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2014年,内布拉斯加州一家长期护理机构发生肺炎支原体疫情。

Mycoplasma pneumoniae outbreak in a long-term care facility--Nebraska, 2014.

作者信息

Hastings Deborah L, Harrington Kari J, Kutty Preeta K, Rayman Rebecca J, Spindola Dana, Diaz Maureen H, Thurman Kathleen A, Winchell Jonas M, Safranek Thomas J

出版信息

MMWR Morb Mortal Wkly Rep. 2015 Mar 27;64(11):296-9.

Abstract

On June 20, 2014, a Nebraska long-term care facility notified the East Central District Health Department (ECDHD) and Nebraska Department of Health and Human Services (NDHHS) of an outbreak of respiratory illness characterized by cough and fever in 22 residents and resulting in four deaths during the preceding 2 weeks. To determine the etiologic agent, identify additional cases, and implement control measures, Nebraska and CDC investigators evaluated the facility's infection prevention measures and collected nasopharyngeal (NP) and oropharyngeal (OP) swabs or autopsy specimens from patients for real-time polymerase chain reaction (PCR) testing at CDC. The facility was closed to new admissions until 1 month after the last case, droplet precautions were implemented, ill residents were isolated, and group activities were canceled. During the outbreak, a total of 55 persons experienced illnesses that met the case definition; 12 were hospitalized, and seven died. PCR detected Mycoplasma pneumoniae DNA in 40% of specimens. M. pneumoniae should be considered a possible cause of respiratory illness outbreaks in long-term care facilities. Morbidity and mortality from respiratory disease outbreaks at long-term care facilities might be minimized if facilities monitor for respiratory disease clusters, report outbreaks promptly, prioritize diagnostic testing in outbreak situations, and implement timely and strict infection control measures to halt transmission.

摘要

2014年6月20日,内布拉斯加州的一家长期护理机构向东中区卫生局(ECDHD)和内布拉斯加州卫生与公众服务部(NDHHS)通报,在过去两周内,该机构有22名居民出现以咳嗽和发热为特征的呼吸道疾病暴发,并导致4人死亡。为确定病原体、识别其他病例并实施控制措施,内布拉斯加州和美国疾病控制与预防中心(CDC)的调查人员评估了该机构的感染预防措施,并采集了患者的鼻咽(NP)和口咽(OP)拭子或尸检标本,送往CDC进行实时聚合酶链反应(PCR)检测。该机构在最后一例病例出现后1个月内不再接收新入院患者,实施了飞沫预防措施,隔离了患病居民,并取消了集体活动。在疫情暴发期间,共有55人出现符合病例定义的疾病;12人住院,7人死亡。PCR在40%的标本中检测到肺炎支原体DNA。肺炎支原体应被视为长期护理机构呼吸道疾病暴发的可能病因。如果长期护理机构监测呼吸道疾病聚集情况、及时报告疫情、在疫情情况下优先进行诊断检测,并实施及时且严格的感染控制措施以阻止传播,呼吸道疾病暴发导致的发病率和死亡率可能会降至最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d9b/4584882/289a016889c2/296-299f1.jpg

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