目的 分析不同年龄、不同季节河源市源城区呼吸道感染的病原学情况,指导临床用药。方法 回顾性研究2020年3月—2022年2月2 468例呼吸道感染的住院患儿,取咽部分泌物送广州达安临床检验中心进行呼吸道核酸六项检测并分析结果。包括：肺炎链球菌（Sp）、呼吸道合胞病毒（RSV）、卡他莫拉菌（MC）、流感嗜血杆菌（Hi）、肺炎支原体（LP）、腺病毒（ADV）。结果 （1）2 468例患儿的标本中阳性率52.8%,其中RSV最高,其他依次为Sp、Hi、MC、MP、ADV。而混合感染仅次于RSV。（2）婴儿组和幼儿组以RSV感染为主,在学龄前组和学龄组儿童中,以Sp感染为主,各病原体的混合感染组合很多,一种细菌合并一种病毒多见。（3）秋冬季是河源市源城区呼吸道感染的高发季节,RSV是秋冬季呼吸道感染最主要的病原体。结论 秋冬季节为河源市源城区呼吸道感染的高发季节,RSV为该季节的主要病原体。RSV也是婴幼儿组感染的主要致病菌,随着年龄增大,细菌感染导致的呼吸道疾病逐渐占优势。混合感染在各年龄组中均占比较高,值得临床诊疗的重视。

Objective To analyze the etiology of respiratory tract infection in Yuancheng District of Heyuan City ,which was in different ages and seasons,and to provide guidance of clinical drug usage．Methods Cases of 2 468 hospitalized children with respiratory tract infection from March 2020 to February 2022 were analyzed．The secretion from pharynx was collected and sent to Guangzhou Da’an Clinical Examination Center for six respiratory nucleic acid tests and then the results were analyzed,including Streptococcus pneumoniae（Sp）,respiratory syncytial virus（RSV）,Moraxella catarrhalis（MC）,Haemophilus influenzae（Hi）,Mycoplasma pneumonia（MP）,adenovirus（ADV）．Results The positive rate of 2 468 hospitalized children with respiratory tract infection was 52.8%,of which the highest was RSV,followed by Sp,Hi,MC,MP,ADV．Meanwhile the mixed infection rate was second to RSV．RSV infection was the main infection in infant group and early-aged children group,while in preschool group and school-aged group,Sp infection was the main infection．There were many mixed infection of pathogen,and one bacteria combined with one virus was more common．Respiratory tract infection had high incidence in autumn and winter in Yuancheng District of Heyuan City,RSV was the major pathogen．Conclusions Autumn and winter were the seasons with high respiratory tract infection incidence in Yuancheng District of Heyuan City,and RSV was the main pathogen in these two seasons．RSV was also the main pathogen of infant group infection．But with the increase of children’s age,bacterial infection became the main reason of respiratory tract diseases．Mixed infection accounts for a high proportion in all age groups,which should be valued in clinical diagnosis and treatment．

目的 深入了解河源市某综合医院职业暴露的真实情况,评估健康风险,从而提出有效的控制措施,并提升医院员工的职业防护意识,以保障他们的健康和安全。方法 采用回顾性调查,从暴露类型、环节、病原体种类、职业类别、工龄等方面,对河源市某综合医院在2022—2023年所发生的职业暴露事件进行统计分析。结果 在2022—2023年期间,该综合医院共计发生了93例血源性病原体职业暴露事件,以锐器伤为主,共80例,占86.02%;职业暴露最多的是护理人员,共发生61例,占65.59%;工作人员中工龄≤2年的职业暴露比例最多,共有71例,占76.34%;职业暴露的发生环节主要集中在处理丢弃锐器物以及进行检查、治疗、护理操作的过程中,均为30例,占32.26%;发生职业暴露的原因主要是缺少防护,出现34例,占36.56%;职业暴露主要发生在普通病房,为37例,占39.78%;其次为门急诊,均为15例,占16.13%;职业暴露发生的暴露源传染病病原体种类以不明病原体为主,为36例,占38.70%;其次是乙型肝炎病毒,为32例,占34.40%;所有发生职业暴露的员工均接受了全面的暴露风险评估、合理的预防性用药措施以及定期的健康监测。结论 医院管理部门需加强职业安全培训,特别是针对护理人员和低年资员工,严格执行标准操作规程,提供充足防护用品,改进医疗设备设计,建立完善的监测报告和保障体系,并强化监督和管理,以降低职业暴露风险,保障员工职业安全。

Objective To gain a deep understanding of the actual situation of occupational exposure in a general hospital in Heyuan City, assess health risks, propose effective control measures,and enhance the awareness of occupational protection among hospital staff to safeguard their health and safety. Methods A retrospective study was conducted to statistically analyze the occupational exposure events that occurred in a general hospital in Heyuan City from 2022 to 2023, in terms of exposure types, links, types of pathogens, occupational categories, and years of service. Results During the period from 2022 to 2023, a total of 93 cases of occupational exposure to blood-borne pathogens occurred in the general hospital, with sharp instrument injuries being the most common, accounting for 80 cases（86. 02%）; nurses accounted for the majority of occupational exposures, with 61 cases（65. 59%）; among the staff, those with a service time ≤ two years had the highest proportion of occupational exposures, with 71 cases（76. 34%）; the main occurrence of occupational exposures was in the processes of disposing of discarded sharp instruments and conducting inspections, treatments, and nursing operations, both accounting for 30 cases（32. 26%）; the main reason for occupational exposures was lack of protection, with 34 cases（36. 56%）; occupational exposures occurred mainly in general wards, with 37 cases（39. 78%）, followed by outpatient and emergency departments, both with 15 cases（16. 13%）; the types of infectious pathogens exposed in occupational exposures were mainly unknown, with 36 cases（38. 70%）, followed by hepatitis B, with 32 cases（34. 40%）; all staff who experienced occupational exposures received comprehensive exposure risk assessments,reasonable preventive medication measures, and regular health monitoring. Conclusions Hospital management departments need to enhance occupational safety training, particularly for nursing staff and junior-level employees, strictly enforce standard operating procedures, provide adequate protective equipment, improve medical device design, establish a comprehensive monitoring and reporting system, strengthen supervision, and manage to reduce the risk of occupational exposure and ensure the occupational safety of employees.