岡山地方における健康成人と呼吸器疾患入院患者血清のLegionella pneumophilaに対する抗体価測定に関する研究
岡山地方におけるLegionnaires′diseaseの疫学的調査を目的として, 岡山県在住の健康成人432例と, 呼吸器内科入院患者160例の血清について間接蛍光抗体法を用いて, Legionella pneumophila serogroups I-IVに対する抗体価測定を行なった. 健康成人432例の血清抗体価は, 314例 (72.7%) が8倍以下で, 64倍が11例 (2.5%), 128倍が3例 (0.7%) であり, 年齢, 性別による頻度の差は認められなかった. 呼吸器疾患入院患者160例の血清の内, 64倍以上の抗体価を示したものは18例 (11.3%) に認められ, 健...
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| Published in | 感染症学雑誌 Vol. 59; no. 4; pp. 373 - 380 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本感染症学会
01.04.1985
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| Online Access | Get full text |
| ISSN | 0387-5911 1884-569X |
| DOI | 10.11150/kansenshogakuzasshi1970.59.373 |
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| Abstract | 岡山地方におけるLegionnaires′diseaseの疫学的調査を目的として, 岡山県在住の健康成人432例と, 呼吸器内科入院患者160例の血清について間接蛍光抗体法を用いて, Legionella pneumophila serogroups I-IVに対する抗体価測定を行なった. 健康成人432例の血清抗体価は, 314例 (72.7%) が8倍以下で, 64倍が11例 (2.5%), 128倍が3例 (0.7%) であり, 年齢, 性別による頻度の差は認められなかった. 呼吸器疾患入院患者160例の血清の内, 64倍以上の抗体価を示したものは18例 (11.3%) に認められ, 健康成人の3.2%に比較して有意に高い成績であった (p<0.0001).さらに, 256倍から1,024倍の高い抗体価を示した症例が5例 (3.1%) 認められた. 64倍以上の抗体価を示した18例中16例は呼吸器感染症例で, 内9例は基礎疾患に慢性閉塞性肺疾患や肺癌を有していた. 以上の結果より, 岡山地方においてもL.pneumoPhilaによる感染症が存在しているものと考えられた. |
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| AbstractList | 岡山地方におけるLegionnaires′diseaseの疫学的調査を目的として, 岡山県在住の健康成人432例と, 呼吸器内科入院患者160例の血清について間接蛍光抗体法を用いて, Legionella pneumophila serogroups I-IVに対する抗体価測定を行なった. 健康成人432例の血清抗体価は, 314例 (72.7%) が8倍以下で, 64倍が11例 (2.5%), 128倍が3例 (0.7%) であり, 年齢, 性別による頻度の差は認められなかった. 呼吸器疾患入院患者160例の血清の内, 64倍以上の抗体価を示したものは18例 (11.3%) に認められ, 健康成人の3.2%に比較して有意に高い成績であった (p<0.0001).さらに, 256倍から1,024倍の高い抗体価を示した症例が5例 (3.1%) 認められた. 64倍以上の抗体価を示した18例中16例は呼吸器感染症例で, 内9例は基礎疾患に慢性閉塞性肺疾患や肺癌を有していた. 以上の結果より, 岡山地方においてもL.pneumoPhilaによる感染症が存在しているものと考えられた. |
| Author | 渡辺, 正俊 川根, 博司 中浜, 力 二木, 芳人 加藤, 収 川西, 正泰 松島, 敏春 副島, 林造 |
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| References | 40) Buesching, W. J., et al.: Enhanced primary isolation of Legionella pneumophila from clinical specimens by low-pH treatment. J. Clin. Microbiol., 17: 1153-1155, 1983. 15) Fallon, R. J., et al.: Polyvalent heat-killed antigen for the diagnosis of infection with Legionella pneumophila. J. Clin. Pathol., 35: 434-438, 1982. 18) Wilkinson, H.W., et al.: Reactivity of serum from patients with suspected Legionellosis against 29 antigens of Legionellaceae and Legionellalike organisms by indirect immunofluorescence assay. J. Infect. Dis., 147: 23-31, 1983. 19) Mayer, R. D., et al.: Legionnaires' disease. Ann. Rev. Med., 31: 219-232, 1980. 27) Politi, B. D., et al.: A major focus of Legionnaires' disease in bloomington, Indina. Ann. Intern. Med., 90: 587-591, 1979. 23) Snowman, W. R., et al.: The role of indoor and outdoor occupations in the seroepidemiology of Legionella pneumophila. J. Infect. Dis., 145 275, 1982. 17) Wilkinson, H. W., et al.: Indirect immunofluorescence test for serodiagnosis of Legionnaires disease: Evidence for serogroup diversity of Legionnaires' disease bacterial antigens and for multiple specificity of human antibodies. J. Clin. Microbiol., 9: 379-383, 1979. 29) Muldoon, R. L., et al.: Legionnaires' disease in children. Pediatrics, 67: 329-332, 1981. 37) Orenstein, W. A., et al.: The frequency of Legionella infection prospectively determined in children hospitalized with pneumonia. J. Pediatr., 99: 403-406, 1981. 