南京地区肺科患者军团菌感染状况调查

了解南京市不同人群军团菌感染情况.选择南京市健康从业人员和肺科住院患者共计912份血清标本,采用微量凝集试验检测军团菌抗体效价,并对受检者进行流行病学调查.结果显示,南京市肺科患者军团菌抗体阳性率(46.3%,265/572)显著高于健康从业人员阳性率(39.4%,134/340)(P＜0.05).女性阳性率(45%)比男性阳性率(42.9%)稍高,但无显著性差异(P＞0.05).肺科患者中Lp 1型阳性率最高(14.2% ),其次为Lp 6型(8.9% ),Lp 10型最低(0.17%).健康从业人员中Lp 1型阳性率最高(12.4%),其次为Lp 3型(7.1%),Lp 6型(6.2%)和Lm型(5.0%)较低,Lp9未检出.结果提示,军团菌感染已经成为南京市肺科疾病重要的因素之一,并已对健康从业人员构成潜在危险.     

石家庄市不同人群呼吸道感染病原体调查分析

目的 了解本地区急性呼吸道感染患者8种呼吸道病原体的流行情况.方法 选取2014年1月1日至2015年12月31日在石家庄市第一人民医院诊治的7545例呼吸道感染患者,对血清进行8种常见呼吸道病原体的IgM抗体检测.结果 本地区2014年检出率较高的呼吸道病原体依次是流感病毒B(17.5％)、流感病毒A(12.9％)、肺炎衣原体(11.8％),2015年检出率较高的呼吸道病原体依次是流感病毒B(20.6％)、肺炎支原体(20.0％)、流感病毒A(11.0％).2015年较2014年流感病毒A、流感病毒B、肺炎衣原体、嗜肺军团菌4种病原体IgM抗体阳性率有所降低,肺炎支原体IgM抗体阳性率有所升高;各年龄组八种病原体抗体阳性率均存在差异,与0～3岁组比较4～15岁组肺炎衣原体、流感病毒A、流感病毒B、副流感病毒、嗜肺军团菌、呼吸道合胞病毒IgM抗体阳性率较高,15岁以上组腺病毒、嗜肺军团菌、呼吸道合胞病毒IgM抗体阳性率较高;与4～15岁组比较15岁以上组腺病毒、嗜肺军团菌IgM抗体阳性率较高;且秋冬季与春夏季比较流感病毒A、流感病毒B、副流感病毒IgM抗体阳性率较高,而肺炎支原体IgM抗体阳性率较低.结论 本地区呼吸道感染的病原体以流感病毒A(INFA)、流感病毒B、肺炎支原体为主,不同年份、不同季节、不同年龄组病原体的种类和感染率具有一定差异性.     

嗜肺军团菌在武钢青山地区的发现及其检测和防治对策

军团病是因1976年在美国费城退伍军人年会中首次发现急性发热性肺部疾患而被命名的。患者以呼吸道感染为主，死亡率较高。嗜肺军团菌（Legionella pneumophila，Lp）是军团菌属的代表种，是近20年来新发现的传染病之一。我们对武钢青山地区10家单位使用1个月后中央空调系统冷却塔水中的嗜肺军团菌进行检测调查，首次发现嗜肺军团菌的存在，并了解其分布特征和菌型特征，制定出相应的防治策略。     

深圳市南山区人群华支睾吸虫感染现状调查

目的了解深圳市南山区各类人群华支睾吸虫感染现状。方法采用整群抽样方法调查不同类型人群，使用“肝吸虫抗体检测试剂盒”，采用酶联免疫吸附试验（ELISA）检测血清华支睾吸虫IgG抗体。结果共调查5185人，华支睾吸虫感染率5．77％。其中，机关事业单位工作人员感染率为6．47％，本地企业员工感染率为3．04％，外来务工人员感染率为1．59％，主动检测人员感染率为32．26％。男性感染率高于女性，40岁年龄组感染率最高。结论本地区属于华支睾吸虫感染的低流行区，机关事业单位工作人员是重点防治人群，应加强宣传教育，同时做好食品卫生整治工作，切断华支睾吸虫的感染来源。     

