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目的了解上海市医院供水系统管道中军团菌属的污染情况,并分析军团菌属污染的危险因素。方法在2009年5-9月采集上海市8所医院供水管道末端水样共193份,分别进行军团菌和阿米巴的培养,应用军团菌乳胶凝集试验将所分离的军团菌属进行血清分型,同时收集相关资料进行危险因素分析。结果在采样的8所医院中,7所(87.5%)医院有军团菌属的污染,2所医院水管出口嗜肺军团菌污染率>30.0%;在采集的193份水样中,83份(43.0%)分离出军团菌属,其中33份(17.1%)分离到嗜肺军团菌,63份水样中军团菌属的浓度≥103CFU/L;在军团菌属污染危险因素分析中,阿米巴的定植、无水管消毒、水管类型为镀锌钢管及水箱间接供水都是独立的危险因素。结论上海市医院供水系统中军团菌属污染常见,且污染浓度高,存在发生医院内军团菌肺炎甚至暴发流行的严重隐患,建议对医院供水系统军团菌属污染情况和医院获得性军团菌病进行监测,并研究具有可行性的供水系统去除军团菌污染的有效方法 。
Objective To understand the contamination of Legionella in the water supply system of Shanghai hospital and to analyze the risk factors of Legionella contamination. Methods A total of 193 water samples collected from the water supply pipelines of eight hospitals in Shanghai from May to September in 2009 were collected for culturing Legionella and Amoeba. Legionella were isolated by serum agglutinin Type, while collecting relevant information for risk factor analysis. Results Among the 8 hospitals sampled, 7 (87.5%) hospitals were contaminated by Legionella, the incidence of Legionella pneumophila infection was> 30.0% at the outlet of 2 hospital water pipes, 83 of the 193 water samples 43.0%) isolated Legionella, of which 33 (17.1%) isolated Legionella pneumophila, 63 water samples Legionella concentration ≥ 103CFU / L; Legionella pollution risk factor analysis, amoeba Pakistan colonization, no water pipe disinfection, pipe type galvanized steel pipe and tank indirect water supply are independent risk factors. Conclusion Legionella contamination in Shanghai hospital water supply system is common and the pollution concentration is high. There is a serious risk of Legionella pneumonia and even outbreak in the hospital. It is suggested that the contamination of Legionella in hospital water supply system and hospital-acquired Legionnaires’ disease Monitor, and study the feasibility of a viable water supply system to remove Legionella contamination.