九江市1例鹦鹉热重症肺炎病例的流行病学调查

Epidemiological investigation of a case of severe Chlamydia psittaci pneumonia in Jiujiang

通过分析江西省九江市1例鹦鹉热重症肺炎病例的流行病学特征及原因,为特异性防控提供参考依据。采用现场流行病学调查和走访的方法,收集患者基本情况及流行病学信息,采集密切接触者和可能接触的禽类标本开展病原学检测。该例患者37岁、女性,先在乡镇卫生院及医疗机构门诊就诊,后因“发热伴咳嗽5 d,加重呼吸困难”入重症医学科住院治疗。病例肺泡灌洗液通过病原微生物靶向二代测序技术检测表明为鹦鹉热衣原体核酸阳性,有明确的鸡鸭接触史。采集密切接触者咽拭子标本4份及患者家中鸡、鸭的脾、肝和肺等组织标本各1份进行病原学检测,其中1份鸭组织标本鹦鹉热衣原体阳性,其他标本均阴性。该例鹦鹉热重症肺炎病例很可能是由于暴露于鹦鹉热衣原体污染的外环境所致,应规范家禽养殖防止禽间感染传播到人间,同时提高医务人员的认识,避免重症死亡的发生。

To clarify the causal factors of a case with severe Chlamydia psittaci pneumonia in Jiujiang District,Jiangxi Province and provide a scientific basis for effective prevention and control.Basic information and epidemiological data of the case were collected by epidemiological survey,and the samples from the close contacts and environment were collected for pathogen detection.A 37-year-old female patient was admitted to the hospital due to"fever with cough for five days and worsening dyspnea".The results of targeted next-generation sequencing(tNGS)of pathogenic microorganisms in the bronchoalveolar lavage fluid of the case indicated that the patient was infected with Chlamydia psittaci.Our epidemiological investigation revealed a clear history of chicken and duck exposure.Four throat swab samples of close contacts and one spleen,liver and lung sample of sick chicken and duck were collected for testing.One of the duck tissue samples tested positive,while the other samples were negative.The severe pneumonia was likely caused by exposure to the external environment contaminated by Chlamydia psittaci.Poultry farming should be regulated to prevent the transmission infection from poultry to humans.Additionally,awareness among medical staff should be increased to prevent severe outcomes.