军团菌病流行病学调查及防制措施研究

目的 ]　了解本区各种人群中军团菌感染情况 ;寻找较为理想的中央空调系统冷却水军团菌消除方法 ,为防制军团菌病提供科学依据。　 方法 ]　收集各种人群血清用微量凝集法检测军团菌抗体。应用病例对照方法分析军团菌性肺炎特殊临床表现及感染危险因素。采用物理除菌方法进行现场军团菌杀灭效果对比实验。　 结果 ]　本区各种人群军团菌抗体总阳性率为 7.5 9% ,肺炎及肺部感染者中军团菌抗体阳性率为 18.85 % ,中央空调冷却水军团菌培养阳性单位人群军团菌抗体阳性率比阴性单位高 4.0 9倍 ( χ2 =17.64 )。 2 3例军团菌性肺炎病例对照调查显示关节肌肉酸痛和胸痛是军团菌病较特异的临床体症 ,而发病前 2周曾去医院就诊或陪护及中央空调工作环境与军团菌的感染关系密切。应用ZG频谱式微电脑杀菌器做军团菌现场消除实验 ,经 72、2 40及 62 4h除菌效果观察均无军团菌生长 ,而对照组持续阳性 ,菌落数在 45～ 2 3 0cfu/mL。　 结论 ]　本区各种人群中均存在军团菌的感染 ,应加强对辖区内商务大楼、宾馆饭店等中央空调冷却水的监测和卫生管理 ,对军团菌培养阳性 ,菌落数≥ 10 0 0cfu/mL应采取强制性控制措施。ZG微电脑杀菌器能有效杀灭军团菌。

Epidemiological survey of Legionnaires' disease and study on its preventive measures

To investigate the infections status of Legionnaires' disease in different groups of people in Luwan districts and to explore an optimal method to remove Legionnaires in cooling water of central air-conditioner system and establish scientific basis of preventing Legionnaires' disease. Serum samples of different groups were collected and micro-coagulation method was used to detect the anti-body of Legionnaires. Case-control study was carried out to analyze Legionnaires' pneumonia's specific clinical manifestations and risk factors of infection. Physical bacterial removing method was used to perform the comparative effect assessment through field trial. The total ratio of positive antibody of Legionnaires' in different people groups of Luwan district was 7.59%, in pneumonia patients and those with lung infection was 18.85% . The positive ratio of Legionnaires' infection in staffs of organizations showing positive cultivation results in air-conditioner's cooling water was 4.09 times higher than those showing negative results (χ 2 =17.64). The case control study of 23 Legionnaires' pneumonia patients indicates that joints, muscle and breast aching were distinctive clinical representations of the disease. The results also showed that close relationship exists between Legionnaires' infection and events such as visiting hospital 2 weeks before illness and working under central air-conditioner systems. ZG frequency spectral style micro-computer bacterial killer was used to perform the spot bacterium eliminating experiment. The results showed that 72h, 240h and 642h after treatment, there was no Legionnaires growth, while the control group showed persistent positive and the number of bacterial colony was between 45～230 cfu/mL. Conclusion] Legionnaires' infection existed in different groups of people in Luwan district. The monitoring and hygienic management work to the cooling water of central air-conditioner system in commercial building, hotels and restaurants should be strengthened. Mandatory control measures should be taken to those organizations with positive Legionnaires' cultivation results or with bacterial colony count ≥1000 cfu/mL. ZG micro-computer bacterial killer can effectively kill the Legionnaires.