福建部分沿海地区嗜人T细胞病毒I型血清流行病学调…

用间接免疫荧光法对福建部分沿海地区１７０３人进行了嗜人Ｔ细胞病毒Ｉ型（ＨＴＬＶ－１）抗体测定，ＨＴＬＶ－Ｉ的抗体阳性率为２．３％，其中白血病患者的抗阳性率（７１％）显著高于其他疾病患者（２．７％）和健康献血员（０．６％），表明了该地区ＨＴＬＶ－Ｉ感染率明显高于国内其他地区的报道。部分病毒携带者的体征和实验室指标有明显增加。     

上海市集中式中央空调冷却塔水嗜肺军团菌污染状况分析

目的了解上海市宾馆、大型商场、超市及写字楼中央空调系统嗜肺军团菌的污染状况。方法采集上海市100家公共场所集中式中央空调冷却塔水100份,经酸处理,以GVPC、BCYE、血平板进行菌落筛选,并应用生化反应鉴定,最后进行血清学分型。结果100份冷却塔水检出嗜肺军团菌的样本数为75份,检出率达75％（75／100）,其中宾馆、大型商场、超市、写字楼阳性率分别为80．6％、72．7％、72．7％、70％。75份检出水样中分离到76株军团菌,血清型别呈多样化,但以LPl为主,同一份水样同时检出2个型别的占总检出水样的1．3％（1／75）。结论上海市公共场所中央空调冷却水中嗜肺军团菌污染严重,血清型别呈多样化,对人群健康构成潜在威胁,需要引起重视,以防军团菌病的暴发流行。     

162例婴幼儿非典型性肺炎患者抗MP、CP和LP抗体检测的临床意义

非典型肺炎(atyccal pneumonia,AP)是社区获得性肺炎(CAP)中的一种,引起AP病原体主要包括肺炎支原体、肺炎衣原体和嗜肺军团菌等.本研究应用间接免疫荧光法(IIF)对162例婴幼AP患者血清进行抗肺炎支原体(mycoplasma pnemnoniae,MP)抗体、抗肺炎衣原体(chlamydiapneumoniae,CP)抗体和抗嗜肺军团菌(Legionella pneumophile,Lp)抗体联合检测,现报道如下.     

清远市无SARS病例地区人群SARS冠状病毒抗体血清流行病学调查

目的探讨清远市无SAILS病例地区人群SAILS冠状病毒（SARS-CoV）抗体水平。方法采集本地区各县区不同年龄、不同职业的人群血液，用酶联免疫法检测血清中SARS-CoV抗体IgG。结果共检测血清样本1484份，SAILS—CoV抗体IgG总阳性率为0．61％（9／1484），其中0—6岁和13—18岁年龄组SAILS．CoY抗体IgG均为阴性，7—12岁年龄组的阳性率为1．82％（8／439），19岁以上年龄组的阳性率为0．10％（1／1009）。在9份SAILS—CoV抗体IgG阳性的血清样本中，1份为饮食服务业从业人员，阳性率为0．39％（1／257）；其余8份为学生，阳性率为1．70％（8／471）。结论本地区人群SAILS-CoV抗体水平比较低，低龄组0—12岁人群SAILS-CoV抗体IgG阳性率高于高龄组13岁以上组人群的阳性率。提示SAILS-CoV可能存在隐性感染、隐性传播和隐性感染聚集性。     

福建北部政和县斯氏并殖吸虫病新疫区调查

目的了解福建北部政和县病例所在地肺吸虫流行情况。方法对病例所在乡村进行人群感染情况以及传播宿主调查。结果政和县西表村人群皮试阳性率7．53％（28／372）,其中5～岁与21～岁年龄组皮试阳性率分别为9．76％（12／123）和6．43％（16／249）;男、女性皮试阳性率分别为9．50％（17／179）和5．70％（11／193）,年龄组及男女性别皮试阳性率无显著差别。皮试阳性者的ELSAS阳性检出率为35．71％（10／28）,其中5～岁与21．岁组ELESA血清抗体阳性率分别为66．67％（8／12）和12．50％（2／16）,两年龄组ELESA血清抗体阳性率具显著性差异。小桥拟钉螺与建欧拟小豆螺的斯氏并殖吸虫尾蚴感染率分别为1．02％和0．08％。福建华溪蟹和福建博特溪蟹的斯氏并殖吸虫尾蚴感染率分别为80．6％和33．3％。结论政和县存在高度感染的斯氏并殖吸虫病流行区．青少年为本病的防治重点。     

