中国首例输入性中东呼吸综合征患者收治单位的消毒隔离措施及效果评价  

Efficacy of disinfection and isolation measures in a hospital that received and treated the first case of imported Middle East respiratory syndrome in China

作　　者：周仕丹[1] 刘春来[1] 钟昱文[2] 毛慧[1] 彭莉利[1] 张卫平[1] 

机构地区：[1]惠州市中心人民医院,广东惠州516001 [2]广东省疾病预防控制中心,广东广州511430

出　　处：《中国感染控制杂志》2016年第8期603-607,共5页Chinese Journal of Infection Control

摘　　要：目的评价中国首例输入性中东呼吸综合征(MERS)患者收治单位的消毒隔离措施及效果。方法 2015年5月28日某院ICU负压病房收治中国首例输入性MERS患者,医院制定和落实一系列消毒隔离措施,以治疗和预防中东呼吸综合征冠状病毒(MERS-CoV)感染。结果 2015年5月28日2:30该院收治1例经广东省疾病预防控制中心(CDC)和国家CDC确诊的MERS患者:患者咽拭子、血液样本实时荧光定量聚合酶链反应(real-time PCR)检测均为MERS-CoV阳性。患者入院后第3天咽拭子即转阴,入院后第8天血转阴,入院2周后粪便转阴,6月21日痰转阴,出院前连续2次咽拭子、痰、血、粪便检测均为阴性,连续10 d无发热,临床症状好转,6月26日康复出院。采集所有参与人员的鼻拭子、咽拭子、血标本,检测均为MERS-CoV阴性;从患者6月26日出院至7月10日对所有参与救治的医务人员进行健康监测,均未出现不适,医务人员零感染。患者入院后第7天、第13天,以及终末消毒后采集环境和物体表面标本,检测均为MERS-CoV阴性。结论严格执行消毒隔离措施,可有效切断MERS的传播途径,保护医务人员的安全。Objective To evaluate the efficacy of disinfection and isolation measures in a hospital that received and treated the first case of imported Middle East respiratory syndrome（MERS）in China.Methods The first MERS case in China was admitted in the negative pressure room of the intensive care unit in a hospital on May 28,2015,a series of disinfection and isolation measures were taken for controlling and preventing MERS coronavirus （MERS-CoV）infection.Results One case of MERS confirmed by Guangdong Provincial Center for Disease Control and Pre-vention （CDC）and Chinese CDC were admitted in a hospital at 2：30 of May 28,2015,throat swabs and blood specimens of patients were detected as positive for MERS-CoV by real-time polymerase chain reaction.On the 3rd day,8th day,2 week after admission,and on June 21 ,throat swabs,blood,stool,and sputum specimen culture were negative respectively;before patient’s discharge,throat swabs,sputum,blood,and stool specimen culture were all negative for consecutive two times,there was no fever for 10 consecutive days,clinical symptoms were im-proved,patient finally recovered and was discharged on June 26.Detection of MERS-CoV were all negative for nasal swabs,throat swabs,and blood specimens from all health care workers （HCWs）participated in the treatment for MERS;all HCWs were performed physical examination from June 26 to July 10,none of them felt discomfort, there was no infection occurred among them.On the 7th,13th day of admission,and following terminal disinfec-tion,specimens of environment and object surface were taken and performed detection of MERS-CoV,all were negative.Conclusion Strict implementation of disinfection and isolation measures can effectively cut off the routes of MERS-CoV transmission and protect the safety of HCWs.

关 键 词：中东呼吸综合征 冠状病毒 MERS 消毒 隔离 医院感染 

分 类 号：R373.1[医药卫生—病原生物学]