嗜肺军团菌聚合酶链反应检测方法及其应用研究

根据嗜肺军团菌基因组ＤＮＡ的种特异性ＤＮＡ片段序列，合成一对引物进行聚合酶链反应（ＰＣＲ）。经琼脂糖凝胶电泳、ＥＢ染色结果表明，一条８７０ｂｐ的核苷酸区带为嗜肺军团菌１～１４血清型菌株所共有。ＰＣＲ检测水中军团菌，其敏感性为３５０ｃｆｕ／ｍｌ，而用同位素标记探针、斑点杂交法检测，其敏感性为４３ｃｆｕ／ｍｌ。ＰＣＲ检测人工感染嗜肺军团菌的豚鼠组织标本，阳性率为８３．３％，而细菌分离培养的阳性率仅为２６．６％。在现场调查中，用ＰＣＲ法初步验证了一起由Ｌｐ１０引起的军团菌病爆发。上述结果表明，ＰＣＲ法能快速、敏感、特异性检测嗜肺军团菌感染。     

Legionellosis associated with artesian well excavation

In October 1990 pneumonia due toLegionella pneumophila was diagnosed in two employees working in the area of Apulia, southern Italy, where artesian wells were in construction. Although the exposure to excavation has been associated with Legionnaires' disease, in our investigation the illness occurred only in those employees who were present when the water emerged from the ground under high pressure. On the basis of this report, water appears as the most likely reservoir of the organism and the main route of infection.Corresponding author.     

嗜肺军团菌肺炎13例临床分析

本文报告１３例嗜肺军团菌肺炎。其中Ｌｐ１型６例；Ｌｐ６型６例；Ｌｐ１２型１例。Ｌｐ１２型国内尚未见文献报告。对临床表现，实验室检查，Ｘ线胸部征象，治疗和预后进行分析。并将部分资料与美国洛杉矶Ｗａｄｓｗｏｒｔｈ医疗中心统计资料分析对比，以探讨国人嗜肺军团菌肺炎临床特征。     

用DNAG C含量和DNA同源性测定法鉴定米克戴德军团菌

本文采用热变性温度法和液相复性速率法对—轻型特征及血清学反应相似米克戴德军团菌(Lm)的菌株进行了测定,结果表明该菌与标准Lm(C DC株)的DNA G Cmol％相差3.45％,与标准Lm(C DC株)的DNA同源性达81.99％,根据伯杰细菌鉴定手册(1984),可判定该菌株与标准Lm(C DC株)为遗传型一致的类群,即从遗传学角度证明该菌为Lm。     

中央空调冷却塔水中嗜肺军团菌的调查

目的：了解医院、宾馆空调冷却塔水中军团菌污染情况。方法：于2001年8月采集W市2家宾馆和4家医院的中央空调冷却塔水样，过滤空调冷却水的滤膜经盐酸处理后其处理液接种于GVPC平板，烛缸培养后选取可疑菌落进行生化试验、血清学试验并以PCR方法鉴定。结果：W市2家医院及1家星级宾馆的中央空调冷却塔水中分离到5株军团菌，2株为嗜肺军团菌血清1型（Lp1），2株为嗜肺军团菌血清5型（Lp5）。结论：应加强对医院、宾馆空调冷却塔水中军团菌的监测。     

军团菌MOMPS基因的克隆并在原核系统中表达

以军团菌DNA为模板，PCR扩增获得军团菌主要外膜蛋白基因（Major outer membrane protein gene，ompS），与原核表达质粒pUC18定向重组，构建重组质粒，转化大肠杆菌BL21，并用限制性酶酶切分析、聚合酶链式反应、核酸序列分析、十二烷基磺酸钠-聚丙烯酰胺凝胶电泳、Western印迹进行鉴定。实验结果表明我们扩增出了军团菌914bp的ompS基因，成功构建了重组质粒pLPompS，并在原核系统中得到了表达。     

Nosocomial Legionella pneumophila serogroup 5 outbreak associated with persistent colonization of a hospital water system

