诺罗病毒引起医院感染性腹泻的调查与控制

Norovirus-induced Nosocomial Diarrhea:Surveillance and Control

目的调查某院诺罗病毒引起的1次腹泻暴发流行的危险因素,为预防与控制类似事件提供参考依据。方法对发生腹泻的两个病区15例患者在2006年11月12-15日期间发生的腹泻感染进行流行病学分析。结果15例患者中有7例为散发病例,8例为同一病原菌腹泻,完善的医院感染监测系统能及时监测到疫情,并有效控制腹泻流行;同时通过北京市医院感染管理质量控制和改进中心平台能做到信息共享,使各医院有所借鉴,避免了全市范围内的医院感染腹泻的流行引起不必要的恐慌。结论社会因素、老年患者体弱、自体免疫力低下等原因是引起诺罗病毒性腹泻感染流行的主要原因;提示完善的医院感染管理监测网络可以及时、敏感地发现医院感染流行趋势,而有针对地采取有效防控措施,及时的信息交流是防止感染蔓延的主要手段,加强医院感染监测网络的建设是预防与控制医院感染的关键。

OBJECTIVE To provide a practical action plan which can prevent and control the similar occurrence through studying the epidemiological characteristics of a norovirus-induced diarrhea outbreak in the wards of our hospital. METHODS To obtain the information about the epidemic situation of norovirus involving 15 patients in the two wards of our hospital, during the period from Nov 12 to 15, 2006. RESULTS It was a norovirus gastroenteritis outbreak in the 8 cases among 15 patients and there were other 7 sporadic cases. The consummate monitoring system on nosocomial infection could gain the information of disease, and be very helpful to control its transmission. Beijing Municipal Center for Quality Control and Improvement of the Management of Nosocomial Infection was known the information and shared it among different kinds of hospitals. Thus an unnecessary panic was avoided in Beijing at that time. CONCLUSIONS The social factor, senile situation and immunocompromise are the causes of this norovirus outbreak. The effective control measures and the information exchange in time could prevent the spread of infection. It is shown that the nosocomial infection monitoring network could catch the epidemic tendency of nosocomial infection sensitively, so to strengthen the monitoring network is the key.