31) Bridge, J. A., et al.: Oropharyngeal colonization with Legionella pneumophila. J. Clin. Microbiol., 18: 1108-1112, 1983. 12) Lattimer, G. L., et al.: Legionnaires' disease serology: Effect of antigen preparation on specificity and sensitivity of the indirect fluorescent antibody test. J. Clin. Pathol., 33: 585-590, 1980. 39) Katz, S. M., et al.: Serum antibodies to Legionella pneumophila in patients with cystic fibrosis. J. A. M. A., 248: 2284-2288, 1982. 4) Wilkinson, H. W., et al.: Indirect immunofluorescence test for Legionnaires' disease. “Legionnaires” the disease, the bacterium an methodology. U.S. Department of Health, Education, and Welfare, C. D. C. Georgia, U. S. A., 1979, p.112-116. 2) Edelstein, P. H., et al.: Legionnaires' disease, a review. Chest, 85: 114-120, 1984. 32) Kirby, B. D., et al.: Legionnaires' disease: Report of sixty-five nosocomially acquired cases and review of the literature. Medicine, 59: 188-205, 1980. 10) Sathapatayavongs, B., et al.: Rapid diagnosis of Legionnaires' disease by urinary antigen detection: Comparison of ELISA and radioimmunoassay. Am. J. Med., 72: 576-582, 1982. 35) Freedman, A. P., et al.: The prevalence of serum antibodies to Legionella pneumophila in patients with chronic pulmonary disease. Am. Rev. Respir. Dis., 123: 238-239, 1981. 20) Storch, G., et al.: Prevalence of antibody to Legionella pneumophila in middle-aged and elderly Americans. J. Infect. Dis., 140: 784-787, 1979. 38) Renner, E. D., et al.: Coinfections of mycoplasma pneumoniae and Legionella pneumo, phila with influenza A virus. J. Clin. Microbiol., 17: 146-148, 1983. 26) Dondero, T. J., et al.: Legionnaires' disease in Kingspot, Tennessee. Ann. Intern. Med., 90: 569-573, 1979. 1) Fraser, D. W., et al.: Legionnaires' disease: Four summers' harvest. Am. J. Med., 68: 1-2, 1980. 33) Klein, G. C., et al.: Cross reaction to Legionella pneumophila antigen in sera with elevated titers to Pseudomonas pseudomallei. J. Clin. Microbiol., 11: 27-29, 1980. 8) Harrison, T. G., et al.: A rapid microagglutination test for the diagnosis of Legionella pneumophila (serogroup 1) infection. J. Clin. Pathol., 35: 1028-1031, 1982. 36) Walder, M., et al.: Incidence of Legionella pneumophila in actute lower respiratory tract infections. Scand. J. Infect. Dis., 13: 159-160, 1980. 21) Katz, S.M., et al.: Prevalence of antibodies to Legionella pneumophila and Legionella micdadei in renal transplant recipients. Transplantation, 32: 784-788, 1979. 22) Helms, C. M., et al.: Indirect immunofluorescence antibodies to Legionella pneumophila: Frequency in a rural community. J. Clin. Microbiol., 12: 326-328, 1980. 44) Muder, R. R., et al.: Nosocomial Legionnaires' disease uncovered in a prospective pneu monia study: Implications for undered in a prospective pneumonia study: Implications for under-diagnosis. J. A. M. A., 249: 3184-3188, 1983. 45) Marrie, T.J., et al.: Causes of atypical pneumonia: Result of a 1-year prospective study. Can. Med. Assoc. J., 125: 1118-1123, 0000. 13) Wilkinson, H. W., et al.: Validation of Legionella pneumophila indirect immunofluorescence assay with epidemic sera. J. Clin. Microbiol., 13: 139-146, 1981. 7) Yonke, C. A., et al.: Evaluation of an indirect hemagglutinination test for Legionella pneumophila serogroups 1-4. J. Clin. Microbiol., 13: 1040-1045, 1981. 