1448例妇科患者HPV感染型别分布及临床分析

目的分析女性HPV感染的阳性率和各年龄段的关系及常见亚型的分布情况,探讨女性HPVDNA基因分型技术检测在宫颈癌防治方面的应用价值。方法采用HPV基因分型技术对1448例妇科门诊就诊者进行HPV分型检测。结果1448例样本中,检出HPV阳性者531例,总阳性率为36．7％,其中高危型HPV468例,占感染率88％,低危型HPV63例,占感染率12％,混合感染HPV122例,占感染率23％,HPV基因型单一感染为77．2％,二重感染为17．9％,三重感染为3．6％,四重感染为1．5％。高危型中未检出HPV35、73、83、MM4型,低危型中未检出HPV43、44型。患者其亚型感染率由高到低依次为HPV58、16、52、33、18、31、53、68、66、51、39、56和59型,低危型依次为HPV11、6、42型。不同年龄组中HPV感染高峰在50～59岁和60～69岁这两个年龄段,感染率分别为78．9％和73．7％。结论HPV感染型别普遍化,各年龄段感染的阳性率差异有统计学意义（P〈0．05）,25岁前后及〉50岁的妇女更应予以重视,对阳性患者要加强定期随访,HPV基因分型及多种亚型的检测有利于宫颈癌的早期预警和早期治疗。     

茂名市公共场所中央空调冷却水中军团菌污染状况调查

目的调查茂名市公共场所大型中央空调冷却水中军团菌的污染状况及主要血清型。方法于2006年8月至2007年7月．共采集茂名市区部分商场、酒店等中央空调冷却水24份，应用GVPC、BCYE、BCY培养基进行军团分离培养、生化鉴定及血清分型。结果冷却塔冷却水中军团菌的污染率达37．5％（9／24），血清型有LP1、U两种，以LJ（6／9）为主。结论茂名市公共场所大型中央空调冷却水中军团菌检出率较高，对市民健康构成了威胁。     

Seroepidemiological study of Legionella infection in Denmark. A 28-month retrospective survey

An indirect immunofluorescence (IF) test for Legionella antibodies has been used since 1978 at Statens Seruminstitut, Copenhagen. An increasing annual number of blood specimens from all parts of the country has been tested by IF and the number of Legionella antigens in the test was increased from 4 over 10 to 13, resulting in an ever growing number of seropositive patients over the years. We investigated the occurrence of serologically diagnosed Legionella infections from November 1982 through February 1985, a period of 28 months during which the same 13 Legionella antigens were applied in the IF test. We used CDC's criteria for the serological diagnosis of a current Legionella infection: a greater than or equal to 4-fold rise in antibody titre to greater than or equal to 128 in the IF test. In a test of more than 5,000 blood specimens from 3,374 patients, 69 were found to have diagnostic titre rises. When analysed according to serological reactions with three groups of antigens, seroconversion to a L. pneumophila antigen was found to be more frequent in patients 30-59 years old than seroconversion to a non-L. pneumophila Legionella antigen, while in the age group 60-69 this relation was reversed. Thirteen of the 69 patients had acquired their infection abroad. Twelve of these were below the age of 60, and they had all seroconverted to a L. pneumophila antigen. Clinical data were in accordance with the assumption that Legionella may have been the aetiological agent of the disease in our patients selected by serological criteria.(ABSTRACT TRUNCATED AT 250 WORDS)     

Cross-reactive Legionella antigens and the antibody response during infection

In order to define cross-reactive Legionella antigens suitable for diagnostic purposes, we investigated sonicate antigens from two Legionella species, including two serogroups of L. pneumophila. The antigens were reacted with heterologous and homologous rabbit antisera in Western blot. Sera from seven patients with culture-verified L. pneumophila infection and nine patients with serologically confirmed L. micdadei infection were also investigated for reactivity with the corresponding antigens. Among the cross-reactive Legionella antigens defined, non-specific reactivity in patients' sera with the 58-kDa common antigen (CA) was noted. Specific reactions were observed with the Legionella flagellum antigen and with the macrophage infectivity potentiator (Mip) protein; with both antigens, however, the reactive sera were too few to suggest the use of a single antigen in a diagnostic test.     

