军团菌与儿童常见疾病关系的研究

用ＥＬＩＳＡ法对一年间住院患儿及健康体检儿童进行９种１５型军团菌ＩｇＭ抗体检测。结果显示：住院病儿军团菌ＩｇＭ抗体阳性率１３１７％，９５％ＣＩ为９７３％～１６６１％，呼吸系统疾病患儿阳性率为１１６８％，上感、肺炎及支气管炎组分别为４０００％、９４０％及２５０％；非呼吸系统疾病阳性率１４３９％，肾脏疾病与血液病、神经系统疾病及先心病组分别为３３３３％、２４３２％及１０３４％；发热待诊组阳性率２１０５％；其它先天性疾病及外科疾病组患儿未检出军团菌ＩｇＭ抗体。住院病儿以嗜肺军团菌、米克戴德军团菌及博杰曼军团菌感染多见。肺炎组与先心病组从嗜肺军团菌感染为多，其它病种则以非嗜肺军团菌感染多见，尤以米克戴德军团菌为众。     

太原市健康人群军团菌感染菌型分布特征的研究

为了解太原地区军团菌感染的菌型分布特点及优势种型，作者用ＥＬＩＳＡ法分别对太原市三城区、一郊区的部分人群进行了９种１５型军团菌ＩｇＧ抗体的检测，结果军团菌各种型均有阳性出现，所调查的人群以嗜肺军团菌感染为主，Ｌｐ１尤著，非嗜肺军团菌抗体阳性率较低，其中Ｌａ感染者较多。优势种型城区与城区间及城区与郊区间有所不同，嗜肺军团菌在城区的感染菌型主要是Ｌｐ１，郊区则是Ｌｐ４；非嗜肺军团菌在南城、北城及河西区分别以Ｌｊ、Ｌｇ及Ｌａ抗体阳性率为高，而郊区Ｌａ、Ｌｂ抗体阳性率稍高，未见Ｌｊ感染者     

肾移植患者CMV医院感染途径研究

目的为明确肾移植受者术后ＣＭＶ医院感染的途径。方法用ＥＬＩＳＡ法对２１份供者及相应４１名受者（Ａ组）１３９份血标本作ＣＭＶＩｇＧ、ＩｇＭ测定；并与同期住院的２１位既往肾移植受者（Ｂ组）结果进行比较。结果供者ＩｇＧ、ＩｇＭ阳性率分别为９０．５％和０；Ａ组术前、术后１月内ＩｇＧ、ＩｇＭ阳性率分别为９２．７％、９．８％及９６％、９．２％。Ｂ组患者ＩｇＧ、ＩｇＭ阳性率分别为１００％及７１．４％，其ＩｇＧ滴度及ＩｇＧ、ＩｇＭ阳性率均高于Ａ组结果（Ｐ均＜０．０１）。结论肾移植受者术前ＣＭＶＩｇＧ阳性率很高，由供者→受者所造成的原发感染比重很小，而继发性感染可能是重要的医院感染途径，是预防工作的重点     

公共场所人群嗜肺军团菌感染状况分析

目的分析和研究公共场人群的血清中嗜肺军团菌的抗体阳性率与具体的分布特点。方法选取本地区超市、宾馆和医院以及酒店等公共场所的健康人群并采集血清共892份,抽取受检者的静脉血3~5mL后进行血清的分离然后放置零下20℃保存,采用抗微量凝集试验法（MAT）进行操作并进行结果的判定。结果全部受检者中,血清抗嗜肺军团菌抗体呈阳性的共76例,总阳性率为8．5％,其中暴露人群的血清嗜肺军团菌感染共51例,总阳性率为10．4％,在暴露人群行业中,超市嗜肺军团菌感染阳性检出率为最高,为21．6％,对照人群血清中的嗜肺军团菌感染共25例,总阳性率5．1％（25／491）,该两组受检者阳性率存在着明显的差异,并且暴露人群的阳性率要明显高于对照组人群（（x毡9．057,P〈0．05）。具有统计学意义。在全部的阳性结果中,同时有两种以及以上血清型呈阳性的共15份,占21．1％（16／76）。结论健康人群中仍然普遍都存着不同程度与不同血清型的嗜肺军团菌的隐性感染,特别是使用中央空调的公共场所属于传播嗜肺军团菌感染的重要高危场所,应当加强进行监测和观察。     