5) Taylor, A. G., et al.: False positive reactions in the indirect fluorescent antibody test for Legionnaires' disease eliminated by use of formalised yolk-sac antigen. Ann. Intern. Med., 90: 686-689, 1979. 9) Herbrink, P., et al.: Detection of antibodies against Legionella pneumophila serogroup 1-6 and the Leiden 1 strain by micro ELISA and immunofluorescence assay. J. Clin. Pathol., 36: 1246-1252, 1983. 11) Wilkinson, H. W., et al.: Formalin killed versus heat-killed Legionella pneumophila serogroup 1 antigen in the indirect immunofluorescence assay for Legionellosis. J. Clin. Microbiol., 16: 979-981, 1982. 30) Yonke, C. A., et al.: Prevalence of antibody to serogroups 1-4 of Legionella pneumophila: A seroepidemiologic study using the indirect hemagglutination test. Am. J. Epidemiol., 115: 633-639, 1982. 28) Grist, N.R., et al.: Legionnaires' disease and the traveller. Ann. Intern. Med., 90: 563-564, 1979. 25) Broom, C. V., et al.: Field investigation team. The Vermont epidemic of Legionnaires's disease. Ann. Intern. Med., 90: 573-577, 1979. 42) Yu, V. L., et al.: Legionnaires' disease: New clinical perspective from a prospective pneumonia study. Am. J. Med., 73: 357-361, 1982. 24) Haley, C. E., et al.: Nosocomial Legionnaires' disease: A continuing common source epidemic at Wadsworth Medical Center. Ann. Intern. Med., 90: 583-586, 1979. 43) White, R. J., et al.: Causes of pneumonia presenting to a district general hospital. Thorax, 36: 566-570, 1981. 14) Wentworth, B. B., et al.: Studies of the specificity of Legionella serology. J. Clin. Microbiol., 15: 961-963, 1982. 3) 中浜力二岡山地方におけるLegionella属の環境材料よりの分離に関する研究.感染誌, 57: 643-655, 1983. 16) 田中光, 他: 健康人及び発熱疾患症例のレジオネラ症に対する抗体分布成績. 感染症誌, 57: 289-296, 1983. 6) Cherry, W. B., et al.: Detection of Legionnaires' disease bacterium in clinical specimens by direct immunofluorescence: “Legionnaires” the disease, the bacterium and methodology, U. S. Department of Health, Education, and Welfare, C. D. C. Georgia, U.S.A., 1979, p.92-103. 34) Harrison, A. G., et al.: Diagnosis of Legionella pneumophila infections by means of formolized yolk sac antigens. J. Clin. Pathol., 35 211-214, 1982. 41) Macfarlane, J. T., et al.: Hospital study of adult community-acquired pneumonia. Lancet, 8292: 255-258, 1982. |
| References_xml | – reference: 2) Edelstein, P. H., et al.: Legionnaires' disease, a review. Chest, 85: 114-120, 1984. – reference: 27) Politi, B. D., et al.: A major focus of Legionnaires' disease in bloomington, Indina. Ann. Intern. Med., 90: 587-591, 1979. – reference: 37) Orenstein, W. A., et al.: The frequency of Legionella infection prospectively determined in children hospitalized with pneumonia. J. Pediatr., 99: 403-406, 1981. – reference: 24) Haley, C. E., et al.: Nosocomial Legionnaires' disease: A continuing common source epidemic at Wadsworth Medical Center. Ann. Intern. Med., 90: 583-586, 1979. – reference: 29) Muldoon, R. L., et al.: Legionnaires' disease in children. Pediatrics, 67: 329-332, 1981. – reference: 6) Cherry, W. B., et al.: Detection of Legionnaires' disease bacterium in clinical specimens by direct immunofluorescence: “Legionnaires” the disease, the bacterium and methodology, U. S. Department of Health, Education, and Welfare, C. D. C. Georgia, U.S.A., 1979, p.92-103. – reference: 