肺军团菌血清1型庞蒂亚克亚型。对环境和患者分离株进行了单克隆抗体分型和限制性内切酶分析。基于限制性内切酶分析的相同模式，确定饮用水为暴发源。尽管康复诊所采用了加热和化学氯化消毒（高达15 ppm），但11个月后又检测到第11例军团病病例。
