烟台市一起新型冠状病毒肺炎聚集疫情调查分析

目的 了解一起新型冠状病毒肺炎(简称新冠肺炎)聚集性疫情的传播特征和传播链,做好密切接触者的追踪和判定,为开展疫情防控提供参考. 方法 按照《新型冠状病毒肺炎防控方案(第四版)》开展现场流行病学调查,同时采集呼吸道标本开展新冠病毒核酸检测. 结果 该起聚集性疫情涉及病例12例,其中无症状感染者4例和确诊病例8例.确诊病...     

一起聚集性腺病毒肺炎疫情的流行病学调查

<正>2012年春季,山西省发生一起腺病毒感染所致的肺炎疫情,发病3例,其中1例死亡,1例重症,1例轻症。各级疾控机构和医疗机构采取积极有效的防控措施后,疫情得到控制。1材料与方法1.1对象山西省2012年4-5月发生的有流行病学联系的3例肺炎病例。1.2方法1.2.1流行病学调查对3例病例的亲属、老师、同学和接诊     

医院获得性肺炎调查分析

医院内获得性肺炎是常见的院内感染之一,现已引起了广泛重视。本文对在本院住院治疗48小时以上的10000例出院患者进行了回顾性调查,以了解我院医院获得性肺炎的发病情况。     

一起学校社区获得性肺炎暴发疫情的流行病学分析

2013年6月4--22日,西安市某学校发生了一起社区获得性肺炎暴发疫情.西安市疾病预防控制中心利用现场流行病学调查分析的方法,结合病原学检测结果,查明并确认是一起以肺炎支原体为病原的社区获得性肺炎(community acquired pneumonia,CAP)[1]暴发的疫情.西安市疾病预防控制中心及时采取了有效措施,控制了此次疫情.现将流行病学分析结果报道如下.     

一起聚集性肺炎疫情病原的快速实验室诊断与分析

目的：通过实验室病原学检测,结合流行病学史及临床表现,初步筛查疫情致病病原体。方法：采集患者咽拭子标本,分别采用荧光PCR方法检测甲型流感病毒、乙型流感病毒、肺炎支原体基因。结果：11份患者咽拭子中有4份标本荧光PCR扩增支原体基因阳性,1份为弱阳性。所有标本的甲、乙型流感荧光PCR扩增结果为阴性。同时采集与患者同班的3例无症状对照标本,3例标本的肺炎支原体DNA检测均为阴性。结论：实验室研究结果并结合此次疫情的流行病学和患儿的临床表现,初步判断可能是一起由肺炎支原体引起的聚集性支原体肺炎疫情。     

发热伴血小板减少综合征家庭聚集病例调查

目的分析和探讨聚集性新布尼亚病毒感染病例的传播途径和传播媒介。方法对一起由新型布尼亚病毒引起的家庭聚集性发热伴血小板减少综合征家庭聚集病例进行流行病学调查,探索该新发传染病的流行病学特征。结果家庭成员8人中,5例出现发热伴血小板减少综合征的临床表现,血WBC和PLT呈进行性下降,病例在发病前均无蜱叮咬史,但4例均有临床诊断病例血液接触史,经山东省疾控中心实验室检测,结果显示4例患者的血样均呈发热伴血小板减少综合征布尼亚病毒（SFTSV）阳性。外环境用布旗法采集蜱类标本中检测出新型布尼亚病毒核酸阳性。结论此次家庭聚集性病例疑为血液传播。     

肺炎查因病例与普通肺炎病例症候群特征监测的对比分析

目的建立肺炎症状的症候群的监测资料,通过对肺炎病例症状的监测,将肺炎查因病例与普通肺炎的临床特征进行对比分析。方法以85例肺炎查因病例与108例普通肺炎病例为对象,比较两组病例的流行病学、临床特征、实验室检查和影像学检查等资料的差异。结果查因肺炎病例组和普通肺炎对照组的家禽养殖接触史(16/85vs9/108,χ2=4.64,P<0.05),气促(48/85vs34/108,χ2=12.15,P<0.01)和全身酸痛出现率(36/85vs18/108,χ2=17.04,P<0.01)、平均发热持续时间(8.46±8.10vs6.6±6.76d)(t=2.67,P<0.05)、出现低氧血症的例数(31/85vs22/108,χ2=6.19,P<0.05)、病灶高峰时平均受累肺叶数(1.8±1.2vs1.03±0.86,t=5.18,P<0.01)相比有显著性差异。结论与普通肺炎病例相比,肺炎查因病例有更多的家禽养殖接触史、发热、气促和全身酸痛等症状及低氧血症更明显,病灶范围更为广泛。     

一起血型HIV感染病例调查

20 0 1年 4月 2 3日 ,怀化市某医院报告我县后塘乡王家村有 1例疑似艾滋病患者 ,4月 2 9日经省疾病预防控制中心确诊为 HIV抗体阳性 ,进而确认该患者为艾滋病病人后。经调查 ,该患者为到河南某地卖血人员 ,为了解同去卖血人员的 HIV感染情况 ,遂于 2 0 0 1年 5月初进行了调查 ,     

