一起幼儿园里肺炎支原体肺炎暴发  

An outbreak of mycoplasma pneumoniae pneumonia in a kindergarten

作　　者：刘春灵[1] 曹晋桂[2] 周平[1] 徐华[3] 纪树国[4] 李衍波[5] 张俊红[3] 刘晓宇[3] 郑春茜[3] 

机构地区：[1]空军总医院感染内科,北京100036 [2]空军总医院感染控制科 [3]空军总医院儿科 [4]空军总医院专家组 [5]空军后勤部直供部卫生处

出　　处：《中华预防医学杂志》2009年第3期206-209,共4页Chinese Journal of Preventive Medicine

摘　　要：目的分析北京市某所幼儿园的1个班级2006年7月暴发的一起肺炎支原体肺炎（MPP）的流行病学和临床特点。方法调查该幼儿园环境，查阅2005年8月1日-2006年7月31日间的幼儿园考勤记录，面对面或电话方式向因病缺勤的儿童家长调查儿童患病情况。住院患儿病史资料专人表格化采集，结合其住院资料进行临床分析。采用日本Fujirebio公司生产的血清Serodia—MycoⅡ凝集试验试剂盒检测MP—IgM抗体。结果2006年7月中旬，该所幼儿园有大、中、小3个班级，大班的25名6岁儿童中，4d内3例患肺炎先后住院，均诊断为MPP。在2006年5月下旬至7月中旬，大班共8例儿童发热、咳嗽，5例做了X线检查，均诊断是肺炎，MP抗体检测均阳性，其中3例双份血清MP抗体滴度升高4倍以上。此间，幼儿园的其他2个班级的儿童无人患肺炎，5例肺炎儿童的家长和大班的教师也无患肺炎者。大班教室通风及日照差，是2006年3月因故临时搬迁至此。有效改善教室通风后，至2006年9月初，大班儿童中未再出现新的肺炎病例。5名肺炎患儿均无鼻塞、流涕，也无耳痛、皮疹等症状及其他肺外并发症，外周血WBC总数均不高[（3．9～7．7）×10^9]。结论这是一起发生在幼儿园的MPP局部暴发，教室通风不良是导致MPP暴发的主要原因。儿童MP感染更易导致肺炎。Objective To study the epidemiological and clinical features of the mycoplasma pneumoniae pneumonia （MPP） that occurred in a single class of a kindergarten in Beijing in July 2006. Methods The environment and the attendance record of the kindergarten from the beginning of August 2005 to the end of July 2006 were investigated, and the sick status of the children absent for illness were interviewed by face to face or telephone through their parents. The disease data of the in-patient children with MPP were collected throughquestionnaires and analyzed. Serological screeningfor MP was performed with the Serodia Myco Ⅱ gelatin particle agglutination test （ Fujirebio ,Japan ）. Results In mid-July 2006 ,in a day-care kindergarten with 3 grade classes ,3 out of 25 six-year-old children in the top class were hospitalized within 4 days and diagnosed as MPP. A total of 8 children had the symptoms of fever and cough during late May and mid-July in 2006,5 children conduct chest radiographs and all had pneumonia, all these five children showed antibody positive for MP,3 of them showed a more than 4-fold increase in antibody titer to MP in serum. There were no pneumoniae cases in the other two classes during the same period, and no pneumoniae cases happened among the teachers in the top class and the parents of the 5 pneumoniae children. All the children were moved to this classroom temporarily with limited ventilation and sunshine in March 2006. After improvement of the ventilation in the classroom, no additional pneumoniae cases occurred in the top class till the early September 2006. The 5 MPP children showed neither sneeze and nasal obstruction,nor skin rash, earache and any other extrapulmonary complication, and their peripheral white blood cell count was in the normal range （ 3.9 - 7.7 ）× 10^9. Conclusion The MPP outbreak in a kindergarten was caused byed poor ventilation of the temporary classroom. MP infection in children is liable to cause pneumonia.

关 键 词：支原体 肺炎 疾病暴发流行 日托幼儿园 通风 

分 类 号：R686[医药卫生—骨科学]