北京市某医院院内感染Noro病毒胃肠炎的调查

目的了解Noro病毒感染引起医院内暴发集体腹泻的临床特点。方法分析一起18例医院内暴发腹泻患者的流行病学和临床资料,同时对每例患者粪便标本进行细菌培养,随机选择7例粪便标本用抗原检测和聚丙烯酰胺凝胶电泳进行轮状病毒RNA检测;用逆转录-聚合酶链反应检测Noro病毒核酸以确定感染的病原,分析感染患者的临床特点和易感因素。结果发病者多为老年合并多种基础疾病;腹泻主要为稀水便(12/18,66.67%),个别为黏液稀便(3/18,16.67%);大部分粪便常规检测正常(10/18,55.56%),个别见少量白细胞(3/18,16.67%)和潜血弱阳性(4/18,22.22%);全部粪便标本细菌学培养阴性;轮状病毒RNA检测阴性;3份标本中检出Noro病毒核酸,阳性率为42.86%(3/7)。结论Noro病毒是此次医院内集体暴发腹泻的重要病原之一,尤其多见于有基础疾病、体弱的老年患者。

Astudy Oil viral gastroenteritis attributed to noroviruses in hospitals

Objective To better understand the clinical feature of viral gastroenteritis attributed to noroviruses and to summarize the experience on an outbreak of acute gastroenteritis through rapidly colleting and confirmation of related information regarding to noroviruses in hospitals. Methods Information on an outbreaks involving 18 patients with acute gastroenteritis in one hospital regarding its epidemiological and clinical features and to perform bacteria culture for stool specimens on every patient. On 7 patients, rotavirus antigen were RNA tested together with norovirus nucleic acid were examined by ELISA and PAGE and RT-PCR. Results (1) Most of the patients were elderly with several chronic diseases. (2) Watery diarrhea (12/18,66.67%) and few with mucous (3/18, 16.67%) were seen. Most stool examination was normal (10/18, 55. 56%) but few stool specimen could be found with some leucocytes (3/18,16.67%) and little occult blood (4/18, 22.22%). (3) All bacteria culture in stools showed negative. There was no rotavirus RNA identified but 3 specimen showed norovirus nucleic acid positive as 42.86% (3/7). Conclusion Norovirus was one of the important pathogens causing acute gastroenteritis outbreaks in hospitals attacking elderly with several chronic diseases in particular. Surveillance program targeting elderly inpatient with diarrhea should be enhanced, especially in autumn and winter.