流行性喘憋性肺炎爆发性流行的调查研究

1986年1~3月份山西运城地K爆发流行性喘憋性肺炎,罹患率为13.77‰(校正罹忠率为17.50‰),病人多为婴幼儿,其中〇~岁组罹患率最高(89.06‰),1~岁组次之(55.7‰),随年龄增民,罹患率下降。性别间发病男性大于女性(χ²=101.09,P<0.00l),男女之比为1.4:1。病人临床表现一般较重,多数具有喘憋症状,病死率为1%。病人分布具苻家庭聚集性.其爆发与气温有关(rs=0.4799,P<0.05),日温差大,发病人数增多;与人均居室面积大小有关,随居室面积增大,罹患率下降(趋势χ²=5.58,P<0.05)。病原学和血清学研究证明,引起爆发的病原体为呼吸道合胞病毒(RSV)。     

Tuberculosis among health care workers

To assess the annual risk for latent tuberculosis infection (LTBI) among health care workers (HCWs), the incidence rate ratio for tuberculosis (TB) among HCWs worldwide, and the population-attributable fraction of TB to exposure of HCWs in their work settings, we reviewed the literature. Stratified pooled estimates for the LTBI rate for countries with low (<50 cases/100,000 population), intermediate (50-100/100,000 population), and high (>100/100,000 population) TB incidence were 3.8% (95% confidence interval [CI] 3.0%-4.6%), 6.9% (95% CI 3.4%-10.3%), and 8.4% (95% CI 2.7%-14.0%), respectively. For TB, estimated incident rate ratios were 2.4 (95% CI 1.2-3.6), 2.4 (95% CI 1.0-3.8), and 3.7 (95% CI 2.9-4.5), respectively. Median estimated population-attributable fraction for TB was as high as 0.4%. HCWs are at higher than average risk for TB. Sound TB infection control measures should be implemented in all health care facilities with patients suspected of having infectious TB.     

In-hospital contact investigation among health care workers after exposure to smear-negative tuberculosis

Background  

Smear-negative pulmonary tuberculosis (TB) accounts for a considerable proportion of TB transmission, which especially endangers health care workers (HCW). Novel Mycobacterium-tuberculosis-specific interferon-γ release assays (IGRAs) may offer the chance to define the burden of TB in HCW more accurately than the Mantoux tuberculin skin test (TST), but the data that is available regarding their performance in tracing smear-negative TB in the low-incidence, in-hospital setting, is limited. We conducted a large-scale, in-hospital contact investigation among HCW of a German university hospital after exposure to a single case of extensive smear-negative, culture-positive TB with pulmonary involvement. The objective of the present study was to evaluate an IGRA in comparison to the TST and to identify risk factors for test positivity.     

336名卫生人员糖尿病患病情况调查

目的　了解卫生人员糖尿病患病情况。方法　对某卫生机构336人进行健康体检,采用己糖激酶法测定空腹血糖。结果　糖耐量低减者(IGT)达26.49%。按WHO糖尿病诊断标准,糖尿病患病率9.23%,其中Ⅱ型占96.77%,Ⅰ型占3.23%。61.23%(19/31)系糖尿病新发,均为Ⅱ型。糖尿病患病率随年龄的增长而增高。IGT发病率分别随年龄、体质指数(BMI)的增长而增高。有阳性家族史者糖尿病发病率是阴性史者的10倍,达46.67%。男女间发病差异无显著性。新发患者中,42.11%已出现并发症,甚至同一病人重叠数种疾病,较突出的是X综合征。结论　提示对卫生人员仍然存在加强糖尿病防治知识再教育,提高其认识的问题。     

211例医务人员锐器伤监测结果分析

目的分析医务人员锐器伤发生情况,为持续改进锐器伤安全管理工作提出建议。方法回顾性分析某院2006年8月—2015年7月上报的《锐器伤登记表》,分析统计相关资料。结果共上报211例锐器伤,主要人群为护士(118例,55.92%)和医生(83例,39.34%);工龄主要为5年及以下者(117例,55.45%);发生地点主要为外科病房(67例,31.75%)、内科病房(65例,30.81%)及门急诊(33例,15.64%);致伤物主要为注射器针头(91例,43.13%)、缝合针(34例,16.11%)和头皮针/输液器针头(27例,12.80%);主要致伤操作为各种注射(40例,18.95%)、静脉输液(38例,18.00%)、手术缝合/剪断(36例,17.06%)。主要致伤环节为操作中(治疗、检查、手术),共109例(51.66%)。血源性病原体污染的器械中,HBV污染95例(76.61%),HCV污染25例(20.16%),HIV污染4例(3.23%)。无血源性病原体感染病例发生。211例医务人员接种乙肝疫苗者155例(73.46%)。结论应重点针对工作时间≤5年的护士和医生,外科病房、内科病房及门急诊的医务人员,注射、静脉输液、缝合/剪断等操作时做好锐器伤防护工作。医院相关部门完善上报流程,加强追踪。     

Nudging influenza vaccination among health care workers

Our online randomized controlled trial on 6230 healthcare workers (HCWs) tests the impact that three nudges – social norms, reminding the impact on beneficiaries, and defaults – have on the intention to vaccinate against seasonal influenza across job families. Willingness to get a flu shot was higher among subjects invited to imagine themselves working at the local health authority (LHA) with the greatest immunization coverage within their region relative to their counterparts prompted to imagine working at the LHA with the lowest coverage. Reminding the impact of flu vaccination on beneficiaries had different effects across job families, with physicians caring more benefits for themselves, nurses about patients’ benefits, and technicians about family and friends. Default responses anchoring toward a high rather than a low vaccination intention increased the willingness to immunize among all HCW except physicians. Targeted nudges can be considered in developing interventions to promote influenza vaccination among HCWs.     