儿童散发性军团菌病流行特征的研究

用ＥＬＩＳＡ方法对１９９１年４月至１９９２年４月从省级医院收集的儿科住院病儿３１７例及健康体检儿童８６例进行９种１５型军团菌ＩｇＭ抗体的检测。３５例（１１．０４％）住院病儿诊为军团菌病，呼吸系统疾病患者中有２５例（１１．６８％）、肾脏疾病、血液病有５例（５／１５），其它疾病有１例（１．４５％）为军团菌病患者；２例（２．３３％）健康儿童为军团菌近期感染。病原以Ｔａｔｌｏｃｋｉａｍｉｃｄａｄｅｉ（２０例，４７．６２％）及Ｌｐ＿１６（１０例，２３．８１％）多见，Ｆｌｕｏｒｉｂａｃｔｅｒｂｏｚｅｍａｎａｅ占１４．２９％，其它种型较少见。军团菌病的分布特点是年长儿童发病多，夏季发病比例高，城乡居住者发病比例差别无统计学意义。     

某些危险人群军团菌感染状况及影响因素的研究

用ＥＬＩＳＡ方法对煤矿职工、恶性肿瘤病人进行９种１５型军团菌抗体的检测，其阳性率分别为３６．７３％、３５．６３％。两种人群感染的主要血清不一致，但均以嗜肺军团菌感染多见，ＬＰ１阳性率最高（１０．２０％及８．０５％）。统计分析表明：煤矿职工各年龄组阳性率接近（Ｐ〉０．０５），井下工人与其他工种工人及干部阳性率差异无显著性，恶性肿瘤病人〈３０岁组阳性率较高，年龄组间阳性率差异显著，煤矿职工近１年患病史     

公共场所人群嗜肺军团菌血清抗体水平的调查研究

目的:了解温州市部分人群血清嗜肺军团菌的抗体阳性率以及嗜肺军团菌抗体(LP1～10)的分布特点。方法:采用微量凝集试验(MAT)测定就业人员血清中嗜肺军团菌1至10型抗体滴度。结果:1000例人群血清抗嗜肺军团菌抗体阳性89例,总阳性率为8.9%,其中暴露人群血清中嗜肺军团菌感染的阳性率11.6%(58/500),对照人群血清中嗜肺军团菌感染的阳性率6.2%(31/500),阳性率有显著性差异,暴露人群高于对照人群(χ2=8.991,P<0.05)。在阳性结果中,2种及以上血清型同时阳性为17份,占19.10%(17/89)。结论:我市健康人群普遍存在不同程度和不同血清型的嗜肺军团菌隐性感染,使用中央空调的场所是嗜肺军团菌感染的高危场所,应加强监测。     

公共场所集中空调通风系统嗜肺军团菌污染对其从业人员嗜肺军团菌感染水平的Meta分析

目的系统评价我国公共场所集中空调通风系统嗜肺军团菌污染对其从业人员嗜肺军团菌感染水平的影响。方法检索Pub Med、中国期刊全文数据库、维普资讯网和万方数据库,收集2006—2014年发表的我国公共场所集中空调嗜肺军团菌污染对其从业人员嗜肺军团菌感染状况的研究文献,采用R 3.0.1软件进行综合分析,评价集中空调嗜肺军团菌污染对人群健康的影响。结果 16篇文献符合条件纳入研究,暴露组人群嗜肺军团菌抗体阳性率为16.01%(95%CI 9.18%~26.47%),对照组人群嗜肺军团菌抗体阳性率为9.60%(95%CI 5.10%~17.34%),暴露组抗体阳性率是对照组的1.68倍,差异有统计学意义(P0.05)。分层分析结果发现不同性别和不同年龄的从业人员嗜肺军团菌抗体水平差异无统计学意义(P0.05),不同类别场所间从业人员嗜肺军团菌抗体水平差异有统计学意义(P0.05),其中超市工作人员的嗜肺军团菌抗体阳性率最高。结论对我国公共场所集中空调嗜肺军团菌的控制和监督监测管理仍需加强。     

