PDF(Pubmed)
Abstract：
UNASSIGNED: The \"LeTriWa study\" on community-acquired cases of Legionnaires\' disease (LD) found that most cases likely acquired their infection at home (AHALD). However, which sources confer the infection is largely unknown. We therefore analyzed the data set from the LeTriWa study to find out if individual sources were associated with AHALD and if specific behavioral habits may increase or lower the risk for AHALD.
UNASSIGNED: During the study we had used two comparison groups: (i) controls matched for age group and hospital (\"controls\"), (ii) household members of cases with AHALD (\"AHALD-HHM\"). We inquired about exposure to water sources, such as showering or wearing dentures, as well as behavioral factors and habits related to oral hygiene. We took standardized household bathroom water and biofilm samples of both cases with AHALD and controls, and in addition from households of cases with AHALD only samples from suspect residential (non-)drinking water sources. We first conducted bivariate analyses for infection sources and behaviors, followed by multivariable analyses.
UNASSIGNED: There were 124 cases with AHALD, 217 controls and 59 AHALD-HHM. In bivariate analyses using controls for comparison, wearing dentures was the only variable significantly positively associated (odds ratio (OR) = 1.7, 95% confidence interval (CI) = 1.1-2.7, p-value = 0.02). Behavioral factors such as showering, letting water run before use and not being alcohol abstinent were significantly negatively associated, smoking was significantly positively associated. In a multivariable analysis, we identified good oral hygiene as a preventive factor for both denture wearers (OR = 0.33, 95% CI = 0.13-0.83, p-value = 0.02) and non-denture wearers (OR = 0.32, 95% CI = 0.10-1.04, p-value = 0.06). Analyses of comparisons with AHALD-HHM showed similar effects but lacked statistical power. We identified Legionella in 16 residential (non-)drinking water sources, one of which was a PCR-positive scratch sample of dentures.
UNASSIGNED: Wearing (inadequately cleaned) dentures or poor oral hygiene might confer an increased risk for AHALD, and oral hygiene may prevent AHALD. The hypothesis that Legionella in oral biofilm or dental plaque may be the cause of cases with AHALD should be examined further. If confirmed this may open new and simple avenues for the prevention of LD.
UNASSIGNED: During the study we had used two comparison groups: (i) controls matched for age group and hospital (\"controls\"), (ii) household members of cases with AHALD (\"AHALD-HHM\"). We inquired about exposure to water sources, such as showering or wearing dentures, as well as behavioral factors and habits related to oral hygiene. We took standardized household bathroom water and biofilm samples of both cases with AHALD and controls, and in addition from households of cases with AHALD only samples from suspect residential (non-)drinking water sources. We first conducted bivariate analyses for infection sources and behaviors, followed by multivariable analyses.
UNASSIGNED: There were 124 cases with AHALD, 217 controls and 59 AHALD-HHM. In bivariate analyses using controls for comparison, wearing dentures was the only variable significantly positively associated (odds ratio (OR) = 1.7, 95% confidence interval (CI) = 1.1-2.7, p-value = 0.02). Behavioral factors such as showering, letting water run before use and not being alcohol abstinent were significantly negatively associated, smoking was significantly positively associated. In a multivariable analysis, we identified good oral hygiene as a preventive factor for both denture wearers (OR = 0.33, 95% CI = 0.13-0.83, p-value = 0.02) and non-denture wearers (OR = 0.32, 95% CI = 0.10-1.04, p-value = 0.06). Analyses of comparisons with AHALD-HHM showed similar effects but lacked statistical power. We identified Legionella in 16 residential (non-)drinking water sources, one of which was a PCR-positive scratch sample of dentures.
UNASSIGNED: Wearing (inadequately cleaned) dentures or poor oral hygiene might confer an increased risk for AHALD, and oral hygiene may prevent AHALD. The hypothesis that Legionella in oral biofilm or dental plaque may be the cause of cases with AHALD should be examined further. If confirmed this may open new and simple avenues for the prevention of LD.
摘要：
■关于社区获得性军团病（LD）病例的“LeTriWa研究”发现，大多数病例可能在家中感染（AHALD）。然而,感染的来源在很大程度上是未知的。因此，我们分析了LeTriWa研究的数据集，以找出个体来源是否与AHALD相关，以及特定的行为习惯是否会增加或降低AHALD的风险。
■在研究期间，我们使用了两个比较组：（i）年龄组和医院匹配的对照组（“对照组”），(ii)AHALD案件的家庭成员(“AHALD-HHM”)。我们询问了接触水源的情况，例如淋浴或戴假牙，以及与口腔卫生相关的行为因素和习惯。我们用AHALD和对照采集了两种情况下的标准化家用浴室水和生物膜样本，此外，AHALD病例的家庭只能从可疑的住宅（非）饮用水源取样。我们首先对感染源和行为进行了双变量分析，其次是多变量分析。
■有124例AHALD，217个对照和59个AHALD-HHM。在使用对照进行比较的双变量分析中，佩戴假牙是唯一显著正相关的变量(比值比(OR)=1.7,95%置信区间(CI)=1.1-2.7,p值=0.02).淋浴等行为因素，让水在使用前运行和不戒酒是显著负相关的，吸烟呈显著正相关。在多变量分析中，我们确定良好的口腔卫生是义齿佩戴者(OR=0.33,95%CI=0.13-0.83,p值=0.02)和非义齿佩戴者(OR=0.32,95%CI=0.10-1.04,p值=0.06)的预防因素.与AHALD-HHM的比较分析显示出类似的效果，但缺乏统计功效。我们在16个住宅（非）饮用水源中确定了军团菌，其中一个是PCR阳性的假牙划痕样本。
■戴假牙（未充分清洁）或口腔卫生不良可能会增加AHALD的风险，口腔卫生可能会阻止AHALD。应进一步研究口腔生物膜或牙菌斑中的军团菌可能是AHALD病例的原因的假设。如果得到证实，这可能会为预防LD开辟新的简单途径。
■在研究期间，我们使用了两个比较组：（i）年龄组和医院匹配的对照组（“对照组”），(ii)AHALD案件的家庭成员(“AHALD-HHM”)。我们询问了接触水源的情况，例如淋浴或戴假牙，以及与口腔卫生相关的行为因素和习惯。我们用AHALD和对照采集了两种情况下的标准化家用浴室水和生物膜样本，此外，AHALD病例的家庭只能从可疑的住宅（非）饮用水源取样。我们首先对感染源和行为进行了双变量分析，其次是多变量分析。
■有124例AHALD，217个对照和59个AHALD-HHM。在使用对照进行比较的双变量分析中，佩戴假牙是唯一显著正相关的变量(比值比(OR)=1.7,95%置信区间(CI)=1.1-2.7,p值=0.02).淋浴等行为因素，让水在使用前运行和不戒酒是显著负相关的，吸烟呈显著正相关。在多变量分析中，我们确定良好的口腔卫生是义齿佩戴者(OR=0.33,95%CI=0.13-0.83,p值=0.02)和非义齿佩戴者(OR=0.32,95%CI=0.10-1.04,p值=0.06)的预防因素.与AHALD-HHM的比较分析显示出类似的效果，但缺乏统计功效。我们在16个住宅（非）饮用水源中确定了军团菌，其中一个是PCR阳性的假牙划痕样本。
■戴假牙（未充分清洁）或口腔卫生不良可能会增加AHALD的风险，口腔卫生可能会阻止AHALD。应进一步研究口腔生物膜或牙菌斑中的军团菌可能是AHALD病例的原因的假设。如果得到证实，这可能会为预防LD开辟新的简单途径。
