Fiore A E, Nuorti J P, Levine O S, Marx A, Weltman A C, Yeager S, Benson R F, Pruckler J, Edelstein P H, Greer P, Zaki S R, Fields B S, Butler J C
Epidemic Intelligence Service, Division of Bacterial and Mycotic Diseases, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Clin Infect Dis. 1998 Feb;26(2):426-33. doi: 10.1086/516309.
In July 1995 we investigated a pneumonia outbreak in a Pennsylvania town. We conducted epidemiological and molecular microbiological studies to determine the outbreak source and interrupt transmission of disease. Legionnaires' disease (LD) was quickly identified by urine antigen testing, and a newly developed immunohistochemical stain confirmed nosocomial transmission to a hospital inpatient. LD was confirmed in 22 patients. Case-patients were more likely than controls to have been within 1,000 feet of the hospital (matched odds ratio, 21.0; 95% confidence interval, 2.9-368) during the 2 weeks prior to illness. Legionella pneumophila serogroup 1 (Lp-1) was isolated from hospital cooling towers (CTs) and rooftop air samples but not from hospital potable water or community CTs. Hospital CT and air Lp-1 isolates matched all five patient isolates by monoclonal antibody, arbitrarily primed polymerase chain reaction, and pulsed-field gel electrophoresis subtyping. Strategies to prevent LD must include minimizing transmission from CTs.
1995年7月，我们对宾夕法尼亚州一个城镇的肺炎暴发事件展开了调查。我们进行了流行病学和分子微生物学研究，以确定暴发源头并阻断疾病传播。通过尿液抗原检测迅速确诊了军团病（LD），一种新开发的免疫组化染色证实了该病在医院内传播至一名住院患者。22名患者被确诊为军团病。与对照组相比，病例患者在发病前2周内身处距离医院1000英尺范围内的可能性更大（匹配比值比为21.0；95%置信区间为2.9 - 368）。嗜肺军团菌血清1型（Lp - 1）从医院冷却塔（CTs）和屋顶空气样本中分离出来，但未从医院饮用水或社区冷却塔中分离出来。通过单克隆抗体、任意引物聚合酶链反应和脉冲场凝胶电泳分型，医院冷却塔和空气样本中的Lp - 1分离株与所有五例患者的分离株相匹配。预防军团病的策略必须包括尽量减少来自冷却塔的传播。
