重症监护病房护理人员人细小病毒B19疑似医院感染暴发调查

Suspected outbreak of human parvovirus B19 healthcare-associated infection among nurses in an intensive care unit

目的对一起由人细小病毒B19(HPV-B19)引发的疑似医院感染暴发事件进行调查分析。方法采用流行病学调查方法和环境卫生学监测,对2021年5月12—19日某三甲医院重症监护病房(ICU)护理人员发生的皮疹事件进行调查,分析其发生的可能因素,并采取有效的控制措施。结果在HPV-B19感染并噬血细胞综合征患者住院期间,ICU共有50名医护人员,其中医生11名,护理人员39名。11名护理人员(22.0%)于患者出院后第5天开始相继出现皮疹。皮疹部位主要为双下肢(100.0%),皮疹多为红色丘疹(45.5%),同时伴有关节痛(72.7%)、浅表淋巴结肿大(63.6%)、乏力(54.5%),肌肉酸痛(45.5%)等。11名护理人员均为女性,平均年龄(27.82±2.6)岁。9名进行了HPV-B19 DNA和(或)特异性抗体IgM检测,结果均阳性。均予复方甘草酸苷片、氯雷他定、岗梅感冒颗粒口服等对症治疗,皮疹持续时间5~60 d。其中1例妊娠者未发生流产,定期产检监测,未发现胎儿异常。自5月19日采取控制措施后未发现相关病例。结论此次事件是ICU疑似HPV-B19医院感染暴发事件,临床医生需加强对该病毒的正确认识,落实感染防控措施,以避免医院感染暴发事件的发生。

Objective To investigate and analyze a suspected outbreak of healthcare-associated infection(HAI)caused by human parvovirus B19(HPV-B19).Methods Epidemiological investigation and environmental hygiene monitoring were used to investigate the rash incident among nurses in intensive care unit(ICU)of a tertiary first-class hospital from May 12 to May19,2021,the possible factors for the occurrence of rash were analyzed and effective control measures were taken.Results During the hospitalization period of patients with HPV-B19 infection and hemophagocytic syndrome,there were 50 health care workers(HCWs)in ICU,including 11 doctors and 39 nurses.Eleven nurses(22.0%)developed rash on the 5th day after patients’discharge.The main rash sites were lower limbs(100.0%),most rash was red papules(45.5%),accompanied by joint pain(72.7%),superficial lymphadenec-tasis(63.6%),fatigue(54.5%),and muscle soreness(45.5%).Eleven nurses were all female,with an average age of(27.82±2.6)years.Nine nurses were tested for HPV-B19 DNA and/or specific antibody IgM,results were all positive.All nurses were given symptomatic treatment such as compound glycyrrhizin tablets,loratadine and Gangmei Ganmao granules,the rash lasted for 5-60 days.One nurse was pregnant,without abortion,fetal abnormality was not found during regular prenatal monitoring.No relevant cases have been found since the control mea-sures were taken from May 19.Conclusion This incident is a suspected outbreak of HPV-B19 HAI in ICU,clinicians need to strengthen the correct understanding of the virus as well as implement infection prevention and control measures to avoid the occurrence of HAI outbreak.