我国公共场所集中空调通风系统嗜肺军团菌污染的Meta分析

Legionella pneumophila contamination in central air-conditioning systems of public places in China:a meta-analysis

目的系统评价我国公共场所集中空调通风系统嗜肺军团菌(LP)检出率,为LP污染防制提供依据。方法检索中国知网、万方数据知识服务平台、中国生物医学文献数据库、PubMed和Web of Science等数据库,收集2010年1月1日至2022年12月31日发表的有关我国公共场所集中空调通风系统LP污染的文献,采用加强流行病学观察性研究的报告(STROBE)声明评价文献质量;采用Stata 16.0软件进行Meta分析,计算LP合并检出率及其95%CI;采用Begg检验评价发表偏倚;采用逐篇剔除法进行敏感性分析,评价结局指标的稳定性。结果检索文献742篇,最终纳入分析29篇,均为横断面研究;其中高质量文献10篇,中等质量文献19篇。样本量为6160份,LP合并检出率为17.20%(95%CI:12.80%~21.90%)。亚组分析结果显示,冷却水LP检出率为21.80%,高于冷凝水的5.50%(P<0.01);采用《公共场所集中空调通风系统卫生规范(2006修订版)》检测评价的LP检出率为23.30%,高于采用WS 394—2012《公共场所集中空调通风系统卫生规范》检测评价的13.20%(P<0.05)。不同场所、地区和样本量的LP检出率比较,差异均无统计学意义(P>0.05)。Begg检验显示无明显发表偏倚,敏感性分析显示研究结果较为稳定。结论我国公共场所集中空调通风系统LP合并检出率为12.80%~21.90%,加强公共场所集中空调的LP污染监测。

Objective To systematically evaluate the detection of Legionella pneumophila in central air-conditioning sys⁃tems of public places in China,so as to provide insights into the management of L.pneumophila contamination.Meth⁃ods The publications pertaining to L.pneumophila contamination in central air-conditioning systems of public places in China were searched in international and national databases,including CNKI,Wanfang Data,CBM,PubMed and Web of Science from January 1,2010 to December 31,2022.The publication quality was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology.A meta-analysis was performed using the software Stata version 16.0.The pooled detection of L.pneumophila and its 95%CI were estimated.The publication bias was evaluated using Begg's test,and sensitivity analysis was performed with the leave-one-out evaluation for assessment of the robustness of the outcomes.Results A total of 742 publications were initially searched,and 29 publications were finally included,all of which were cross-sectional studies.The publications included 10 high-quality and 19 moderate-quality studies covering 6160 samples,and the pooled detection of L.pneumophila was 17.20%(95%CI:12.80%-21.90%).Subgroup analysis showed a higher detection rate of L.pneumophila in cooling water(21.80%)than in condensed water(5.50%)(P<0.01).According to the criteria defined in Hygienic Specification of Central Air-conditioning Ventilation System in Public Buildings(2006 version),the detection of L.pneumophila was 23.30%,which was higher than the detection(13.20%)according to the Hygienic Specification of Central Air-conditioning Ventilation System in Public Buildings(WS 394-2012)(P<0.05).The detection of L.pneumophila did not vary in place,region or sample(P>0.05).Begg's test showed no significant publication bias,and sensitivity analysis showed robustness of the results.Conclusions The detection of L.pneumophila ranges from 12.80%to 21.90%in central air-conditioning systems of public places in Chi⁃na.Health and environmental protection sectors need to improve the monitoring of L.pneumophila contamination in cen⁃tral air-conditioning systems of public places.