呼吸道传播性疾病院内防控体系的建立及效果初探

孙芳艳; 王爱; 郭勤; 何紫棠; 张国杰; 张占杰; 柴文昭

doi:10.12290/xhyxzz.20200078

呼吸道传播性疾病院内防控体系的建立及效果初探

Establishment and Evaluation of the Prevention and Control System of Respiratory-borne Diseases

摘要

摘要:
目的探讨建立以医院为主体的呼吸道传播性疾病防控体系对减少季节性流行性感冒(简称“流感”)院内传播的效果。
方法回顾性收集并分析2017年11月至2020年2月3个流感季北京协和医院上报的流感病例的临床资料。根据其发生地点分为院内和院外流感病例。比较防控体系建立前(2017—2018年、2018—2019年)与建立后(2019—2020年)流感季院内流感病例比率变化。
结果共5427例流感病例入选本研究。其中院内335例(6.17%，335/5427)，院外5092例(93.83%，5092/5427)；2017—2018年流感病例1594例(29.37%，1594/5427)，2018—2019年流感病例2579例(47.52%，2579/5427)，2019年—2020年流感病例1254例(23.11%，1254/5427)。2019—2020年院内流感病例比率(3.51%，44/1254)显著低于2017—2018年(7.59%，121/1594)和2018—2019年(6.59%，170/2579)(P＜0.001)，2017—2018年院内流感病例比率与2018—2019年无显著差异(P＞0.05)。相比2017—2018年、2018—2019年，2019—2020年发生院内流感病例的相对危险度(relative risk，RR)分别为0.53(95% CI：0.39~0.74)、0.46(95% CI：0.33~0.65)。
结论呼吸道传播性疾病院内防控体系的建立可能对院内流感传播的预防有一定价值。

Abstract:
Objective The aim of this study is to establish a hospital-based prevention and control system of respiratory-borne diseases for seasonal influenza and to verify the effect.
Methods Influenza cases reported by Peking Union Medical College Hospital in the three flu seasons from November 2017 to February 2020 were retrospectively analyzed. According to the location of occurrence, the influenza cases are divided into hospital influenza cases and non-hospital influenza cases. The incidence of hospital influenza cases before and after the implementation of the prevention and control system of respiratory diseases were compared.
Results A total of 5427 influenza cases that met the inclusion and exclusion criteria were selected for this study. Among them, there were 335 cases (6.17%, 335/5427) of hospital influenza and 5092 cases (93.83%, 5092/5427) of non-hospital influenza. There were 1594 influenza cases(29.37%, 1594/5427) in the 2017—2018 influenza season, 2579 cases(47.52%, 2579/5427) in the 2018—2019 influenza season, and 1254 cases(23.11%, 1254/5427) in the 2019—2020 influenza season.The incidence of hospital influenza of the 2019—2020 influenza season (3.51%) is much lower than those of the 2017—2018 influenza season (7.59%) and 2018—2019 influenza season (6.59%) (P < 0.001).There was no statistical difference between the 2017—2018 influenza season and 2018—2019 influenza season (P > 0.05). Compared with the 2017—2018 influenza season and 2018-2019 influenza season, the relative risk (RR) of hospital influenza cases in the 2019—2020 influenza season is 0.53 (95% CI: 0.39-0.74) and 0.46 (95% CI: 0.33-0.65), respectively.
Conclusion Hospital-based prevention and control system of seasonal influenza may effectively prevent influenza cases from appearing in hospital.

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