综合医院肺炎病人血清中嗜肺军团菌抗体调查

目的调查我国三地区综合医院肺炎病人血清中嗜肺军团菌抗体水平。方法于2012年6月—2013年6月以北京、江苏和深圳3个地区的7家综合性医院的70名住院肺炎病人为研究对象,调查问卷收集基本信息,间接酶联免疫吸附法检测血清中嗜肺军团菌1—6血清型Ig G/Ig A/Ig M联合抗体。结果入院当天和入院两周后肺炎病人血清中嗜肺军团菌抗体阳性率分别为20%(7/35)和20%(7/35),其中5例肺炎病人双份血清均为阳性。结论我国综合医院肺炎病人存在嗜肺军团菌感染,采集入院当天和入院两周后血清同时进行嗜肺军团菌抗体检测可有效降低假阴性率。     

北京市部分肺炎病人嗜肺军团菌感染情况监测

我市在对健康人群抗体水平调查的基础上,进一步了解在临床肺炎病人中嗜肺军团菌感染的情况,以便为临床、流行病学的诊断、防治等措施提供可靠的依据,为此,于1986年     

2011年铁岭地区首次检出嗜肺军团菌

[目的]了解铁岭地区公共场所集中空调系统嗜肺军团菌污染状况。[方法]2011年10月采集铁岭地区部分公共场所集中空调冷凝水,进行嗜肺军团菌的分离培养、血清学分型及鉴定。[结果]检测4份冷凝水样品,检出4株2个血清型的嗜肺军团菌,检出率为4／4。[结论]铁岭地区公共场所集中空调冷凝水确实存在嗜肺军团菌的污染,需要引起监管部门足够的重视,以防止军团菌病的暴发流行。     

重症嗜肺军团菌肺炎2例临床经过报告

重症嗜肺军团菌肺炎２例临床经过报告抚顺中心医院内科（１１３００６）尚士尧，韩玉英，田芦丰，刘桂珍１９９２年７月以来我院收治军团病２例，１例治愈，１例死亡，现报告如下。临床资料例１，男，３７岁，经营茶叶工人。患者于１９９２年７月１５日因发热、发冷、咳嗽...     

从肺炎病人血液中分离到一株嗜肺军团菌

从肺炎病人血液中分离到一株嗜肺军团菌宫仕梅，万超群，任红宇，卢锡华，李晓荧，肖彩云军团菌广泛存在于自然环境中，是一种条件致病菌，可引起以肺炎为主的多系统损伤性疾病。我国自８０年代初发现有军团病的爆发流行，并陆续分离到军团菌［１～４］．我们对首都医科大...     

酒店浴室花洒头上检出嗜肺军团菌的报告

目的 了解上海市奉贤区部分公共场所环境中军团菌的污染状况,为军团菌病的预防控制提供依据.方法 采集该区使用集中式空调系统的大型酒店及超市的环境样品共80份进行军团菌检测,将聚合酶链反应(PCR)技术和常规方法结合,样品先进行PCR检测,阳性样品再进行常规分离和鉴定.结果 从某酒店的浴室花洒环节标本中检出2株嗜肺军团菌.结论 环境中有嗜肺军团菌存在,易受到感染,存在隐患.     

四川省首次从肺炎病人痰样中分离到嗜肺军团菌

20 0 0年 5月我们从 1例肺炎病人痰样标本中分离到 1株嗜肺军团菌。现简要报告如下。病人男性 ,6 4岁 ,某市工商局退休职工。因发热、咳嗽、肌痛、腹泻入院治疗。体温 :38℃～ 39 8℃、Ｐ :10 0次 /分、Ｒ :2 2次 /分、ＢＰ :135 /80ｍｍＨｇ。血液白细胞 19 8× 10 9/Ｌ。大便常规未见异常。查体 :右下肺语颤减弱 ,右下肺叩浊 ,呼吸音降低 ,可闻及管状呼吸音及湿呜。胸片显示右下肺可见淡薄斑片状影 ,界欠清 ,肺纹理增多模糊 ,右下胸外带可见一隐约向内凸的弧形影 ,诊断为①右下肺炎。②右下胸膜炎。③右下包裹性积液 ?Ｂ超显示双侧胸腔第…     

老年糖尿病并发嗜肺军团菌肺炎13例临床分析

糖尿病慢性并发症较多,合并嗜肺军菌菌肺炎报道较少。现将我们收集的2所医院1995年～2000年老年2型糖尿病合并嗜肺军团菌肺炎19例报道如下。 1 临床资料 1.1 一般资料本组19例,其中男14例,女5例,年龄在60岁～82岁,平均65岁。全部病例为2型糖尿病,并全部符合嗜肺军团菌肺炎诊断标准:(1)具有发热、咳嗽等呼吸道感染症状;(2)X线胸片有炎症性阴影;(3)血试管凝集试验     

