Miyamoto H, Jitsurong S, Shiota R, Maruta K, Yoshida S, Yabuuchi E
Department of Microbiology, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan.
Microbiol Immunol. 1997;41(3):197-202. doi: 10.1111/j.1348-0421.1997.tb01190.x.
To determine the infection source of a sporadic Legionella pneumonia case associated with a hot spring bath, we used five molecular methods, including repetitive element polymerase chain reaction (rep-PCR), arbitrarily primed PCR (AP-PCR), ribotyping, restriction endonuclease analysis (REA), and macrorestriction endonuclease analysis (MREA) by pulsed-field gel electrophoresis. L. pneumophila serogroup (SG) 3 strain EY 3702, isolated from an intratracheal specimen of a 71-year-old Japanese female who developed pneumonia after nearly drowning in a hot spring spa bath, produced rep-PCR and AP-PCR fingerprints identical to those of L. pneumophila SG 3 strains EY 3768 and EY 3769 isolated from the bath water. Four epidemiologically unrelated L. pneumophila SG 3 strains showed different rep-PCR or AP-PCR fingerprints from those of the three EY strains (EY 3702, 3768, and 3769). The three EY strains were also genotypically indistinguishable by ribotyping with EcoRI and PstI, by REA with EcoRI or HindIII, and by MREA with NotI. Based on these results, we identified the bath water of the hot spring spa as the source of infection of this patient, even though the viable number of the organisms in the bath water was low (3 CFU/100 ml) when determined 27 days after her nearly drowning.
为确定一起与温泉浴相关的散发性嗜肺军团菌肺炎病例的感染源，我们使用了五种分子方法，包括重复元件聚合酶链反应（rep-PCR）、任意引物PCR（AP-PCR）、核糖体分型、限制性内切酶分析（REA）以及通过脉冲场凝胶电泳进行的宏观限制性内切酶分析（MREA）。嗜肺军团菌血清型（SG）3菌株EY 3702，从一名71岁日本女性的气管内标本中分离得到，该女性在温泉浴场险些溺水后患上肺炎，其产生的rep-PCR和AP-PCR指纹图谱与从浴场水中分离得到的嗜肺军团菌SG 3菌株EY 3768和EY 3769相同。四株在流行病学上无关联的嗜肺军团菌SG 3菌株显示出与三株EY菌株（EY 3702、3768和3769）不同的rep-PCR或AP-PCR指纹图谱。通过用EcoRI和PstI进行核糖体分型、用EcoRI或HindIII进行REA以及用NotI进行MREA分析，这三株EY菌株在基因分型上也无法区分。基于这些结果，我们确定该温泉浴场的水为该患者的感染源，尽管在她险些溺水27天后检测时，浴场水中该微生物的活菌数量较低（3 CFU/100 ml）。
