2006—2012年我国公共场所集中空调通风系统嗜肺军团菌污染状况meta分析

Contamination status of Legionella pneumophila in central air conditioning systems in public buildings in China during 2006-2012:a meta-analysis

目的对近年来我国公共场所集中空调通风系统嗜肺军团菌的污染状况进行meta分析。方法检索Pub Med、中国期刊全文数据库、维普中文科技期刊全文数据库和万方数据库,得到我国2006—2014年4月发表的公共场所集中空调通风系统嗜肺军团菌的研究文献,根据文献纳入和排除标准筛选文献,对纳入研究的文献采用meta分析法进行分析。结果本研究共纳入85篇文献,涉及全国19个省、自治区和直辖市,共计3 100余家公共场所的近8 000个采样点。我国公共场所集中空调通风系统冷却水嗜肺军团菌合并检出率为34.04%（95%CI：29.05%-39.22%）,冷凝水嗜肺军团菌合并检出率为6.88%（95%CI：3.99%-10.48%）。我国南方和北方地区,宾馆、商场超市和医院集中空调通风系统中冷却水和冷凝水中嗜肺军团菌检出率差异无统计学意义（P〉0.05）;2006—2012年冷却水中嗜肺军团菌检出率呈波动下降趋势（P〈0.05）,冷凝水中嗜肺军团菌检出率差异无统计学意义（P〉0.05）;清洗后冷却水中嗜肺军团菌检出率低于清洗前（P〈0.05）。结论我国对公共场所集中空调通风系统中嗜肺军团菌的管理虽渐有成效,但检出率依然偏高,仍需按照相关法规进一步加强监管和监测。

Objective To analyze the contamination status of the Legionella pneumophila（ Lp） in central air conditioning systems in public buildings in China.Methods Studies about the Lp in air conditioning ventilation systems in public buildings during 2006-Apr.2014 were searched through Pub Med,CNKI,VIP,and Wanfang databases.According to the inclusion and exclusion criteria for screening studies,pooled estimates were summarized by meta-analysis.Results A total of 85 eligible studies were included in this meta-analysis,related to 19 provinces,autonomous regions and municipalities,nearly 8 000 samples in more than 3 100 public places.The pooled positive rate of Lp in cooling tower of air conditioning ventilation systems in public buildings for all studies was 34.04%（95%CI：29.05%-39.22%）,and pooled positive rate in condensed water was 6.88%（95%CI：3.99%-10.48%）.There were no significant differences（P〉0.05） in the pooled positive rates of Lp between the southern and northern areas in China,and among different public buildings of hotels,supermarkets and hospitals,through stratified comparison.In the years from 2006 to 2012,the pooled positive rate of Lp in cooling tower showed a declining trend（P〈 0.05）,and the positive rate in condensed water was no significant differences（P〉 0.05）.And there was a significant difference in the pooled positive rates of Lp before and after cleaning of cooling tower（P〈0.05）.Conclusion Management of Lp in central air conditioning systems in public buildings in China has got obvious effect,but the positive rate is still high and it＇s still needed to further enhance supervision and monitoring.