目的 分析医院感染暴发疫情特点,探讨疫情发生原因。方法 采集医院感染病例咽拭子、血清标本和病房外空调循环水、房间的沐浴水、医生办公室以及屋顶空调系统循环水,对咽拭子和血清标本检测嗜肺军团菌IgM和流感病毒核酸,采集的水样培养嗜肺军团菌。采用血清间接免疫荧光法检测嗜肺军团菌IgM定性和细菌培养定量;逆转录聚合酶链反应检测流感病毒核酸及分型等。结果 本次疫情病例均发生在医院内分泌科,累计报告10例患者,以呼吸道症状为主,疫情持续9 d,患者年龄在71~ 87岁,主要为住院病人,共6例;医护人员发病4例,年龄在24~ 37岁。患者血清嗜肺军团菌IgM抗体(+)7例;冷凝水、循环水和咽试子标本嗜肺军团菌培养均为阴性;流感病毒核酸阳性5例(甲型H₃N₂)。结论 此次事件可能是由嗜肺军团菌合并普通季节性流感病毒感染引起的医院感染暴发疫情。

Objective The characteristics of nosocomial infection outbreak were analyzed and the causes were discussed. Methods Pharyngeal swabs, serum samples and air conditioning circulating water outside the ward, bath water in the room, circulating water in the doctor's office and roof air conditioning system were collected in hospital infection cases. IgM of legionella pneumophila and influenza virus nucleic acid were detected in pharyngeal swabs and serum samples, and the water samples were collected for the culture of legionella pneumophila.Serum indirect immunofluorescence assay was used to determine IgM and bacterial culture of legionella pneumophila.Reverse transcription polymerase chain reaction (PCR) was used to detect nucleic acid and genotyping of influenza virus. Results All the cases of this epidemic occurred in the endocrinology department of the hospital, and 10 patients were reported in total, mainly respiratory symptoms. The epidemic lasted for 9 days, and the patients were 71 to 87 years old, mainly hospitalized patients, a total of 6 cases.There were 4 cases of illness among medical staff, aged 24~ 37 years.Serum IgM antibody (+) of legionella pneumophila in 7 patients; The culture of legionella pneumophila in condensed water, circulating water and pharynx samples was negative. Influenza virus nucleic acid positive in 5 cases (H₃N₂). Conclusion This may be an outbreak of nosocomial infection caused by legionella pneumophila combined with common seasonal influenza virus infection.