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目的了解上海市黄浦区各医院中央空调冷却水和自来水军团菌污染状况。方法 2008—2009年5—12月每月1次对黄浦区4家综合性医院(其中3家三级医院、1家二级医院)监测点的中央空调冷却水和ICU病房、急诊室、手术间的自来水进行采样,用血清学凝集试验、胶乳凝集试验进行分型。结果各监测点中央空调冷却水军团菌均有检出,128件样品中共检出阳性20件,总检出率为15.63%(20/128),三级医院检出率为18.75%(18/96),二级医院检出率为6.25%(2/32);总阳性率以5月和10月较高,分别达31.25%(5/16)和50.00%(8/16);共检出31株菌株,Lp1和Lp7为优势菌株。各监测点ICU病房、急诊室、手术间的自来水均未检出军团菌。结论各监测点空调水存在军团菌污染现象,尤以三级医院较严重;自来水供水系统卫生状况良好。应于夏秋季在重点场所加强监测,以防止军团菌病的暴发流行。
Objective To understand the pollution situation of Legionella pneumophila in central air conditioning and tap water in hospitals in Huangpu District of Shanghai. Methods From January 2008 to December 2009, the hospital once a month evaluated the central air-conditioning cooling water and ICU wards, emergency rooms, and surgery in 4 general hospitals (including 3 tertiary hospitals and 1 secondary hospital) in Huangpu District Tap water between the sampling, serological agglutination test, latex agglutination test for typing. Results Legionella pneumophila in the central air conditioning cooling water were detected at all monitoring points. Totally 20 positive samples were detected in 128 samples, with the total detection rate of 15.63% (20/128) and the tertiary hospital detection rate of 18.75% (18 / 96). The detection rate of secondary hospitals was 6.25% (2/32). The total positive rate was 31.25% (5/16) and 50.00% (8/16) respectively in May and October. Out of 31 strains, Lp1 and Lp7 were dominant strains. The ICU wards, emergency rooms and tap water in the operation rooms of the monitoring points did not detect Legionella. Conclusion Legionella contamination was found in air-conditioning water at all monitoring sites, especially in tertiary hospitals. The sanitary condition of tap water supply system was good. Monitoring should be stepped up in key places in summer and autumn to prevent the outbreak of Legionnaires’ disease.