Legionella pneumophila: Population genetics, phylogeny and genomics

Legionella pneumophila is a human pathogen that was recognized only about 30 years ago. It is the causative agent of Legionnaires’ disease, a severe pneumonia that is transmitted through inhalation of aerosols of contaminated water. Shortly after its discovery, the ability of Legionella to multiply intracellularly in fresh water protozoa was discovered. This long lasting co-evolution between the eukaryotic host and Legionella has led to the selection of a panoply of virulence factors, which allow to exploit important cellular processes during infection. Compelling evidence for the importance of protozoa in the evolution of this bacterium comes from analysis of complete genome sequences. A key feature of the L. pneumophila genomes is the presence of a high number and wide variety of eukaryotic like proteins and protein domains probably acquired through horizontal gene transfer and/or convergent evolution.In the last years several different typing methods aiming in investigating the molecular epidemiology of L. pneumophila have been developed. Furthermore, the access to whole genome sequences of several L. pneumophila strains allowed to apply large scale comparative genomic studies using DNA arrays. A higher genetic diversity among environmental isolates with respect to clinical isolates and the presence of specific clones of L. pneumophila overrepresented in human disease or causing legionellosis world wide, were identified. Further studies analyzing the natural populations of Legionella more in detail will allow to gain a better understanding of the population structure and the ecological diversity of this species. This review describes the latest observations about the structure of L. pneumophila populations, the techniques used to study the molecular epidemiology and evolution of L. pneumophila, the knowledge gained from genome analysis, and discusses future perspectives.     

Influence of sequential cultivation on virulence of Legionella pneumophila and Staphylococcus aureus

Virulence of Legionella pneumophila strain Monza 3 and Staphylococcus aureus strain Smith diffuse was investigated after sequential cultures on nutrient media. L. pneumophila lost its ability to multiply within Acanthamoeba polyphaga after 50 passages on Legionella selective agar, while S. aureus maintained its pathogenicity in the mouse peritonitis model after 100 sequential cultures on tryptic soy agar. These results demonstrate high preservation of virulence in staphylococci in contrast to legionellae. Differentiation of virulent and avirulent phenotypes of legionellae by the protozoal model may be helpful for detecting sources of infection in water hygiene.     

嗜肺军团菌致病性与效应蛋白的研究进展

嗜肺军团菌是一种可以引起军团菌肺炎和庞蒂亚克热的兼性胞内病原菌,主要侵染阿米巴原虫和人类巨噬细胞。该菌在宿主胞内能依靠Dot/Icm IVB型分泌系统产生的效应蛋白成功逃避溶酶体的降解。本文主要对嗜肺军团菌的致病物质、胞内存活与增殖机制及其效应蛋白的生物学功能进行综述,详细介绍嗜肺军团菌的毒力因子与致病机制,为军团病防治的研究提供新思路,也为其他胞内病原菌所致感染性疾病的研究提供重要的借鉴意义。     

嗜肺军团菌致病性与效应蛋白的研究进展

嗜肺军团菌是一种可以引起军团菌肺炎和庞蒂亚克热的兼性胞内病原菌，主要侵染阿米巴原虫和人类巨噬细胞。该菌在宿主胞内能依靠Dot/Icm IVB型分泌系统产生的效应蛋白成功逃避溶酶体的降解。本文主要对嗜肺军团菌的致病物质、胞内存活与增殖机制及其效应蛋白的生物学功能进行综述，详细介绍嗜肺军团菌的毒力因子与致病机制，为军团病防治的研究提供新思路，也为其他胞内病原菌所致感染性疾病的研究提供重要的借鉴意义。     

Comparison of clinical and environmental samples of Legionella pneumophila at the nucleotide sequence level

Legionella pneumophila serogroup 1 is the most common etiological agent of legionellosis. We have used clinical and environmental isolates from different sources to compare their genetic variability. We have obtained the nucleotide sequence for six protein-coding loci, included in the SBT scheme for L. pneumophila, and three intergenic regions from 127 samples, 47 of environmental origin and 80 from clinical samples. Levels of genetic variability were found to be higher in the environmental than in the clinical samples, but these did not represent a mere subset of the former. Not a single case of full identity between clinical and environmental isolates was found, which raises the possibility that only a specific subset of environmental isolates is actually capable of producing infection in humans. A phylogenetic analysis of the concatenate alignment of the nine loci sequences showed four main groups, each including clinical and environmental isolates, although their distribution was not uniform among them. The comparison of each individual gene tree with the others revealed several cases of incongruence involving samples from both origins, thus suggesting the presence of recombination in the two groups.     

