一起集体上呼吸道爆发感染的调查

目的调查与分析深圳市1起集体上呼吸道爆发感染的原因,及时采取措施控制疫情。方法按照《公共交通等候室卫生标准》（GB9672—1996）,《公共场所卫生监测技术规范》（GB／T17220—1998）和《公共场所集中空调通风系统卫生规范》进行调查。结果在病人咽拭子中未检出引起上呼吸道感染的病毒,病人血清中有1份A型流感IgM抗体阳性;病人咽拭子中溶血性链球菌和金黄色葡萄球菌的阳性率分别为12．5％和20．8％,经PFGE分析,病人咽拭子和车间空气中分离出的金黄色葡萄球菌无同源性;车间4楼空调系统积尘中细菌总数和霉菌数分别为20060和10810cfu／g;车间4楼空气细菌总数达3650cfu／m^3,超出标准要求,这与该次感染在4楼罹患率最高保持一致。结论结合流行病学特征、临床症状和实验室检查结果,可判断该次感染为1起细菌性近距离传播所致的群体上呼吸道爆发感染。

Investigation of a Breakout of Collective Respiratory Infection

[Objective]To analyze the cause of a collective respiratory infection and take effective measures to control it.[Methods]Investigation was made according to "Sanitation Criterion for Public Traffic Waiting Rooms" GB 9672-1996,"Technical Criterion for Sanitation Surveillance in Public Places" GB/T 17220-1998 and "Sanitation criterion for the Central Conditioning System in Public Places".[Results]NO respiratory virus was found in the oropharyngeal swabs of the patients;one positive IgM antibody of type A influenza was found in the patients' serum;the positive rate of Hemolytic streptococcus and staphylococcus aureus in the oropharyngeal swabs was 12.5% and 20.8% respectively.The Pulse-field gel electrophoresis(PFGE) analysis indicated no autoploidy between the staphylococcus aureus from the staphylococcus aureus and that from the oropharyngeal swabs.The bacterial count and the fungi count in the dust of central conditioning system of the workplaces on the 4th floor were 20 060 cfu/g and 10 810 cfu/g respectively,the bacterial count in the air was 3 650 cfu/m~3,which exceeded the sanitary standard and was consistent with the morbidity.[Conclusion]According to the epidemic features,clinical symptoms and the lab results,it can be concluded that this is a collective respiratory infection caused by close spread of bacteria.