肝炎患者柯萨奇B组病毒感染状况及其关系的探讨

用免疫酶组化法对１２１例各型临床肝炎患者和１０８名献血员进行了抗－ＣＶＢＩｇＭ和ＩｇＧ检测。两组的阳性率分别为９．９％、１９．８％和８．３％、３６．１％，总阳性率分别是２５．６％和４０．７％；非乙型肝炎患者抗－ＣＶＢＩｇＭ和ＩｇＧ及总阳性率为１３．８％、２４．１％和３１．０％，乙肝患者抗－ＣＶＢＩｇＭ、ＩｇＧ及总阳性率分别为６．３％、１５．９％和２０．６％。肝炎患者，尤其是乙肝患者抗－ＣＶＢＩｇＧ及总阳性率与对照组差异有显著性。结果提示：乙肝患者可能对ＣＶＢ感染的免疫应答较低，因此其抗－ＣＶＢ检出率低；也可能是因为ＨＢＶ感染后，对再感染ＣＶＢ有干扰作用之故。其详细机理有待进一步研究     

958例儿童急性呼吸道感染九种病原体IgM抗体检测结果分析

目的了解本地区儿童急性呼吸道感染患者中九种常见病原体感染情况。方法采用间接免疫荧光法检测2011年12月-2012年11月本院958例门诊及住院拟诊呼吸道感染患儿血清中九种病原体：嗜肺军团菌（LP）、肺炎支原体（MP）、肺炎衣原体（CP）、Q热立克次体（C0x）、腺病毒（ADV）、呼吸道合胞病毒（RSV）、甲型流感病毒（FluA）、乙型流感病毒（FluB），副流感病毒（PIV）的感染情况。结果958例6月-14周岁儿童急性呼吸道感染患儿，九种常见病原体IgM抗体检测阳性结果259例，阳性率27．0％；肺炎支原体、副流感病毒、乙型流感病毒、呼吸道合胞病毒、腺病毒、肺炎衣原体、甲型流感病毒、嗜肺军团菌、Q热立克次体IgM抗体阳性率分别是17．1％、7．5％、4．1％、1．4％、1．0％、0．1％、0．1％、0．0％、0．0％。单一病原体IgM抗体阳性率为22．8％；两种及两种以上病原体IgM抗体？昆合阳性率为4．3％。男性患儿IgM抗体阳性率（24．0％）显著低于女性（32．8％，X^2=8．52，P〈0．01）。夏、秋、冬、春季节IgM抗体阳性率分别为21．5％、15．4％、25．1％、33．0％，差异有统计学意义（X^2=20．64，P〈0．01）。结论本地区6月-14周岁儿童急性呼吸道感染以肺炎支原体为首要病原体，且以冬春季高发。     

Nosocomial legionella pneumonia: demonstration of potable water as the source of infection

From January 1983 until December 1985, 35 cases of sporadic nosocomial legionella pneumonia, all caused by Legionella pneumophila, were diagnosed in a university hospital. L. pneumophila serogroup (SG) 1 was cultured from 12 of the 35 cases and compared to corresponding L. pneumophila SG 1 isolates from water outlets in the patients' immediate environment by subtyping with monoclonal antibodies. The corresponding environmental isolates were identical to 9 out of 12 (75%) of those from the cases. However, even in the remaining three cases identical subtypes were found distributed throughout the hospital water supply. From the hospital water supply four different subtypes of L. pneumophila SG 1 were isolated, three of which were implicated in legionella pneumonia. Of 453 water samples taken during the study 298 (65.8%) were positive for legionellae. Species of Legionella other than L. pneumophila have not been isolated. This may explain the exclusiveness of L. pneumophila as the legionella pneumonia-causing agent. Our results suggest that the water supply system was the source of infection.     

