北京市某宾馆培训基地成人肺炎支原体暴发流行的调查分析

Study on the outbreak epidemic of adult mycoplasma pneumoniae in the training base of a hotel in Beijing

目的分析肺炎支原体感染的流行规律、临床特征,评价控制措施的效果,为今后迅速有效地控制疫情提供依据。方法采用流行病学现况研究方法,对所有研究对象进行个案调查,抽取有典型症状的静脉血和咽拭子各9份,用明胶颗粒载体的凝集试验检测肺炎支原体抗体。结果该宾馆封闭式培训基地居住密度为2.2平米/人,通风不良,从2005年3月20日至4月27日共发病71例,发病年龄在17～25岁之间,其中住院治疗9例,肺炎1例,罹患率为43.3%,性别间罹患率差异无显著性。临床特点为发热、干咳、咽痛、胸痛、乏力,白细胞升高,9份送检血清中7份支原体抗体IgM(+)。实施隔离、通风、消毒、服用罗红霉素等措施对迅速控制疫情有较好的效果。结论在通风不良、居住密度高的条件下,肺炎支原体可引起成人感染的暴发。

Objective This study was conducted to make an analysis of the epidemic pattern and clinical features of Mycoplasma pneumoniae infection and an evaluation of the effects of the control measures to provide data for a quick and effective control of the epidemic hereafter. Methods Epidemiological study of current situation was used to make individual investigation in all the subjects and intravenous blood and throat swab specimens were respectively taken from 9 patients with the typical symptoms for the detection of mycoplasma pneumoniae antibody by gelatine particle agglutination assay （PA）. Results The residential density was 2.2 square meter in the close training center in the hotel with a poor ventilation system. A total of 71 infected cases was found from March 20, 2005 to April 27, 2005 , with the onset age range between 17 and 25 years. Of the 71 cases, 9 patients with the infection, including one case of mycoplasma pneumonia, were admitted to hospital for treatment. The morbidity rate was 4,3.3% ,with no significant difference in the rnobidity between males and females. The patients manifested fever, dry cough, chest pain, fatigue, sore throat and elevated WBC count. Positive mycoplasma antibody （IgM） was detected in 7 of the 9 serum specimens tested. Good results were achieved in the rapid control of the epidemic through isolation, ventilation, sterilization and administration of roxithromycin. Conclusion Poor ventilation and high residential density predispose to the outbreak of adult mycoplasma pneumoniae infection.