Sections of Infectious Diseases, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Influenza Other Respir Viruses. 2012 Sep;6(5):374-9. doi: 10.1111/j.1750-2659.2011.00322.x. Epub 2012 Jan 2.
Preventing nosocomial transmission of influenza is essential to reduce the morbidity and mortality associated with this infection. In October 2009, an outbreak of the 2009 influenza A (H1N1) virus occurred in a hematology ward of a children's hospital over a 21-day period and involved two patients and four healthcare workers.
To investigate nosocomial transmission of the 2009 influenza A (H1N1) virus in patients and healthcare workers.
DESIGN, SETTING, AND PARTICIPANTS: An outbreak investigation was initiated in response to suspected nosocomial transmission of the 2009 influenza A (H1N1) virus during the peak of the 2009 pandemic. Cases were confirmed using a polymerase chain reaction (PCR) test specific for the 2009 H1N1 influenza A virus. Viruses isolated from nasopharyngeal swabs were genetically characterized using Sanger sequencing of uncloned "bulk" PCR products.
Virus sequencing to investigate nosocomial transmission.
Two immunocompromised patients and four healthcare workers were found to be part of a nosocomial outbreak of the 2009 influenza A (H1N1) virus. One immunocompromised patient had a second episode of clinical influenza infection after isolation precautions had been discontinued, resulting in additional exposures. Strain-specific PCR showed that all cases were caused by infection of the 2009 H1N1 virus. Sequencing of viral genes encoding hemagglutinin and polymerase basic subunit 2 (PB2) revealed that all viruses isolated were genetically identical at these loci, including the two episodes occurring in the same immunocompromised patient.
Prompt institution of isolation precautions is essential in preventing nosocomial outbreaks of the 2009 novel influenza A (H1N1) virus. Our data suggest that isolation precautions may need to be continued for a prolonged period of time in immunocompromised patients with influenza infection.
预防医院内流感传播对于降低这种感染相关发病率和死亡率至关重要。2009 年 10 月，在一家儿童医院的血液科病房中，2009 年甲型 H1N1 流感病毒爆发，持续了 21 天，涉及两名患者和四名医护人员。
调查 2009 年甲型 H1N1 流感病毒在患者和医护人员中的医院内传播情况。
设计、地点和参与者：在 2009 年大流行期间，疑似发生 2009 年甲型 H1N1 流感病毒医院内传播后，启动了暴发调查。使用针对 2009 年 H1N1 流感 A 病毒的聚合酶链反应（PCR）检测确认病例。使用桑格测序对未克隆“批量”PCR 产物对从鼻咽拭子中分离的病毒进行基因特征分析。
病毒测序以调查医院内传播情况。
发现两名免疫功能低下的患者和四名医护人员是 2009 年甲型 H1N1 流感病毒医院内暴发的一部分。一名免疫功能低下的患者在隔离预防措施停止后出现第二次临床流感感染，导致更多的接触。株特异性 PCR 显示所有病例均由 2009 年 H1N1 病毒感染引起。血凝素和聚合酶碱性亚基 2（PB2）基因编码病毒的测序显示，所有分离的病毒在这些基因座上的遗传均相同，包括同一免疫功能低下患者的两次发作。
及时采取隔离预防措施对于预防 2009 年新型甲型 H1N1 流感病毒医院内暴发至关重要。我们的数据表明，对于流感感染的免疫功能低下患者，可能需要长时间持续采取隔离预防措施。
