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2011 年东日本大地震后住院患者早期感染性疾病的特征:肺炎是导致住院治疗的重要原因。

Characteristics of infectious diseases in hospitalized patients during the early phase after the 2011 great East Japan earthquake: pneumonia as a significant reason for hospital care.

机构信息

Department of Infection Control and Laboratory Diagnostics, Internal Medicine, Sendai, Japan.

Department of Regional Cooperation for Infectious Diseases, Tohoku University Graduate School of Medicine, Sendai, Japan.

出版信息

Chest. 2013 Feb 1;143(2):349-356. doi: 10.1378/chest.11-3298.

Abstract

BACKGROUND

Natural catastrophes increase infectious disease morbidity rates. On March 11, 2011, a 9.0-magnitude earthquake and associated Pacific coast tsunami struck East Japan. The aim of this study was to investigate the characteristics of patients with infectious diseases who needed hospitalization after this disaster.

METHODS

We searched the medical records of 1,577 patients admitted to Tohoku University Hospital in the Sendai area within 1 month (March 11, 2011-April 11, 2011) after the disaster. We examined (1) changes in the rates of hospitalizations for infectious diseases over time and (2) the variety of infectious diseases.

RESULTS

The number of hospitalized patients with infectious diseases increased after the fi rst week to double that during the same period in 2010. Pneumonia comprised 43% of cases, and 12% consisted of skin and subcutaneous tissue infection, including tetanus. Pneumonia was prevalent in elderly patients (median age, 78 years) with low levels of serum albumin and comorbid conditions, including brain and nervous system disorders. Sputum cultures contained Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae , known pathogens of community-acquired pneumonia in Japan. In addition, 20.5% of patients had positive results for urinary pneumococcal antigen.

CONCLUSIONS

Among hospitalized patients, infectious diseases were significantly increased after the disaster compared with the same period in 2010, with pneumonia being prominent. The analyses suggest that taking appropriate measures for infectious diseases, including pneumonia, may be useful for disaster preparedness and medical response in the future.

摘要

背景

自然灾害会增加传染病发病率。2011 年 3 月 11 日,日本东部发生了 9.0 级地震和太平洋沿岸海啸。本研究旨在调查此次灾害后需要住院的传染病患者的特征。

方法

我们检索了在灾难发生后 1 个月内(2011 年 3 月 11 日至 2011 年 4 月 11 日)入住东北大学医院的 1577 名患者的病历。我们检查了(1)传染病住院率随时间的变化,以及(2)传染病的种类。

结果

受灾后第一周,住院传染病患者人数增加,是 2010 年同期的两倍。肺炎占 43%,12%为皮肤和皮下组织感染,包括破伤风。肺炎常见于血清白蛋白水平低且伴有脑和神经系统疾病等合并症的老年患者(中位年龄为 78 岁)。痰培养中含有肺炎链球菌、卡他莫拉菌和流感嗜血杆菌,这些是日本社区获得性肺炎的常见病原体。此外,20.5%的患者尿肺炎球菌抗原检测阳性。

结论

与 2010 年同期相比,受灾后住院患者的传染病明显增加,以肺炎为主。分析表明,采取适当的传染病措施,包括肺炎,可能对未来的灾害准备和医疗应对有用。

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