军团菌病对伊尔库茨克肺炎致命后果的影响

A. D. Botvinkin, V. Svistunov, E. A. Sidorova, A. E. Makarova, N. A. Kravchenko, L. A. Stepanenko, T. Bayanova, M. V. Lemeshevskaya, T. Balandina, O. S. Gibteva, E. Andaev, S. Balakhonov
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摘要

的目标。研究伊尔库茨克地区2016-2018年肺炎死亡患者军团菌病诊断情况。材料与方法。我们对伊尔库茨克市(2016-2018年)65例肺炎死亡患者进行尸检,研究其病例史,并通过接种和聚合酶链反应对510份自来水样本进行嗜肺军团菌检测。在伊尔库茨克2016-2018年期间登记的65例致命肺炎中,军团菌病已在3例(4.6%)中得到确认。其中两名患者处于艾滋病毒感染的晚期,而第三名患者,74岁,患有多种合并症。其中一例疑似医院感染。这三个病人在生命的最后一个月都没有离开伊尔库茨克。2013年和2015年采集的自来水样本中均检出嗜肺军团菌,推定传播因子为自来水。严重肺炎患者需要进行军团菌病筛查,以便进行正确治疗,特别是在COVID-19大流行期间。
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The impact of legionellosis into fatal outcomes of pneumonia in Irkutsk
Aim. To study the diagnosis of legionellosis in patients who died because of pneumonia in Irkutsk (2016-2018).Materials and Methods. We performed 65 autopsies of patients who died from pneumonia in Irkutsk (2016-2018), studied their case histories, and interrogated 510 tap water samples for Legionella pneumophila by means of inoculation and polymerase chain reaction.Results. Among 65 fatal pneumonia outcomes registered in Irkutsk during 2016-2018, legionellosis has been confirmed in three cases (4.6%). Two of these patients were at the late stages of HIV infection while the third, 74-yearold, patient had multiple comorbid conditions. Nosocomial infection was suspected in one of these cases. None of these three patients left Irkutsk during the last month of their life. The assumed transmission factor was tap water, as Legionella pneumophila was found in tap water samples collected in 2013 and 2015.Conclusion. Patients with severe pneumonia need screening for legionellosis to perform the correct treatment, particularly during COVID-19 pandemic.
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