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首页> 外文期刊>Journal of Clinical Microbiology >Multiple Types of Legionella pneumophilaSerogroup 6 in a Hospital Heated-Water System Associated with Sporadic Infections
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Multiple Types of Legionella pneumophilaSerogroup 6 in a Hospital Heated-Water System Associated with Sporadic Infections

机译：与散发感染相关的医院热水系统中的多种嗜肺军团菌血清群6

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Five sporadic cases of nosocomial Legionnaires’ disease were documented from 1989 to 1997 in a hospital in northern Italy. Two of them, which occurred in a 75-year-old man suffering from ischemic cardiopathy and in an 8-year-old girl suffering from acute leukemia, had fatal outcomes. Legionella pneumophila serogroup 6 was isolated from both patients and from hot-water samples taken at different sites in the hospital. These facts led us to consider the possibility that a single clone of L. pneumophila serogroup 6 had persisted in the hospital environment for 8 years and had caused sporadic infections. Comparison of clinical and environmental strains by monoclonal subtyping, macrorestriction analysis (MRA), and arbitrarily primed PCR (AP-PCR) showed that the strains were clustered into three different epidemiological types, of which only two types caused infection. An excellent correspondence between the MRA and AP-PCR results was observed, with both techniques having high discriminatory powers. However, it was not possible to differentiate the isolates by means of ribotyping and analysis of rrnoperon polymorphism. Environmental strains that antigenically and chromosomally matched the infecting organism were present at the time of infection in hot-water samples taken from the ward where the patients had stayed. Interpretation of the temporal sequence of events on the basis of the typing results for clinical and environmental isolates enabled the identification of the ward where the patients became infected and the modes of transmission of Legionellainfection. The long-term persistence in the hot-water system of different clones of L. pneumophila serogroup 6 indicates that repeated heat-based control measures were ineffective in eradicating the organism.
机译：从1989年到1997年，在意大利北部的一家医院记录了5例散发的医院军团病患者病例。其中两个发生致命的结果，分别发生在一个患有缺血性心脏病的75岁男子和一个患有急性白血病的8岁女孩中。从患者和医院不同地点的热水样本中分离出肺炎军团菌血清群6。这些事实使我们考虑了 L的单个克隆的可能性。肺炎支原体血清群6在医院环境中持续了8年，并引起了零星的感染。通过单克隆亚型分型，宏限制性分析（MRA）和任意引物PCR（AP-PCR）对临床和环境菌株进行比较，结果表明该菌株被分为三种不同的流行病学类型，其中只有两种类型可导致感染。观察到MRA和AP-PCR结果之间的良好对应关系，这两种技术都具有很高的区分能力。然而，不可能通过核糖分型和 rrn 操纵子多态性分析来区分分离株。在感染时，从患者住所的病房采集的热水样本中存在与感染生物体抗原和染色体相匹配的环境菌株。根据临床和环境分离株的分型结果来解释事件的时间顺序，可以确定患者感染病房以及 Legionella 感染的传播方式。 L的不同克隆在热水系统中的长期持久性。肺炎双球菌血清群6表明，反复进行的基于热的控制措施对消灭该生物体无效。

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