两篇基础性的文章描述了这种“新”致病菌的发现情况和阶段,这种致病菌导致了这种致命肺炎的突然爆发。1977年12月1日,在疫情爆发一年半后,Fraser et al.[1]和J.E. McDade et al.[2]分别在著名医学杂志《新英格兰医学杂志》上发表了对肺炎疫情的描述和病原检测的诊断过程。他们的研究是受CDC[3]委托进行的。CDC是一个拥有强大的科学、技术和财政资源的美国联邦机构,其唯一目标就是找出美国媒体所称的“费城杀手”!
图11. L.pneumophila 在变形虫和人类巨噬细胞中的生命周期。 图表改编自参考文献[15] (译者注:1.entry of bacteria into amoebae(water) 1.细菌进入变形虫(水);2.entry of bacteria into human pulmonary macrophages 2.细菌进入人肺巨噬细胞;replicative forms of the fused bacteria in the endoplasmic reticulum融合细菌在内质网中的复制形式;release of bacteria by pores formation 细菌在孔隙形成过程中的释放)
图14. 1988-2018 年法国军团病通报病例数和年发病率的演变。 [资料来源:经 Santé Publique France 许可转载(见参考文献[19])] (译者注:nombre de cas 病例数;taux de notification pour 100000 每十万人的发病率;N cas N个病例;Taux de notification 发病率)
AFNOR标准 NF T 90-431对供水网络系统的研究进行了很好的编码:“水质-军团菌属和嗜肺军团菌的搜索和计数”。这是一种直接接种和经过浓缩后的方法。它适用于所有类型的水:干净的和脏的。自2010年以来,采用分子生物学型PCR检测的NF T90-471标准已经存在:该技术是在卫生当局提出特定要求的情况下进行的。
[1] Fraser DW, Tsai TR, Orenstein W. et al Legionnaires’ disease: description of an epidemic of pneumonia. N. Engl. J. Med.1977, 297, 1189-1197
[2] McDade JE, Shepard CC, Fraser DW et al. Legionnaires’ disease. Isolation of a bacterium and demonstration of its role in other respiratory disease. N. Engl. J. Med. 1977, 297, 1197-1203
[4] Thomas G. & Morgan-Witts M., Trauma – The search for the cause of Legionnaires’ disease. Arrow Books, 1981; Thomas G. & Morgan-Witts M., Trauma – In search of a murderous virus, French translation by Destanque P., Ed. Encre 1982
[5] Brenner DJ, Steigerwalt A.G. McDade J.E. Classification of the Legionnaires’ Disease bacterium: Legionella pneumophila, genus novum, species nova of the family Legionellaceae, familia nova. Ann. Intern. Med. 1979, 90, 656-658.
[6] Moliner C., Ginevra C., Jarraud S. et al. Rapid identification of Legionella species by mass spectrometry. J. Med. Microbiol. 2010, 59,273-284;
[8] Gomez-Valero L., Rusniok C., Carson D. et al. More than 18,000 effectors in the Legionella genus genus provide multiple, independent combinations for replication in human cells. Process Nat. Acad. Sci. USA 116 (6) 2265-2273; first published January 18, 2019 https://doi.org/10.1073/pnas.1808016116
[9] Fliermans C.B., Cherry W.B., Orisson L.H., Smith S.J., et al. Ecological distribution of Legionella pneumophila. Appl. Environm. Microbiol. 1981, 41, 9-16
[10] Orisson L.H., Cherry W.B., Fliermans C.B. et al. Characteristics of environmental isolates of Legionella pneumophila. Appl. Environm. Microbiol. 1981, 42, 109-115
[11] Molmeret M. et al. Amaoebae as training grounds for intracellular bacterial pathogens. Appl. About. Microbiol. 2005; doi:10.1128/AEM.71.1.1.20-28.2005
[12] Lau H.Y. &Ashbolt N.J. The role of biofilm and protozoa in Legionella pathogenesis: implications for drinking water. J. Appl. Microbiol. 2009,107,368-378; Steinert M., Hentschel U.& Hacker J. Legionella pneumophila: an aquatic microbe goes astray. FEMS Microbiol. Rev. 2002, 26, 149-162; Declerck P. Biofilms: the environmental playground of Legionella pneumophila. Env.Microbiol.2010, 12, 557-566; Abdl-Nour, Duncan C, Low D.E et al . Biofilms: the stronghold of Legionella pneumophila. Int J. Mol. Sci. 2013, 14, 21660-21675
[13] Dietersdorfer E., Kirschner A., Schrammel B. et al Starved viable but non-culturable (VBNC) Legionella can infect and replicate in amoebae and human macrophages. Water Res. 2018
[14] Fields B.S., Benson R.F. & Besser R.E. Legionella and Legionnaires’ Disease: 25 years of investigation. Clin. Microbiol. Rev. 2002, 13, 506-526
[15] Cunha B.A., Burillo A.&Bouza E. Legionnaires’ disease. Lancet 2016, 387, 376-385
[16] McCormick J.B. & Fisher-Hoch S. 1997. Chasseurs de virus. Presses de la Cité, 498 pages
[17] Jarraud S., Reyrole M., Meugnier H. et al Légionellose. Presse Med 2007, 36, 279-87; Jamilloud Y., Jarraud S., Lina G., et al. Legionella, legionellosis, 2012, Med Sci (Paris) 28, 639-45
[22] 法国公共卫生。自2016年5月1日起,它已包括:INVS(Institut National Veille Sanitaire)、Inpes(Institut national预防和健康教育),Eprus(建立对突发卫生事件的准备和响应)。
[23]European Centre for Disease Prevention and Control, Legionnaires’ disease. In: ECDC. Annual epidemiological report for 2017 (2019), Stockholm.
[24] https://www.hcsp.fr notices and reports/guide for investigation and case management assistance in legionellosis, https://www.iledefrance.ars.sante.fr/la-legionellose (in french)
[25] Cheron J. (2006) Maîtriser le risque légionelles. Ed. Johanet, 325 p. (in french)