摘要
目的明确某院内感染流感疫情流行特征及可能的暴发原因,为控制疫情提供科学依据。方法制订病例定义进行病例搜索,采取现场流行病学调查方法开展个案调查和现场卫生学调查;采用描述性流行病学和病例对照研究方法,结合病例临床特征和实验室病毒核酸检测结果,分析疫情的流行特征和可能的暴发原因。结果此次院内感染疫情共报告实验室确诊病例9人,临床诊断病例8人。发病高峰为5月31日。推算潜伏期最短为1 d,最长4 d,平均为2.6 d;一楼住院病人和护士的发病率差异无统计学意义(P=0.695);护士是否在1楼上班发病率差异有统计学意义(OR=6.60,95%CI:1.48~29.36);采集10例患者标本进行RT-PCR检测,9例均为H3N2流感病毒核酸阳性;所有护士无流感疫苗免疫接种史;通过对病例的隔离治疗,所有病例病情稳定或痊愈,且在最长潜伏期内无新发病例出现。结论本次疫情为一起医院内由新入院患者作为传染源,在护士和其他住院患者间经飞沫传播的甲型H3N2流感暴发疫情;及时进行隔离治疗是最有效的防控措施之一;护士可能是导致此次流感疫情暴发的主要传播者之一;医疗卫生机构工作人员应加强流感疫苗的接种,以增强免疫力或减轻流感症状。
Objective To investigate the epidemic characteristics and possible causes of an influenza outbreak caused by noso- comial infection so as to provide a scientific basis for epidemic situation control. Methods The ease definition was developed, and then the eases were searched. Case investigation and field hygiene investigation were conducted by using field epidemiological survey methods. The epidemic characteristics and possible causes of the outbreak were analyzed by using descriptive epidemiologi- cal method, case-control study, the clinical features of the cases and the laboratory results of virus nucleic acid detection. Re- suits There were 9 cases of laboratory diagnosis and g cases of clinical diagnosis reported during this nosocomial infection. The peak of the incidence was on May 31st. The shortest latency period was 1 day, and the longest 4 days, with the average being 2.6 days. No statistically significant difference was found in the incidence rate between the inpatients living on the first floor and nurses （P--0.695）. Whether the nurses worked on the first floor had a significant influence on the incidence （ OR = 6. 60,95% CI： 1.48- 29.36）. 10 patients＇ specimens were collected to perform RT-PCR detection, and 9 were positive for influenza H3N2 virus nucleic acid. All nurses had no history of influenza vaccination. Through the isolation and treatment of the cases, all the cases were stable or cured. And no new case was found in the longest latency period. Conclusions This is an outbreak of influenza A （H3N2） epidemic, which is caused by a newly admitted patient who is considered as the source of infection, and is spread by respiratory droplets between nurses and other inpatients. Timely isolation and treatment is one of the most impoitant prevention and control measures. Nurses may be one of the main disseminators inducing the influenza outbreak. Professionals of medical institutions should receive a flu vaccination so as to enhance the immunity or alleviate flu symptoms.
出处
《实用预防医学》
CAS
2018年第2期188-191,共4页
Practical Preventive Medicine
基金
湖南省卫生计生委科研计划课题(B2017172)
关键词
甲型H3N2
流行病学调查
院内感染
influenza A （H3N2）
epidemiological investigation
nosocomial infection
