بررسي وضعيت آلودگي منابع آب به لژيونلا در ايران و ساير كشورها و عوامل مؤثر بر آن؛ مرور نظام مند

Survey of legionella water resources contamination in Iran and foreign countries: A Systematic Review

زمينه و هدف: مطالعات متعدد آلودگي منابع آب طبيعي و مصنوعي را به باكتري لژيونلا بررسي كرده است. هدف اين پژوهش، مرور نظام مند وضعيت آلودگي منابع آب طبيعي و مصنوعي به باكتري لژيونلا در ايران و جهان مي باشد. مواد و روش ها: در اين مطالعه جستجوي نظام مند مقالات در منابع الكترونيكي معتبر PubMed، ScinceDirect، Springerlink و Google Scholar، SID،Iranmedex ، Irandoc و Magiran بدون محدويت زماني صورت گرفت. بررسي و انتخاب مقالات بر اساس چك ليست PRISMA و استانداردهاي ارزيابي كيفيت Cochrane انجام شد. از ميان 1386 مقاله يافت شده تعداد 56 مطالعه مرتبط انتخاب شدند. مقالاتي كه شناسائي و جداسازي گونه هاي لژيونلا را با روش كشت و واكنش هاي زنجيره اي پلي مراز انجام داده بودند وارد مطالعه شدند. اطلاعات استخراج شده در يك جدول طبقه بندي و آناليز داده ها و رسم نمودارها با نرم افزار Excel انجام شد. يافته ها: از 56 مقاله انتخاب شده به ترتيب 9 و 47 مقاله به مطالعات انجام شده در ايران و ساير كشورها مربوط بود. در ايران 70%-5/7% از نمونه ها به لژيونلا آلوده است. در مراكز بيمارستاني ايران 41/75%-2/85% نمونه ها به لژيونلا پنوموفيلا آلوده و در ساير كشورها 1000% نمونه ها آلوده است. در مراكز بيمارستاني ساير كشورها 98/7-17% نمونه ها به لژيونلا پنوموفيلا آلوده هستند. نتيجه گيري: هر چند در ايران آلودگي به لژيونلا كمتر از ساير كشورها است اما براساس استاندارد سازمان جهاني بهداشت (CFU/l 1) در مورد باكتري لژيونلابرنامه ريزي براي كنترل و عفونت هاي ناشي از آن از مهم ترين اولويت هاي بهداشتي است.

Background and Aims: Several studies were investigated legionella contamination in natural and man made water resources. The aim of this research was systematically review of legionella water contamination in natural and manmade resources in Iran and foreign countries. Materials and methods: In this systematic review study, the required data was collected using suitable keywords through PubMed, Science direct, Springer link, Google scholar, SID, Iranmedex, Irandoc and Magiran databases. Background and Aim: Several studies were investigated legionella contamination in natural and man made water resources. The aim of this research was systematically review of legionella water contamination in natural and manmade resources. Materials and Methods: In this systematic review study, the required data was collected using suitable keywords through PubMed, Science direct, Springer link, Google scholar, SID, Iranmedex, Irandoc and Magiran databases. The search was conducted without publication date limitation. Survey and selection of articles was conducted based on PRISMA checklist and Cochrane quality assessment standards. Out of 1386 articles, 56 articles were considered after excluding the remaining articles which were not related to the study objectives. Identification and isolation of legionella with PCR technique and culture in BCYE is one of the article selection criteria. The relevant data were classified in extracted table and analyzed manually. Excel 2007 software was used for to draw diagrams. Due to heterogeneity of data metaanalysis could not be conducted. Results: Out of 56 articles, 9 and 47 articles were published in Iran and foreign countries respectively. In Iran, 5.770% of sles were contaminated. In Iranrsquo s hospitals 2.8541.75% of sles were contaminated by Legionella pneumophila. In foreign countries, 0100% of sles were contaminated and in these countriesrsquo hospitals Legionella pneumophila contamination was 17%98.7%. Conclusion: Although in Iran legionella water contamination is lower than foreign countries but, based on WHO guideline (1CFU/L) for legionella, planning for control of this bacteria and relevance infectious is one of the health priorities. The search was conducted without publication date limitation. Survey and selection of articles was conducted based on PRISMA checklist and Cochrane quality assessment standards. Out of 1386 articles, 56 articles were considered after excluding the remaining articles which were not related to the study objectives. Identification and isolation of legionella with PCR technique and culture in BCYE is one of the article selection criteria. The relevant data were classified in extracted table and analyzed manually. Excel 2007 software was used for to draw diagrams. Due to heterogeneity of data metaanalysis could not be conducted. Results: Out of 56 articles, 9 and 47 articles were published in Iran and foreign countries respectively. In Iran, 5.7 70% of sles were contaminated. In Iranrsquo s hospitals 2.8541. 75% of sles were contaminated by Legionella pneumophila. In foreign countries, 0100% of sles were contaminated and in these countriesrsquo hospitals Legionella pneumophila contamination was 17%98. 7%. Conclusion: The results of this study revealed that the conventional water treatment processes were not effective for legionella elimination and eradication of this agent should be considered in point offuse with effective techniques.