26) Dondero, T. J., et al.: Legionnaires' disease in Kingspot, Tennessee. Ann. Intern. Med., 90: 569-573, 1979. – reference: 18) Wilkinson, H.W., et al.: Reactivity of serum from patients with suspected Legionellosis against 29 antigens of Legionellaceae and Legionellalike organisms by indirect immunofluorescence assay. J. Infect. Dis., 147: 23-31, 1983. – reference: 21) Katz, S.M., et al.: Prevalence of antibodies to Legionella pneumophila and Legionella micdadei in renal transplant recipients. Transplantation, 32: 784-788, 1979. – reference: 25) Broom, C. V., et al.: Field investigation team. The Vermont epidemic of Legionnaires's disease. Ann. Intern. Med., 90: 573-577, 1979. – reference: 28) Grist, N.R., et al.: Legionnaires' disease and the traveller. Ann. Intern. Med., 90: 563-564, 1979. – reference: 36) Walder, M., et al.: Incidence of Legionella pneumophila in actute lower respiratory tract infections. Scand. J. Infect. Dis., 13: 159-160, 1980. – reference: 1) Fraser, D. W., et al.: Legionnaires' disease: Four summers' harvest. Am. J. Med., 68: 1-2, 1980. – reference: 5) Taylor, A. G., et al.: False positive reactions in the indirect fluorescent antibody test for Legionnaires' disease eliminated by use of formalised yolk-sac antigen. Ann. Intern. Med., 90: 686-689, 1979. – reference: 15) Fallon, R. J., et al.: Polyvalent heat-killed antigen for the diagnosis of infection with Legionella pneumophila. J. Clin. Pathol., 35: 434-438, 1982. – reference: 34) Harrison, A. G., et al.: Diagnosis of Legionella pneumophila infections by means of formolized yolk sac antigens. J. Clin. Pathol., 35 211-214, 1982. – reference: 38) Renner, E. D., et al.: Coinfections of mycoplasma pneumoniae and Legionella pneumo, phila with influenza A virus. J. Clin. Microbiol., 17: 146-148, 1983. – reference: 8) Harrison, T. G., et al.: A rapid microagglutination test for the diagnosis of Legionella pneumophila (serogroup 1) infection. J. Clin. Pathol., 35: 1028-1031, 1982. – reference: 12) Lattimer, G. L., et al.: Legionnaires' disease serology: Effect of antigen preparation on specificity and sensitivity of the indirect fluorescent antibody test. J. Clin. Pathol., 33: 585-590, 1980. – reference: 33) Klein, G. C., et al.: Cross reaction to Legionella pneumophila antigen in sera with elevated titers to Pseudomonas pseudomallei. J. Clin. Microbiol., 11: 27-29, 1980. – reference: 20) Storch, G., et al.: Prevalence of antibody to Legionella pneumophila in middle-aged and elderly Americans. J. Infect. Dis., 140: 784-787, 1979. – reference: 9) Herbrink, P., et al.: Detection of antibodies against Legionella pneumophila serogroup 1-6 and the Leiden 1 strain by micro ELISA and immunofluorescence assay. J. Clin. Pathol., 36: 1246-1252, 1983. – reference: 31) Bridge, J. A., et al.: Oropharyngeal colonization with Legionella pneumophila. J. Clin. Microbiol., 18: 1108-1112, 1983. – reference: 7) Yonke, C. A., et al.: Evaluation of an indirect hemagglutinination test for Legionella pneumophila serogroups 1-4. J. Clin. Microbiol., 13: 1040-1045, 1981. – reference: 11) Wilkinson, H. W., et al.: Formalin killed versus heat-killed Legionella pneumophila serogroup 1 antigen in the indirect immunofluorescence assay for Legionellosis. J. Clin. Microbiol., 16: 979-981, 1982. – reference: 23) Snowman, W. R., et al.: The role of