北京市某医院传染性非典型肺炎医院内感染传播途径的初步调查  

Preliminary result on the nosocomial infection of severe acute respiratory syndrome in one hospital of Beijing

作　　者：何耀[1] 姜勇[1] 邢玉斌[2] 钟光林 王磊[4] 孙正基[4] 贾红[5] 常青[1] 王勇[5] 倪彬[1] 陈世平[2] 

机构地区：[1]解放军总医院老年医学研究所,北京100853 [2]解放军总医院医院感染管理研究科,北京100853 [3]解放军总医医疗处,北京100853 [4]解放军总医院医疗处,北京100853 [5]解放军总后勤部卫生防疫队

出　　处：《中华流行病学杂志》2003年第7期554-556,共3页Chinese Journal of Epidemiology

摘　　要：目的　探讨传染性非典型肺炎 [严重急性呼吸综合征 (SARS) ]医院感染的传播途径。方法　选择北京市某综合性医院 3月 2～ 31日期间收治和医院感染的 1 0例SARS病例 ,进行个案调查和发病所在科室的流行病学侦查。结果　 (1 )发病病例的地理分布主要集中在住院大楼西单元的5个楼层的 4、5号病房 ,住院患者多数年龄较大且合并较严重的基础病 ;(2 )输入性病例是导致医院感染的第一代传染源 ,医院内继发感染的住院者是进一步扩散蔓延的第二批传染源 ,同时不排除隐性带病毒者 (曾密切接触SARS病例而未发病者 )作为潜在传染源的可能 ;(3)资料分析结果支持近距离飞沫传播和密切接触传播为该次SARS医院感染的主要传播途径 ,同时还提示 :存在气溶胶 (飞沫核 )经病房排风系统垂直长距离传播的可能性。结论　医院感染是SARS流行初期的主要形式。其传播途径除近距离飞沫传播和密切接触外 ,应进一步收集和积累是否存在气溶胶 (或飞沫核 )Objective To study the transmission route of severe acute respiratory syndrome (SARS) nosocomial infection. Methods Ten identified SARS patients were selected from a general hospital in March. Survey was carried out through a standardized questionnaire provided by Chinese Center for Disease Control and Prevention. Contents of the questionnaire would include: history of contact with SARS patient, route of infection, methods used for protection and so on. Results (1) Distribution os SARS patients were confined to 3 wards: 4,5, and 6 on the 7,8,12,13 and 14 floors in the west unit of the inpatient building. Most of the inpatients were elderly and having severe original diseases. (2) Index patients were the first generation source of transmission and they infected inpatients and medical staff, making them the second generation. People with latent infection who had close contact with SARS patients might also serve as the possible source of transmission. (3)The major transmission routes were: near distant droplet infection and close contact infection. There was also a clue to the probability of aerosol or droplet nuclei infection through air conditioning and ventilation system. Conclusion Nosocomial infection appeared to be the main characteristic of the SARS epidemic in the early stage of this hospital. Other than close contact and near space airborne transmission of SARS virus, the possibility of long distance aerosol transmission called for further epidemiological and experimental studies in the future.

关 键 词：北京市 传染性非典型肺炎 医院内感染 传播途径 调查 流行病学 

分 类 号：R181.3[医药卫生—流行病学]