深圳市龙华区预防接种门诊发生手足口病病原体污染风险的调查分析

Investigation and analysis of pathogen contamination risk of hand foot and mouth disease in vaccination clinic of Longhua District

目的调查深圳市龙华区预防接种门诊发生手足口病病原体污染风险的情况。方法将深圳市龙华区获得卫生行政部门批准的13个预防接种门诊纳入研究。通过试子采样法采集在候诊区内的椅子和洗手间内的非感应型水龙头的开关、疫苗接种台等区域的物体表层样本计200份,采用实时定量荧光PCR法检测标本病毒污染情况。分析不同采样环境、预防接种门诊面积、接种量以及建筑设置类型的病原体污染情况。结果肠道病毒通用型阳性率为12.50%。不同采样环境、不同接种量门诊的肠道病毒检出率比较,差异均有统计学意义(χ^(2)=67.081,P<0.001;χ^(2)=17.073,P<0.001);接种门诊面积<300m2的接种门诊肠道病毒检出率明显高于接种门诊面积≥300m2的接种门诊(χ^(2)=19.864,P<0.001),独立建筑的接种门诊肠道病毒检出率低于非独立建筑的接种门诊(χ^(2)=50.726,P<0.001)。结论预防接种门诊发生手足口病病原体污染风险不容忽视,合理建设预防接种门诊以及开展物表消毒处理可能是减少或避免儿童在预防接种门诊发生手足口病病原体污染的重要手段。

Objective To investigate the pathogen contamination risk of hand-foot-mouth disease(HFMD)in the vaccination clinics of Longhua District of Shenzhen city.Methods A total of 13 clinics authorized by the health administration department to carry out vaccination in Longhua District of Shenzhen were included in the study.Two hundred samples were collected from chairs in the waiting area,non-inductive faucet switches in the toilet and the surface of the vaccine table and tested for virus contamination by real-time quantitative fluorescence PCR.The pathogen contamination of different environments,clinic sizes,vaccination quantity,levels of vaccination clinics and building types were analyzed.Results The positive rate of enterovirus was 12.50%.There were significant differences in the detection rate of enterovirus in different sampling environments and different doses of inoclation(χ^(2)=67.081,P<0.001;χ^(2)=17.073,P<0.001).The detection rate of enteroviruses in the vaccination clinics with an area less than 300m 2 was significantly higher than those with an area more than 300m 2(χ^(2)=19.864,P<0.001).The enterovirus in vaccination clinics of independent buildings was lower than those without independent buildings(χ^(2)=50.726,P<0.001).Conclusion The risk of pathogen contamination of HFMD should not be ignored in the vaccination clinics.The reasonable construction and strict disinfection of surfaces may be an important means to reduce or avoid such pathogen contamination.