2011-2018年上海市公共场所人工水环境中军团菌污染情况调查及其病原型别鉴定

目的了解2011-2018年上海市公共场所人工水环境中军团菌的流行病学特征和病原学特征,为军团菌病的防控提供科学依据。方法2011-2018年累计采集上海市黄浦、静安、徐汇、松江4个区内的31家公共场所人工水环境标本4817份,对采集的年份和月份的时间特征、地区和场所类型特征、标本的类型进行流行病学特征分析,在对采集的水样进行处理、培养和分离鉴定后,再对检测阳性的标本进行军团菌型别特征分析。结果4817份标本中,军团菌阳性率为21.57%(1039份),其中单种型别阳性占96.25%(1000/份),以嗜肺军团菌1型为主,占84.31%(876份),其次为嗜肺军团菌7型和6型,分别占4.72%(49份)和3.75%(39份);同时检出多种型别阳性29份占2.79%(29份);有10份标本无法进一步分型。5-10月份中,以7和8月份的阳性率最高,分别为27.61%(222份)和28.61%(230份),不同月份间差异有统计学意义(P<0.001);以中央空调冷却水和冷冻水的阳性率最高(32.40%),不同水样类型间差异有统计学意义(P<0.001)。不同地区、不同时间、不同场所和不同类型的公共场所人工水环境中均为嗜肺军团菌1型、7型、6型为主的多样性分布,以嗜肺军团菌1型占比最高,不同情况下占阳性标本的比例均超过71.64%。结论上海市公共场所人工水环境中存在以嗜肺军团菌1型为主的较严重污染,每年夏季需加强大型商场、超市、地铁站等公共场所的中央空调冷却水/冷冻水的消毒。

Investigation of Legionella contamination in artificial water environment of public places and identification of its pathogenic types in Shanghai from 2011 to 2018

Objective To understand the epidemiological and pathogenic characteristics of Legionella in artificial water environment of public places in Shanghai from 2011 to 2018,and to provide scientific basis for the prevention and control of Legionellosis.Methods A total of 4817 samples of artificial water environment were collected from 31 public places in Huangpu,Jing′an,Xuhui and Songjiang districts of Shanghai from 2011 to 2108.Epidemiological characteristics of the collected years and months,regional and site types,and sample types were analyzed.After treatment,culture and isolation of the collected water samples,the positive samples were analyzed for Legionella typing characteristics.Results The positive rate of Legionella pneumophila was 21.57%(1039/4817),of which 96.25%(1000/1039)was single type,84.31%(876/1039)was Legionella pneumophila type 1,followed by Legionella pneumophila type 7 and 6,which accounted for 4.72%(49/1039)and 3.75%(39/1039),respectively,and 29(29/1039)were multi-type positive.Further typing.From May to October,the highest positive rates were found in July and August,27.61%(222/804)and 28.61%(230/804)respectively.There were significant differences between different months(P<0.001);the highest positive rates were found in central air-conditioning cooling water and chilled water(32.40%)and there were significant differences among different water samples(P<0.001).Legionella pneumophila type 1,type 7 and type 6 were the main diversity distribution characteristics in artificial water environment of different regions,different time,different places and different types of public places.Legionella pneumophila type 1 accounted for the highest proportion,and the proportion of positive samples under different epidemiological characteristics was more than 71.64%.Conclusion There is relatively serious pollution of Legionella pneumophila type 1 in the artificial water environment of public places in Shanghai.It is necessary to strengthen the disinfection of cooling water/freezing water of central air conditioning in public places in July and August every year.