与医院水系统相关的军团病. 一份关于连续高化五年进展报告
C M Helms1, R M Massanari, R P Wenzel
1Department of Internal Medicine, University of Iowa College of Medicine, Iowa City.
JAMA
|April 22, 1988
概括
连续高化控制的流行病性医院病房军团病毒病在血液病瘤病房. 然而,Legionella pneumophila血清组1感染的零星病例持续存在,未确定环境储库.
科学领域:
- 传染性疾病 传染性疾病
- 环境健康 环境健康
- 医院流行病学 医院流行病学
背景情况:
- 在医疗保健机构中,鼻性军团病爆发带来了重大风险,特别是在免疫功能低下的患者群体中.
- 在一个新的血液瘤学部门的初始爆发中,莱吉欧内拉肺炎1血清组被确定为致病原体.
- 水分系统被认为是最初爆发疫情的环境储库.
研究的目的:
- 评估持续高化在控制医院病房里传染病爆发的疗效.
- 评估过度化对医院水系统中军团菌污染的长期影响.
- 为了调查在实施高化后发生的零星军团病病例.
主要方法:
- 单克隆抗体类型和限制性内核酶等离子体分析用于菌株鉴定.
- 热水和冷水系统的连续高化在3-5 mg/L的水平下实施.
- 监测水样是否存在军团菌,并随着时间的推移跟踪患者病例.
主要成果:
- 连续的高化已经成功地从水系统中消除了莱吉欧内拉肺炎菌1血清组的流行菌株 (09,04) 超过五年.
- 发生过多化后的四起与不同菌株 (09,00) 相关的病房内传染性军团病的零星病例,环境来源不明.
- 在度超过4毫克/升时,观察到三甲 (潜在的致癌物) 含量升高,系统腐蚀增加.
结论:
- 持续的高化有效控制了流行病性医院里昂氏菌病,但并没有消除零星病例.
- 对零星的Legionella pneumophila血清组1感染的环境储库仍然未被确定,需要进一步调查.
- 虽然有希望,但连续高化是一种实验性控制技术,具有潜在的副作用,如增加三甲和系统腐蚀.
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