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目的总结防控经验为甲型H1N1流感医院感染防控提供参考。方法采用面对面访谈和电话询访方式,调查2009年8月11~18日暴露于小儿外科的住院患者、陪护家属及医务人员;并开展病例对照研究,病例组为暴露于小儿外科且符合病例定义的人员,对照组为暴露于小儿外科且不符合病例定义的人员。结果共发现35例病例,罹患率26.5%,其中12例确诊病例,23例疑似病例,无重病例症;首例病例为一患儿,8月11日入住小儿外科前已有流感样症状;35例病例发病时间为8月7~17日;患儿、陪护、医师及护士罹患率为46.2%、19.6%、26.3%和5.6%,差异有统计学意义(χ2=13.14,P<0.01);25份咽拭子标本检出12例甲型H1N1流感病毒核酸阳性,灌肠室暴露、病区长时间暴露、近距离接触是危险因素;暴露时间越长,风险越大。结论院外甲型H1N1流感患儿入住小儿外科病区导致甲型H1N1流感医院感染;患病坚持在岗的医护人员导致病毒传播。
Objective To summarize the experience of prevention and control for the prevention and control of Influenza A (H1N1) infection. METHODS: In-person interviews and telephone interviews were conducted to investigate inpatients, relatives and medical staff who were exposed to pediatric surgery from August 11 to August 18, 2009. A case-control study was conducted in which the case group was exposed to pediatric surgery and was in line with the definition of the case The control group was exposed to pediatric surgery and did not meet the definition of case. Results A total of 35 cases were found, with an attack rate of 26.5%. Among them, 12 cases were diagnosed, 23 cases were suspected and no case was severe. The first case was a child with flu-like symptoms before admission to pediatric surgery on August 11; The incidence of 35 cases was from August 7 to August 17. The attack rates of children, accompanying physicians and nurses were 46.2%, 19.6%, 26.3% and 5.6%, respectively, with significant difference (χ2 = 13.14, P <0.01) ; 25 throat swab specimens were detected in 12 cases of influenza A (H1N1) virus nucleic acid positive, enema room exposure, ward prolonged exposure, close contact is a risk factor; exposure time, the greater the risk. Conclusions Children with type A H1N1 influenza in hospital stay in pediatric surgical ward and cause hospital infection of type A H1N1 flu; illness insists on-the-job medical staff lead to virus transmission.