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目的探索呼吸道合胞病毒(RSV)的传播途径,制定出切实可行切断传播途径的措施,并评价该措施的效果。方法收集医院新生儿科2007年1-12月RSV病例92例,对所有与其接触前和接触后物品的物体表面采用逆转录PCR方法进行病原学检测,以寻找RSV的传播途径,根据结果重新制定消毒隔离措施,并应用于2008年,比较2007、2008年RSV患儿医院感染情况以评价措施的有效性。结果 61.8%的工作人员接触患儿后手上检出RSV,38.5%的RSV患儿使用后的布类物品上发现RSV,60.9%的工作人员帽子上发现RSV,38.9%的患儿粪内检测出RSV,40.4%的患儿尿内检测出RSV;严格的消毒隔离措施制定后应用于2008年,与2007年的病例进行比较,RSV医院感染率明显下降,差异有统计学意义(P<0.05);RSV的流行季节为冬春季节,但其他月份存在散在病例。结论 RSV可通过呼吸道以及接触传播,病毒存在于所有与患儿接触过的物品上,故应做好严格的消毒隔离措施,有效的控制可以大大降低RSV的医院内传播。
Objective To explore the route of transmission of respiratory syncytial virus (RSV), to develop practical measures to cut off the route of transmission, and to evaluate the effect of this measure. Methods Ninety-two RSV cases from Jan.-Dec. 2007 in our hospital were collected. Pathogens were detected by reverse transcription polymerase chain reaction (RT-PCR) on all the surfaces of objects before and after contact with them to search for the route of RSV transmission. Isolation measures, and applied to 2008, compared 2007 and 2008 in children with RSV infection in hospital to evaluate the effectiveness of the measures. Results RSV was detected in 61.8% of the workers when they contacted the children, RSV was found in the cloths of 38.5% of children with RSV, RSV was detected in 60.9% of the staffs, and feces was detected in 38.9% of children RSV was detected in 40.4% of the infants; RSV was detected in urine after strict disinfection and isolation measures were formulated and applied in 2008, and compared with 2007 cases, the infection rate of RSV in hospital decreased significantly with a significant difference (P <0.05 ); The epidemic season of RSV is winter and spring, but there are scattered cases in other months. Conclusions RSV can be transmitted through the respiratory tract and the contact. The virus exists in all the objects that have contact with the child. Therefore, strict disinfection and isolation measures should be taken. Effective control can greatly reduce the spread of RSV in the hospital.