indoor and outdoor occupations in the seroepidemiology of Legionella pneumophila. J. Infect. Dis., 145 275, 1982. – reference: 39) Katz, S. M., et al.: Serum antibodies to Legionella pneumophila in patients with cystic fibrosis. J. A. M. A., 248: 2284-2288, 1982. – reference: 40) Buesching, W. J., et al.: Enhanced primary isolation of Legionella pneumophila from clinical specimens by low-pH treatment. J. Clin. Microbiol., 17: 1153-1155, 1983. – reference: 42) Yu, V. L., et al.: Legionnaires' disease: New clinical perspective from a prospective pneumonia study. Am. J. Med., 73: 357-361, 1982. – reference: 45) Marrie, T.J., et al.: Causes of atypical pneumonia: Result of a 1-year prospective study. Can. Med. Assoc. J., 125: 1118-1123, 0000. – reference: 17) Wilkinson, H. W., et al.: Indirect immunofluorescence test for serodiagnosis of Legionnaires disease: Evidence for serogroup diversity of Legionnaires' disease bacterial antigens and for multiple specificity of human antibodies. J. Clin. Microbiol., 9: 379-383, 1979. – reference: 10) Sathapatayavongs, B., et al.: Rapid diagnosis of Legionnaires' disease by urinary antigen detection: Comparison of ELISA and radioimmunoassay. Am. J. Med., 72: 576-582, 1982. – reference: 3) 中浜力二岡山地方におけるLegionella属の環境材料よりの分離に関する研究.感染誌, 57: 643-655, 1983. – reference: 22) Helms, C. M., et al.: Indirect immunofluorescence antibodies to Legionella pneumophila: Frequency in a rural community. J. Clin. Microbiol., 12: 326-328, 1980. – reference: 35) Freedman, A. P., et al.: The prevalence of serum antibodies to Legionella pneumophila in patients with chronic pulmonary disease. Am. Rev. Respir. Dis., 123: 238-239, 1981. – reference: 13) Wilkinson, H. W., et al.: Validation of Legionella pneumophila indirect immunofluorescence assay with epidemic sera. J. Clin. Microbiol., 13: 139-146, 1981. – reference: 14) Wentworth, B. B., et al.: Studies of the specificity of Legionella serology. J. Clin. Microbiol., 15: 961-963, 1982. – reference: 41) Macfarlane, J. T., et al.: Hospital study of adult community-acquired pneumonia. Lancet, 8292: 255-258, 1982. – reference: 30) Yonke, C. A., et al.: Prevalence of antibody to serogroups 1-4 of Legionella pneumophila: A seroepidemiologic study using the indirect hemagglutination test. Am. J. Epidemiol., 115: 633-639, 1982. – reference: 32) Kirby, B. D., et al.: Legionnaires' disease: Report of sixty-five nosocomially acquired cases and review of the literature. Medicine, 59: 188-205, 1980. – reference: 44) Muder, R. R., et al.: Nosocomial Legionnaires' disease uncovered in a prospective pneu monia study: Implications for undered in a prospective pneumonia study: Implications for under-diagnosis. J. A. M. A., 249: 3184-3188, 1983. – reference: 16) 田中光, 他: 健康人及び発熱疾患症例のレジオネラ症に対する抗体分布成績. 感染症誌, 57: 289-296, 1983. – reference: 43) White, R. J., et al.: Causes of pneumonia presenting to a district general hospital. Thorax, 36: 566-570, 1981. – reference: 4) Wilkinson, H. W., et al.: Indirect immunofluorescence test for Legionnaires' disease. “Legionnaires” the disease, the bacterium an methodology. U.S. Department of Health, Education, and Welfare, C. D. C. Georgia, U. S. A., 1979, p.112-116. – reference: 19) Mayer, R. D., et al.: Legionnaires' disease. Ann. Rev. Med., 31: 219-232, 1980. |
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