Comparison and evaluation of four commercial kits relative to an in-house immunofluorescence test for detection of antibodies against <Emphasis Type="Italic">Legionella pneumophila</Emphasis>

Four commercially available kits from (1) Focus Diagnostics, (2) SERION, (3) Zeus and (4) Vircell for detection of antibodies to Legionella pneumophila were evaluated with panels of sera from patients with proven Legionella infection (n = 81) and/or other bacterial infections (n = 75). An in-house indirect Legionella immunofluorescence antibody test (IF test) was used as reference. All sera from the laboratory-proven Legionella pneumophila cases [culture, urinary antigen test and/or polymerase chain reaction] of Legionella infection were found to be positive by the in-house IF test. The relative sensitivity for Focus Diagnostics, SERION, Zeus and Vircell kits was 81.5, 76.5, 68.8 and 62.5%, respectively, and the false-positive rate was 16.0, 5.6, 29.0 and 2.7%, respectively. The in-house IF test had a false-positive rate of 4.0%. It was found that none of the four commercial kits were as sensitive and specific as the in-house IF test.     

Characterization of a lipoprotein common to Legionella species as a urinary broad-spectrum antigen for diagnosis of Legionnaires' disease

We have previously identified the Legionella 19-kDa peptidoglycan-associated lipoprotein (PAL) as a species-common immunodominant antigen. We describe here for the first time the excretion and detection of the PAL antigen in infected urine specimens, which is useful for the diagnosis of Legionnaires' disease. Rabbit anti-PAL immunoglobulin G (IgG) antibody was produced by immunization with the purified, recombinant PAL of Legionella pneumophila serogroup 1 and used in the PAL antigen capture enzyme-linked immunosorbent assay (ELISA) to detect urinary PAL antigen. A soluble-antigen capture ELISA using rabbit IgG antibodies against Legionella soluble antigens was prepared independently and used as a broad-spectrum standard test to detect soluble antigens of several Legionella species. Urine samples were obtained from guinea pigs experimentally infected with each of L. pneumophila serogroups 1, 3, and 6, and other Legionella species. The absorbance values of the PAL antigen ELISA highly correlated with those of the soluble-antigen ELISA in infected urine samples, with a correlation coefficient of 0.84 (P < 0.01). When applied to 17 infected urine samples and 67 negative controls from guinea pigs, the sensitivity and specificity of the PAL antigen capture ELISA were 88.2 and 95.5%, respectively. Compared to the commercial Biotest enzyme immunoassay, the PAL antigen ELISA was more efficient for detecting pneumophila non-serogroup 1 and nonpneumophila species. None of the 161 control human urine specimens obtained from healthy adults and patients with either non-Legionella pneumonia or urinary tract infections tested positive in the PAL antigen ELISA. The present study shows that the Legionella PAL is a very useful broad-spectrum antigen for urinary diagnostic testing. Moreover, since recombinant PAL antigen can be produced more efficiently than the soluble antigens, the development of a broad-spectrum diagnostic immunoassay based on the detection of the PAL antigen appears to be warranted.     

Agglutinating antibody titers to members of the family Legionellaceae in cystic fibrosis patients as a result of cross-reacting antibodies to Pseudomonas aeruginosa.

The objective of this study was to evaluate the prevalence and significance of antibody titers to organisms in the family Legionellaceae in 128 serum samples collected from cystic fibrosis patients at routine examinations. Antibody titers were determined for 10 antigenic types of Legionellaceae; Legionella pneumophila serogroups 1 to 6, Fluoribacter (Legionella) bozemanae, Fluoribacter (Legionella) dumoffii, Fluoribacter (Legionella) gormanii, and Tatlockia (Legionella) micdadei. The method of antibody titer determination was the microagglutination test. Elevated titers (greater than or equal to 1:64) to one or more antigens were found in 41.3% of cystic fibrosis patients but in only 9.7% of 103 normal control subjects (P less than 0.01). Titers to 8 of the 10 antigens were directly correlated with the number of Pseudomonas aeruginosa precipitating antibodies in patient sera, as determined by crossed immunoelectrophoresis (correlation coefficients, greater than or equal to 0.74). Cross-reactions between P. aeruginosa and L. pneumophila were substantiated by crossed immunoelectrophoresis of hyperimmune rabbit serum as well as patient sera against P. aeruginosa and Legionellaceae antigens. Monospecific antibody to the "common antigen" of P. aeruginosa was used to demonstrate the presence of this antigen in L. pneumophila. The presence of cross-reacting antibodies in cystic fibrosis patients chronically infected with P. aeruginosa emphasizes the need for cautious interpretation of antibody titers to members of the family Legionellaceae.     