北京市某宾馆一起军团病爆发的调查报告

  目的   报告2020年上海市发生的一起洗浴中心庞蒂亚克热暴发疫情的流行病学调查结果,以期为后续同类疫情的监测和调查处置提供参考。  方法   对上海市奉贤区发热门诊2020年12月18 — 21日具有某洗浴中心暴露史的139例发热病例进行流行病学调查。以在该洗浴中心有明确轨迹和饮食信息的74 例患者为病例组,以有该洗浴中心暴露史但未发热的44名健康人群作为对照组进行流行病学病因调查,采用logistic回归分析暴露危险因素,并使用RT-PCR方法对病例组15例发热患者深咳痰液样本进行病原核酸检测,利用BCYE平板进行军团菌培养。使用余氯检测仪现场检测该洗浴中心水中游离性余氯。  结果   除发热外,139例病例出现频率最高的症状依次为乏力（71例,51.08%）、头痛（58例,41.73%）和肌痛（58例,41.73%）,疫情潜伏期为12～68 h,M为36 h。病例对照研究中,单因素分析结果显示在该洗浴中心泡汤是发热的危险因素（OR = 9.036,95%CI = 3.521～23.189）;多因素logistic回归结果分析显示曾在美肌汤池泡汤者的危险度是未泡者的5.456倍（95%CI = 1.746～17.042）。4例发热病例深咳痰液样本检出军团菌核酸阳性,4份环境样品培养出军团菌菌株,2个汤池余氯低于标准值（分别为0.2 、0.09 mg/L）。  结论  结合流行病学、临床表现和实验室检测结果,综合判断此次疫情为一起由军团菌引起的庞蒂亚克热暴发。     

呼吸机相关性肺炎患者气囊上滞留物病原菌分布及耐药性分析

目的 研究呼吸机相关性肺炎(VAP)患者气囊上滞留物病原菌分布并进行耐药性分析,指导临床合理使用抗菌药物,防治VAP.方法 将43例VAP患者气囊上滞留物进行引流,并将气囊上滞留物与下呼吸道分泌物分离出的339株病原菌进行鉴定和耐药分析,并进行对比分析.结果 43例VAP患者气囊上液分离出201株病原菌,其中革兰阴性杆菌166株,占82.6%,主要优势菌为鲍氏不动杆菌、铜绿假单胞菌、嗜麦芽寡养单胞菌、肺炎克雷伯菌,革兰阳性菌26株,占12.9%,主要为金黄葡萄球菌、表皮葡萄球菌,真菌9株,占4.5%;不同病原菌对抗菌药物多药耐药率均较高,但不同抗菌药物耐药率差异较大;下呼吸道分泌物共分离出138株病原菌,两者主要病原菌分布、构成比及耐药情况差异无统计学意义(P>0.05).结论 VAP气囊上滞留物病原菌分布革兰阴性杆菌为主.均存在多药耐药,气囊上液与下呼吸道分泌物病原菌株菌种的一致性且构成比及耐药性类似.     

医院与社区获得性肺炎患者病原菌分布及耐药性对比分析

目的 分析基层医院与社区获得性肺炎患者病原菌分布及耐药性,为临床抗感染治疗提供依据.方法 对2005年6月-2009年6月门诊及住院部送检痰标本进行细菌分离培养与鉴定,并对医院获得性肺炎与社区肺部感染患者病原菌分布及耐药性进行对比分析.结果 从社区获得性肺部感染患者标本分离培养出病原菌117株,分离的主要病原菌依次为肺炎链球菌(24.8%)、肺炎克雷伯菌(16.2%)、铜绿假单胞菌及金黄色葡萄球菌(均为12.0 %);医院获得性肺炎患者标本分离培养出病原菌208株,分离的主要病原菌依次为铜绿假单胞菌(24.0%)、肺炎克雷伯菌(18.8%)、大肠埃希菌(11.1%),社区与医院获得性肺炎患者病原菌分布差异有统计学意义;革兰阳性菌对常规抗菌药物耐药率高.结论 临床在抗感染治疗中,应结合该地区及医院病原菌变化分布特点,实行优化性的经验性的治疗,结合实验室检测及药敏试验,合理使用抗菌药物.