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目的 探讨严重急性呼吸综合征 (SARS)医院感染的流行病学特点和预防控制措施。方法 选择某综合性医院 3～ 4月份收治和医院感染的 SARS病例 ,进行个案调查和发病所在科室的流行病学侦查。结果 (1)流行病学特点 :时间分布在 3月中旬和下旬有两个发病高峰 ,地理分布 :发病病例主要集中住院大楼西单元的 5个楼层的 4、5号病房 ,人群分布 :住院患者多年龄较大且合并较严重的基础病 ,而受染的医护人员以工作在一线的中青年为主 ;(2 )输入性病例是导致医院感染的第一代传染源 ,医院内继发传染的住院者和医护人员是进一步扩散蔓延的第 2批传染源 ;(3)研究发现近距离空气传播和密切接触传播为本次 SARS医院感染的主要传播途径 ,同时还提示 :存在气溶胶经病房排风系统垂直长距离传播的可能性 ;(4 )控制隔离传染源、加强病区通风换气和定时消毒、关闭空调新风系统、医护人员加强防护等各项措施采取后 ,医院感染得到有效控制。结论 医院感染是SARS流行初期的主要形式 ,该院医护人员的受染方式前期以医院内传染为主 ,后期以门急诊窗口岗位受染较为突出 ,通过采取针对性预防控制措施 ,SARS医院感染是可控可防的。
Objective To explore the epidemiological characteristics and prevention and control measures of nosocomial infection in severe acute respiratory syndrome (SARS). Methods The cases of SARS admitted to hospitals and nosocomial infections from March to April in a general hospital were selected for case investigation and epidemiological investigation in the department where the disease occurred. Results (1) Epidemiological characteristics: The time distribution has two peak incidences in mid-March and the end of the year. The geographical distribution is as follows: incidence cases mainly focus on the five floors of West Unit of Ward No. 4,5 Ward, population distribution: Inpatients Older and more complicated basic diseases, while the infected medical staff mainly work in the middle-aged and young adults; (2) The imported cases are the first generation of infectious diseases that cause nosocomial infections and the secondary ones in the hospital (3) The study found that short-range air transmission and close contact transmission are the main routes of transmission of nosocomial infections in SARS, and also suggest the presence of aerosols in the wards Ventilation system vertical long-distance transmission possibilities; (4) control of isolated sources of infection, strengthen ventilation and timely disinfection of the ward, turn off the air conditioning and fresh air system, health care workers and other measures to strengthen protection, the hospital infection is effectively controlled . Conclusions Nosocomial infection is the main form of SARS epidemic in the early stage. The way of infection of hospital staff is mainly hospital infection. In the late stage, the infection of post and emergency department is more prominent. Through targeted prevention and control measures, SARS hospital infection is Controllable and preventable.