Prevalence of pneumonias caused by Legionella species among patients on whom autopsies were performed

We wanted to determine the prevalence of pneumonias caused by Legionella species among patients on whom autopsies were performed in two medical centers in St Louis from January 1976 to June 1981. We screened formaldehyde-fixed deparaffinized lung tissue sections with microscopic evidence of pneumonia from 97 patients with use of the direct immunofluorescence antibody technique with a multivalent antilegionella conjugate containing antibodies to Legionella pneumophila serogroups 1 through 4 plus other Legionella species. One patient (1%) had disseminated L pneumophila serogroup 1 infection. We conclude that the prevalence of pneumonias caused by L pneumophila (serogroups 1 through 4), Legionella micdadei, Legionella bozemanii, Legionella dumoffii, or Legionella gormanii is low in the patients studied.     

Evaluation of the L-CLONE Legionella pneumophila Serogroup 1 Urine Antigen Latex Test.

The purpose of this study was to evaluate the L-CLONE Legionella pneumophila Serogroup 1 Urine Antigen Latex Test (Access Medical Systems, Inc., Branford, Conn.) for detection of Legionella antigen in urine. A total of 481 frozen urine samples previously tested by an in-house solid-phase radioimmunoassay (RIA) was thawed and retested by using L-CLONE. Included in this sample were 140 RIA-positive samples from culture-positive or serologically confirmed cases of legionellosis and 341 RIA-negative samples from patients with non-Legionella respiratory disease or bacteriuria. The original RIA test result was accepted as the true value. L-CLONE correctly identified 76 of 140 (54%) known positive samples. False-negative results could not be attributed to a low Legionella antigen concentration or to a Legionella antigen subgroup. L-CLONE correctly identified 252 of 341 (74%) known negative samples. False-positive results were experienced in all groups of negative samples, regardless of the patients' underlying diseases. A total of 141 fresh urine samples was tested; all were Legionella antigen negative by RIA. L-CLONE provided 86% specificity. The sensitivity of the L-CLONE in testing fresh urine samples could not be evaluated because of the lack of Legionella antigen RIA-positive samples.     

Real-time PCR assay targets the 23S-5S spacer for direct detection and differentiation of Legionella spp. and Legionella pneumophila

A real-time PCR for the ABI Prism 7000 system targeting the 23S-5S spacer of Legionella spp. was developed. Simultaneous detection and differentiation of Legionella spp. and Legionella pneumophila within 90 min and without post-PCR melting-curve analysis was achieved using two TaqMan probes. In sputum samples from 23 controls and 17 patients with legionellosis, defined by positive culture, urinary antigen testing, or seroconversion, 94% sensitivity and 100% specificity were observed.     

Diagnosis of pneumococcal pneumonia by enzyme-linked immunosorbent assay of antibodies to pneumococcal hemolysin (pneumolysin).

An enzyme-linked immunosorbent assay (ELISA) with a highly purified pneumolysin as the antigen was evaluated for serological diagnosis of pneumococcal pneumonia. One hundred four healthy controls were tested, and the specificity of the test was set to 95%. In samples from patients with bacteremic pneumococcal pneumonia, 82% (18 of 22) were positive, i.e., at least one serum sample had a titer above the upper normal limit or at least a twofold rise in antibody titers was noted. In nonbacteremic pneumococcal pneumonia, 45% (21 of 47) of samples were positive. All sera were negative for patients with pneumonia caused by Haemophilus influenzae, Legionella pneumophila, Chlamydia psittaci, and influenza A virus. However, in patients with a diagnosis of Mycoplasma pneumoniae infection, 8 of 25 (32%) samples were positive for antibodies to pneumolysin. All sera, including those from patients with mycoplasma infection, were negative to a protein control antigen by ELISA. Serum immunoglobulin G response to pneumolysin as measured by ELISA might thus be an aid in the laboratory diagnosis of pneumococcal pneumonia. This assay may also help to further elucidate the occurrence of dual infections with pneumococci.