目的 本研究对广州地区5家教学医院的鲍曼不动杆菌进行分子流行病学分析。方法 5家教学医院共采集138株鲍曼不动杆菌,利用多位点序列分型(multilocus sequence typing,MLST)及eBURST算法评价菌株之间的遗传关系。结果 MLST将138株鲍曼不动杆菌分为8个已有序列类型(STs),分别为ST195、ST208、ST457、ST136、ST254、ST548、ST445和ST53,还发现17个新STs。其中ST195的数量最多,占所有分离株的35.5%(49/138),其次为ST208,占所有分离株的21.0%(29/138)。eBURST算法分析显示以ST195为预测祖先型的克隆复合体(clonal complex, CC) 195在医院环境中广泛传播。结论 鲍曼不动杆菌CC195是广州地区的流行克隆,各家医疗机构应根据其自身实际制定感染防控策略。
Objective We analyzed the molecular epidemiology of A.baumannii isolated from 5 teaching hospitals in Guangzhou to identify the epidemic clone in this area. Methods A total of 138 strains of A.baumannii were collected from 5 teaching hospitals, and the genetic relationship was evaluated by multilocus sequence typing (MLST) and eBURST algorithm. Results MLST divided 138 strains of A.baumannii into 8 existing sequence types (STs), namely ST195, ST208, ST457, ST136, ST254, ST548, ST445 and ST53, and 17 new STs. Among them, ST195 had the largest number, accounting for 35.5% (49/138) of all isolates, followed by ST208, accounting for 21.0% (29/138) of all isolates. eBURST algorithm showed that the clonal complex (CC) 195, the predicted founder ST195, was widely spread in the hospital environment. Conclusion A.baumannii CC195 was an epidemic clone in Guangzhou area. Medical institution should develop infection prevention and control strategies according to its own actual conditions.
目的 探讨无症状感染者在新冠肺炎家庭聚集性疫情中的传播风险,分析家庭聚集性疫情中所有患者的住院治疗情况,为防控策略和治疗方案制定提供依据。方法 通过现场流行病学调查获得旅居史和暴露危险因素,并收集临床治疗资料,利用统计软件进行作图和分析。结果 指示病例的潜伏期为15天,其余4名家庭成员的潜伏期为1～15天,其中指示病例作为无症状感染者,在感染后第4～6天内具有传染性相继导致4名成员感染;指示病例携带病毒8天以上,其余4人从2天到31天不等; 症状持续时间5~20天,住院期间共进行CT检查次数为4～10次,肺部炎症最快在住院第三天好转。发病初期只有1个病例出现白细胞、淋巴细胞降低。发病到就诊和住院的时间间隔为1～10天,平均住院时间为23.4天。结论 无症状感染者在家庭聚集性疫情传播中具有关键作用,难以及时发现,存在较大传播风险,为新冠肺炎疫情防控带来较大难度。
Objective To study the transmission risk of asymptomatic patient in a family-clustered outbreak of new coronavirus pneumonia, analyze the hospitalization,and provide a basis for prevention strategies and treatment plan. Methods We collected the information about residence history and exposure risks by onsite epidemiological investigation, and collected clinical treatment-related data, used statistical software for mapping and analysis. Results The incubation period of the indicated case was 15 days, and the incubation period of the remaining four family members were 1-15 days. The indicated case as an asymptomatic patient had infectious succession within 4-6 days after infection,and four family members were infected one after another. The indicated case carried the virus for more than 8 days, and the remaining 4 patients ranged from 2 to 31 days. The duration of symptoms was 5-20 days of all 5 patients, and the number of CT examinations during hospitalization was 4-10 times. The pulmonary inflammation was improved on the third day of hospitalization at best. In the early stage of the disease, only one patient had leukopenia and lymphopenia decreased. The interval between onset and hospitalization was 1-10 days for five family members, with an average hospitalization time of 23.4 days. Conclusion The asymptomatic infected patient of COVID-19 plays a key role in the family convergence epidemic transmission. The symptoms are inapparent, so it is difficult to find in time. It will cause the risk of infection and increase the difficulty of COVID-19 prevention and control.
新型冠状病毒肺炎是一种新发的急性呼吸道疾病,如何准确、完整、及时的记录好新冠肺炎患者的病历信息,为医学研究提供科学的依据是医院病案管理统计的工作重点。本文结合国家相关的规定和某新冠肺炎定点救治医院疫情防控工作经验,提出针对新冠肺炎病历的管理方案,包含病历的书写、编码、运行管理三方面,配合医院做好疫情防控工作的同时妥善记录好新冠肺炎患者病历信息。
Coronavirus disease 2019 is a new type of acute respiratory disease. Recording accurately, completely and timely the medical records of patients with COVID-19 and providing a scientific basis for medical research are the focus of the medical records management statistics. This paper proposes a management plan including writing, coding, and operation management for COVID-19 medical records, combining with the relevant national regulations and a COVID-19 designated hospital's experiences of epidemic prevention and control. This management plan cooperates with the hospital to do epidemic prevention and control work, and properly recordes the medical records of COVID-19 patients.
目的 了解近五年某地市级综合医院传染病病例疫情情况,分析其流行病学特征,为探索医院传染病预防控制工作提供科学依据。方法 采用描述性流行病学方法和Excel 2007软件对传染病疫情报告资料进行分析。结果 2010—2014年法定报告的传染病发病例数基本呈持续上升趋势。2010—2014年共报告传染病11 673例次,发病数居前5位的传染病依次为手足口病、乙型肝炎、梅毒、生殖道沙眼衣原体感染、肺结核,分别占21.17%、12.44%、12.16%、8.51%和7.52%;总死亡数为21例,病死率为1.799‰。5年来,不同传染病发病数呈现出不同的变化趋势。结论 及时掌握当地传染病的发病情况,加强对常见传染病的防控力度,提高病原检测力度,做好传染病的筛查工作,防止传染病在医院内传播。
Objective To analyze the characteristic features of notifiable diseases in a general hospital from 2010 to 2014, and provide basis information for notifiable diseases' prevention and control. Methods Using descriptive epidemiological methods and microsoft Excel 2007, the report data of notifiable diseases was statistically analyzed. Results The number of notifiable diseases increased during 2010 to 2014. 11 673 cases of notifiable diseases were reported in the hospital at the same time.The top five reported cases of notifiable diseases were hand-foot-and-mouth disease(HFMD),hepatitis B virus, syphilis, chlamydia trachomatis infection and tuberculosis, account for 21.17%,12.44%,12.16%,8.51% and 7.52% accordingly. Moreover, there are total 21 death cases have been reported and case fatality rate was 1.799‰.Different infectious diseases showed different trend variation during the above mentioned period. Conclusion We should understand and grasp the local incidence of infectious disease, strengthen the prevention and control, improve the pathogen detection, make an effort on screening, and prevent the spread of infectious diseases in the hospital.