医务人员职业暴露监测分析

目的探讨医务人员职业暴露人群分布、高危环节以及暴露源等,为制定职业防护措施、预防职业暴露后感染提供依据。方法利用湘雅感染监测管理系统开展监测,分析2011年8月-2013年8月上报的医务人员发生职业暴露数据。结果两年上报254人次职业暴露事件,职业暴露人群以临床护士最高,200人次占78.74%,工龄≤6年人员发生职业暴露达208人次占81.90%,针刺伤是职业暴露最主要方式,达213人次占83.86%,暴露源确定感染乙型肝炎病毒、丙型肝炎病毒、戊型肝炎病毒、苍白密螺旋体、人类免疫缺陷病毒等血源性病原体达121人次占47.64%,确认职业暴露后发生丙型肺炎病毒感染两人,感染率为8.70%,坚持完成1年聚乙二醇干扰素联合利巴韦林抗病毒治疗获得痊愈。结论落实标准预防、推广无针注射和无针输液,是降低医务人员职业暴露有效措施;暴露后遵医嘱及时预防性用药,追踪监测、尽早诊断急性感染、积极抗病毒治疗,是预防暴露后感染以及感染后发展为慢性病的有力保障。     

医务人员手卫生依从性调查

目的对某院医务人员手卫生采取综合干预措施,比较干预前后医务人员手卫生执行情况,评价干预效果。方法2013年4-6月为该院医务人员手卫生基线调查阶段,2013年7月开始实施干预,2013年10-12月为干预后效果评价阶段。调查人员利用调查表,隐蔽观察医务人员手卫生执行情况。 结果通过多种干预措施,医务人员手卫生依从率为53.86%,显著高于干预前的38.02%,差异有统计学意义（χ2=181.82,P＜0.05）;内科、外科、重症监护室手卫生依从率均高于干预前（均P＜0.05）。干预后,不同操作时机医务人员整体手卫生依从率为53.45%(2 044/3 824),显著高于干预前的41.87%(1 740/4 156)（χ2=107.2,P＜0.05）;除无菌操作,其余4个操作时机医务人员手卫生依从率均高于干预前（均P＜0.05）;不同岗位医务人员手卫生依从率均高于干预前（均P＜0.05）。结论采取积极的手卫生干预措施,可有效提高医务人员手卫生依从性。     

Hepatitis B vaccination among primary health care workers

Health care workers' immunization against hepatitis B is an essential measure to avoid occupational transmission of hepatitis B virus at primary health care centers. The aims of this study were to investigate the prevalence of complete-series vaccination against hepatitis B, estimate the prevalence of confirmed immunity, and verify the factors associated with complete-series vaccination among primary health care workers in Florianópolis, Santa Catarina State, Southern Brazil. A total of 1,249 primary health care workers participated in this study. The prevalence of complete hepatitis B vaccination was 64.61%, and 29.82% of workers indicated knowing they were immunized after taking a serological test to confirm immunity. In the adjusted analysis, complete-series vaccination was positively associated with higher level of schooling and contact with potentially infectious materials or sharps, and negatively associated with precarious employment status and current smoking. Educational measures are recommended to achieve vaccination of health workers who have not been vaccinated or have not completed the series and to inform on the need for vaccine response monitoring.     

徐州地区医务人员锐器伤现状调查分析

目的调查徐州地区各级医院医务人员锐器伤发生及上报情况,为制定本地区锐器伤防护措施、完善上报制度提供依据。方法 2016年7—8月,采用多阶段分层随机抽样方法随机抽取徐州市13所不同级别医院的医务人员,对其一般资料、锐器伤发生及上报情况等进行问卷调查。结果共收集2 694份有效问卷,医务人员锐器伤发生率为10.32%,例次发生率为12.84%,上报率为30.64%。医务人员锐器伤例次发生率一级医院为44.83%,二级医院为11.53%,三级医院为12.52%,不同级别医院锐器伤例次发生率比较,差异具有统计学意义(χ~2=55.148,P0.001)。锐器伤发生时机主要为医务人员在回套针帽时(79例次,22.83%),器具种类主要为中空针类(297例次,85.84%)。参加培训情况不同的医务人员锐器伤发生率比较,差异具有统计学意义(χ~2=66.760,P0.001)。结论本地区医务人员的锐器伤现状不容乐观,存在培训效果欠佳,上报率较低且安全器具使用率不高等问题,应进一步采取有效措施,建立有效的锐器伤监测追踪系统以减少锐器伤的发生。