An outbreak of infections caused by Legionella pneumophila serogroup 5 was detected in a university hospital, and nosocomial reservoirs of the legionella epidemic were examined. Clinical isolates from two patients who had been affected by the L. pneumophila serogroup 5 outbreak, and from another patient with a legionella infection caused by the same serogroup 3 years later, were compared to L. pneumophila serogroup 5 isolates from the hospital water supply by two molecular methods, amplified fragment length polymorphism (AFLP) analysis and random amplified polymorphic DNA analysis (RAPD). Genotyping confirmed the epidemiological linkage of the first two patients, and linked their infections with the hospital water supply. The third clinical strain, which was also linked to the hospital water, was very similar to the epidemic strain. Even though the water distribution system was sanitized (superheat and flush sanitation), the epidemic strain was shown to be persisting in the hospital water outlets several years after its initial discovery.     

北京市东城区公共场所冷却塔使用状况及健康风险评估

目的了解北京市东城区公共场所冷却塔使用及卫生状况,评估各场所冷却塔军团菌病健康风险。方法2018年5—9月,采集东城区内三类共26家公共场所冷却塔冷却水,填写相关调查问卷,通过冷却塔军团菌病健康风险指数模型计算各场所健康风险。结果本次研究中各场所冷却水样本嗜肺军团菌检测均为阴性,合格率为100%。游离性余氯平均为0.15 mg/L。酒店类场所冷却塔规模、加药方式和频率与其他场所有明显差别。26家公共场所健康综合风险平均为61.49,其中军团菌增殖风险、含菌气溶胶传播风险、暴露人群易感风险分别为16.13、22.66和22.70。不同场所冷却塔军团菌病健康风险评估结果存在一定差异,医院类场所健康风险指数高于酒店和商场(F=3.78,P<0.05)。结论冷却塔军团菌病健康风险高低主要受公共场所周围易感人群影响,该地区相关卫生部门应加强对相关易感人群的保护,对各类场所相关政策法规进行制定、完善和实施。     

Legiolert酶底物法与传统培养法对公共场所水体样本中嗜肺军团菌检出结果的比较

目的比较Legiolert酶底物法与传统培养法对公共场所水体样本中嗜肺军团菌的检出效果。方法分别利用Legiolert酶底物法与传统培养法对采集于公共场所的冷却水、淋浴水样本进行嗜肺军团菌检测,并对分离株进行验证及血清分型。结果共采集并检测样品68份,传统培养法与Legiolert酶底物法的检出率分别为5.88%(4/68)及35.29%(24/68),差异有统计学意义(χ2=16.41,P<0.01)。两种方法的检测符合率为64.71%(44/68),检测效果的差异有统计学意义(配对χ2=16.41,P=0.000)。分离出的25株嗜肺军团菌血清型以LP1为主(14/25)。结论Legiolert酶底物法对公共场所水体样本中嗜肺军团菌的检出率高于传统培养法。     

Estimate of Burden and Direct Healthcare Cost of Infectious Waterborne Disease in the United States

Provision of safe drinking water in the United States is a great public health achievement. However, new waterborne disease challenges have emerged (e.g., aging infrastructure, chlorine-tolerant and biofilm-related pathogens, increased recreational water use). Comprehensive estimates of the health burden for all water exposure routes (ingestion, contact, inhalation) and sources (drinking, recreational, environmental) are needed. We estimated total illnesses, emergency department (ED) visits, hospitalizations, deaths, and direct healthcare costs for 17 waterborne infectious diseases. About 7.15 million waterborne illnesses occur annually (95% credible interval [CrI] 3.88 million–12.0 million), results in 601,000 ED visits (95% CrI 364,000–866,000), 118,000 hospitalizations (95% CrI 86,800–150,000), and 6,630 deaths (95% CrI 4,520–8,870) and incurring US $3.33 billion (95% CrI 1.37 billion–8.77 billion) in direct healthcare costs. Otitis externa and norovirus infection were the most common illnesses. Most hospitalizations and deaths were caused by biofilm-associated pathogens (nontuberculous mycobacteria, Pseudomonas, Legionella), costing US $2.39 billion annually.