西北某三甲医院院内外获得性甲型流感的流行特征分析

Epidemic characteristics of community and hospital acquired influenza A in a tertiary hospital of Northwest China

目的分析西北地区社区获得性甲流(CAIA)、医院获得性甲流(HAIA)的流行特征,为制定甲流防控方案提供参考依据。方法从西安市疾控中心获取近5年流感疫情信息,回顾性分析2018年12月1日至2019年4月30日某三甲医院CAIA(门诊确诊和住院≤48小时确诊)、HAIA(住院>48小时罹患)患者的资料。结果西安市2019年初流感发病陡增。某三甲医院门诊确诊1012例CAIA,疑似甲流患者确诊阳性率在12月最高,且在不同年龄层次不一致;次年1月达到甲流发病数目高峰,不同性别的疑似甲流患者确诊阳性率无显著差异。门诊CAIA就诊集中于发热门诊(38.4%)、急诊科(33.8%)、呼吸内科(14.6%)、儿科门诊(7.6%)。住院患者中检出HAIA共256例,主要分布在老年病科(15.6%),神经内科(13.7%)和心脏外科(12.1%);院内感染甲流使患者住院时间显著延长,中位住院时间为9.5天。结论甲流发病逐年上升,在西北地区流行高峰为1月份。值得关注的HAIA,主要分布在老年病科、神经内科和心脏外科;在院内感染甲流会带来额外的治疗负担。

Objective Through analyzing the epidemic characteristics of community-acquired influenza A(CAIA)and hospital-acquired influenza A(HAIA)in North-west China,we aimed to provide a scientific basis for formulating plans to prevent and control influenza A outbreak.Methods The information of CAIA(diagnosis in outpatient department and diagnosis≤48h after hospital admission),and HAIA(diagnosis>48h after hospital admission)in a tertiary hospital from December 1,2018 to April 30,2019 was reviewed.Results In Xi′an,the incidence of influenza increased sharply in early 2019.In a tertiary hospital,1012 cases of CAIA were diagnosed among outpatients.The positive rate of suspected influenza A was highest in December and inconsistent among different age groups.January of the following year had the highest incidence of influenza A.There was no gender difference in infection of influenza A.CAIA among outpatients were detected most in clinic of fever(38.4%),emergency(14.6%),respiratory(14.6%)and pediatric(7.6%).A total of 256 HAIA cases mainly distributed in Department of Geriatrics(15.6%),Neurology(13.7%)and Cardiovascular Surgery(12.1%).Nosocomial influenza A significantly prolong the hospital stay,with a median of 9.5 days.Conclusion The incidence of influenza A is increasing year by year,with a peak epidemic in January,North-west China.HAIA,which is worthy of attention,mainly distributes in Department of Geriatrics,Neurology and Cardiovascular Surgery,and brings additional burden of treatment.