国内军团菌病暴发病例临床特征分析  

Analysis of clinical characteristics of outbreaks of Legionnaires′disease in China

作　　者：张美彤 董颖 陈愉[1] 贾琳[1] 陈乾华 赵立[1] ZHANG Mei-tong;DONG Ying;CHEN Yu;JIA Lin;CHEN Qian-hua;ZHAO Li(Shengjing Hospital of China Medical University,Shenyang,Liaoning 110004,China)

机构地区：[1]中国医科大学附属盛京医院呼吸科,辽宁沈阳110004 [2]中国医科大学航空总医院呼吸科,北京100012

出　　处：《中华医院感染学杂志》2018年第20期3187-3191,共5页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81170009)

摘　　要：目的了解国内军团菌病暴发的临床特征,提高对该病暴发病例的认识。方法检索国内1982-2016年CNKI、维普、万方等各类期刊杂志数据库中发表的军团菌病暴发及相关流行病学的文献,按纳入标准对病例资料进行分析。结果收录军团菌病暴发11起,涉及224例患者。暴发场所为部队营地、医院、学校等人群聚集处。6例暴发考虑淋浴水为主要传染源;男女比例为1.96∶1,年龄为19～55岁。其中嗜肺军团菌(Lp)占64.71%(88/136),博杰曼军团菌(Lb)和米克戴德军团菌(Lm)各占17.65%(24/136);在Lp中,Lp1型占23.86%(21/88)。表现为肺炎型患者占18.75%(42/224),Pontiac热型患者占81.25%(182/224)。两种临床表现形式在一起暴发事件中可单独存在,也可同时存在。死亡2例,病死率为0.89%。结论对环境潮湿聚集居住的场所应加强通风,并对生活供水系统加强军团菌的环境监测,减少军团菌病暴发流行。对暴发出现的呼吸道感染病例应进行军团菌相关检测,早期诊断,积极治疗,以降低病死率。OBJECTIVE To understand the clinical characteristics of outbreaks of Legionnaires＇ disease in China,and to improve the awareness of the disease.METHODS The literatures and documents related to Legionnaries＇ disease outbreaks which were published in CNKI,Whipple,Wanfang journals were retrieved in the database from 1982 to 2016,and analyzed.RESULTS There were 11 reports of Legionnaires＇ disease outbreak in China recruited in the study,with a total of 224 patients.The outbreak places were army camp,hospitals,schools,and other public environments.There were 6 outbreaks associated with water from shower.The ratio of male and female was 1.96：1,and the ages varied from 19 to 55 years old.Among them,the detection rate of Legionella pneumophila（Lp）was 64.71%（88/136）,in which Lp1 accounted for 23.86%（21/88）.The detection rates of Legionella bozemanae（Lb）and Legionella micdadei（Lm）were both 17.65%（24/136）.The number of patients with pneumonia was 42（18.75%,42/224）,while that of Pontiac fever was 182（81.25%,182/224）.Both clinical manifestations could exist together or separately in one outbreak.There were 2 cases of death,and the mortality rate was 0.89%.CONCLUSIONThe ventilation system in wet,crowded living environment and detection for Legionellain water supply system should be reinforced to decrease Legionella infection outbreaks.Wide spreading the knowledge of Legionnaires′disease,increasing the awareness about the disease,taking Legionella tests on respiratory infection patients in outbreaks will facilitate early diagnosis so that active treatment can be taken,and the mortality might be reduced.

关 键 词：军团菌病 暴发 临床特征 

分 类 号：R378[医药卫生—病原生物学]