Castellani Pastoris M, Ciceroni L, Lo Monaco R, Goldoni P, Mentore B, Flego G, Cattani L, Ciarrocchi S, Pinto A, Visca P
Laboratorio di Batteriologia e Micologia Medica, Istituto Superiore di Sanità, Rome, Italy.
Eur J Clin Microbiol Infect Dis. 1997 Dec;16(12):883-92. doi: 10.1007/BF01700554.
Fatty acid profile analysis, monoclonal antibody (MAb) subtyping, pulsed-field gel electrophoresis (PFGE), arbitrarily primed polymerase chain reaction (AP-PCR), and ribotyping were used to compare clinical and environmental Legionella pneumophila serogroup 1 isolates from an outbreak of Legionnaires' disease presumptively associated with cooling towers. According to the Oxford subtyping scheme, the MAb subtype of patients' isolates and of two strains originating from a cooling tower was Pontiac, whereas the other isolates were subtype Olda. The strains showed no intrinsic strain-to-strain difference in fatty acid profiles, and ribotyping and length polymorphism of the 16S-23S rDNA intervening regions failed to reveal any differences between the isolates. Conversely, PFGE and AP-PCR appeared to be more discriminatory, as the same genomic profile was found for the clinical and some environmental strains. Meteorologic and epidemiological data and the results of molecular analysis of the Legionella pneumophila serogroup 1 isolates support the hypothesis that the infection was transmitted from one of the cooling towers to the indoor environment of the same building, to homes in proximity that had open windows, and to the streets. In fact, the outbreak diminished and later ended after a part in the tower was replaced. This investigation demonstrates the utility of combined molecular methods (i.e., phenotypic and genomic typing) in comparing epidemiologically linked clinical and environmental isolates. Finally, the outbreak confirms the risk of Legionnaires' disease posed by cooling towers, mainly when atmospheric thermal and humidity inversions occur. This finding emphasizes the need to determine whether the source of infection is in the living or working environment or somewhere else.
脂肪酸谱分析、单克隆抗体（MAb）分型、脉冲场凝胶电泳（PFGE）、任意引物聚合酶链反应（AP-PCR）和核糖体分型被用于比较临床分离株和环境分离株，这些嗜肺军团菌1血清型分离株来自一起推测与冷却塔有关的退伍军人病暴发。根据牛津分型方案，患者分离株以及源自一座冷却塔的两株菌株的MAb亚型为庞蒂亚克型，而其他分离株为奥尔达亚型。这些菌株在脂肪酸谱方面未显示出菌株间的内在差异，16S - 23S rDNA间隔区的核糖体分型和长度多态性也未能揭示分离株之间的任何差异。相反，PFGE和AP-PCR似乎更具鉴别力，因为临床菌株和一些环境菌株具有相同的基因组图谱。气象和流行病学数据以及嗜肺军团菌1血清型分离株的分子分析结果支持这样的假设，即感染是从其中一座冷却塔传播到同一建筑物的室内环境、附近有开窗房屋的家庭以及街道。事实上，在冷却塔的一部分被更换后，疫情有所缓解并最终结束。这项调查证明了联合分子方法（即表型和基因组分型）在比较具有流行病学关联的临床和环境分离株方面的实用性。最后，此次疫情证实了冷却塔带来的退伍军人病风险，主要是在出现大气热力和湿度逆温的时候。这一发现强调了确定感染源是在生活或工作环境还是其他地方的必要性。