集中空调系统及其他生活环境水中军团菌污染状况

目的 为了解与生活环境密切相关水体中军团菌的污染状况.方法 根据天津市区的地理分布(加湿器同时考虑家庭居住面积)选择75个监测点,其中,集中式空调冷却水36个,空调冷凝水10个,宾馆淋浴喷头水17个,家用超声波加湿器储水12个.于2003年5月-2004年4月,采集空调冷却水、空调冷凝水、淋浴喷头水、加湿器水样,采用血清学与半套式PCR方法对水样进行检测.结果 共采集水样186件,军团菌阳性16件,阳性率为8.60%,嗜肺军团菌阳性15件,阳性率为8.06%.空调冷却水中军团菌、嗜肺军团菌阳性率均高于空调冷凝水、淋浴喷头水、加湿器水,但4种水样中军团菌、嗜肺军团菌的阳性率总体上差异均无统计学意义(军团菌:χ2=5.722,P=0.126;嗜肺军团菌:x2=7.567,P=0.056).共分离出8型军团菌,其中以Lp9型最多,并检出Lp7型.其中,空调冷却水检出Lp1、Lp3、Lp5、Lp7、Lp8、Lp9型,淋浴喷头水检出Lp2、Lp9、Lp10型.空调冷凝水检出1株约旦军团菌,加湿器水中未检出军团菌.结论 空调冷却水、空调冷凝水、淋浴喷头水是可能被军团菌污染的高危水体,需引起足够重视,以防止军团病的流行.     

Serological cross-reaction between Legionella pneumophila and campylobacter in the indirect fluorescent antibody test.

Sera from 50 patients with culture-proven campylobacter gastroenteritis were examined for the presence of antibodies to Legionella pneumophila. Ten patients (20%) had a positive titre (> or = 16) as measured by indirect immunofluorescence. Antibodies were detected in only 1 of 36 acute sera but in 10 of 14 (71%) sera obtained more than 10 days after the onset of symptoms. All positive sera contained specific IgM antibodies but specific IgG or IgA could not be detected in any sample. No legionella antibodies could be detected in sera from 42 similar patients with salmonella gastroenteritis. These results were shown to be due to serological cross-reaction between L. pneumophila and campylobacter.     

Could Legionella pneumophila infection cause bronchial hyperreactivity

11 children with bronchial hyperreactivity were tested for Legionella pneumophila serotype 1 and 2-14, including 3 girls, who were treated a year before because of atypical pneumonia, probably caused by Legionella pneumophila, 2 brothers of the girls and 6 children from a different village as well as 5 adults--parents of the girls. In all of them a significant level of antibodies against Legionella pneumophila serotype 2-14 was detected with indirect immunofluorescence. One of previously treated girls presented with increased level of IgG antibodies (ELISA), the remaining two had increased levels of IgA against Legionella pneumophila serotype 1. Other patients in the group presented no IgM, IgA or IgG against Legionella pneumophila serotype 1. Patients with bronchial hypersensitivity received clarithromycin and inhalation steroids with good clinical effect.     

Isolation of pathogenic Legionella species and legionella-laden amoebae in dental unit waterlines

Legionella released into the air during treatment are a potential source of infection. Water stagnation in dental unit waterlines (DUWLs) creates biofilms and promotes the proliferation of these micro-organisms. This study investigated the presence of amoeba infected with legionella, L. pneumophila and other pathogenic Legionella species in a dental teaching hospital. Water samples were collected in the morning and afternoon from 99 dental units and 16 taps connected to the municipal water supply. Samples were plated on selective media and tested for legionella using the direct immunofluorescent antibody technique and the latex agglutination test. Legionella were found in 33% of the DUWLs and in 47% of the mains taps supplying these units. Legionella-laden amoebae occurred in one mains tap sample and in 20% of DUWLs in a clinic of the teaching hospital. L. micdadei was the predominant species isolated from this clinic. L. pneumophila serogroups 2-14 predominated in the mains water, whereas L. pneumophila serogroup 1 was found in approximately half of the contaminated DUWLs and mains taps irrespective of the time of sampling. Pathogenic Legionella species seeded by municipal water into DUWLs is a potential source of legionella infection for both dental personnel and patients during prolonged dental treatment. This problem is compounded by the presence of legionella-laden amoebae which may contain levels of organism well within the infective dose. The interaction of legionella with amoebae is an important ecological factor that may significantly increase the risk of legionellosis, and thus should be given further consideration in the refinement of risk assessment models.     

1985年北京市健康人群嗜肺军团菌I型抗体水平调查

作者对北京市12个区、县837名健康人血清用ELISA法检查嗜肺军团菌I型抗体,其几何平均滴度为16.6,抗体水平 ≥ 1:160者有43名,占5.14%,表明我市城乡人群中有军团菌感染之可能。各年龄组的抗体几何平均滴度以30岁组最高,为19.42。饮食服务行业中以炊事员抗体滴度最高,占阳性人群的11/43。     

Legionella infections in Scotland.

Four thousand two hundred and thirty-five sera from 2794 patients and 740 sera from 735 tourists domiciled in Scotland recently returned from abroad were examined between 1977 and 1981 for antibodies to Legionella pneumophila and related organisms. In addition, specimens were examined from some patients for cultural or serological demonstration of these organisms in lung or sputum. One hundred and ten cases were diagnosed, 104 serologically, five by immunofluorescence demonstration of legionellas in lung biopsy or autopsy specimens and L. pneumophila serogroup 1 was isolated from a further case. Of patients with pneumonia 6.7% showed evidence of legionella infection. Only 0.4% of healthy tourists had antibodies at a level of greater than or equal to 256. The majority of cases occurred in patients aged 50-69 and in 36 patients the infection was acquired outside the United Kingdom. Males predominated, the male: female ratio being 2: 1. Cases were less frequent in the first quarter of the year but those originating in Scotland were equally common in the remaining three quarters. Cases with disease acquired abroad added to indigenous cases resulted in a summer peak occurring in July, August and September. There were no outbreaks of legionellosis in Scotland.     

Exposure to Legionellaceae at a hot spring spa: a prospective clinical and serological study

Following the occurrence of five cases of Legionnaires' disease among patients and therapists at a French hot spring spa, a series of cleansing procedures and an epidemiological study were undertaken. During a 3-month period, the spring water was repeatedly sampled. Serum samples were taken from 689 randomly selected patients, 230 therapists, 134 administrative staff and a control group of 904 blood donors. Legionellaceae were present in the spring water at concentrations of 10(3)-10(5) colony forming units/l. Fifteen different species or serogroups were isolated with Legionella pneumophila serogroups 3 and 1 predominating. No clinical cases of Legionnaires disease were observed during the study. However, 11% of the therapists and 5% of the patients either had a high titre of antibody (greater than or equal to 256) to at least one species or serogroup or seroconverted during the study. Mean antibody titres in the three study groups were significantly higher than those in the blood donors against 11 of the 32 legionella antigens tested. Nine of these 11 antigens corresponded to species or serogroups isolated from the spring water. The highest mean antibody titres in all three study groups were against L. pneumophila serogroup 3, the most common legionella in the spring water. These findings have important implications for the maintenance of adequate standards of hygiene, bacteriological sampling and clinical surveillance in this and similar establishments.     

Legionella pneumonia from a novel industrial aerosol

After a worker from a plastics factory was diagnosed with legionella pneumonia it was learnt that a retired employee at the factory had been in hospital with a serious chest infection six months before and legionella pneumonia was diagnosed in retrospect from stored serum. The likeliest common source was a machine cooling system that took water from an uncovered water tank outdoors (from which Legionella pneumophila was isolated) and which generated an aerosol through a crack in the flow meter sight glass.