使用血清型特异性尿液免疫测定法来确定甲型流感并发医院感染暴发的病程。
Use of a serotype-specific urine immunoassay to determine the course of a hospital outbreak of complicated by influenza A.
作者信息
Sheppard Carmen L, Clark John, Slack Mary P E, Fry Norman K, Harrison Timothy G
机构信息
Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England , 61 Colindale Avenue, London NW9 5EQ , UK.
Department of Microbiology & Virology, Epsom & St Helier University Hospitals NHS Trust , UK.
出版信息
JMM Case Rep. 2016 Feb 12;3(1):e005002. doi: 10.1099/jmmcr.0.005002. eCollection 2016 Feb.
INTRODUCTION
An outbreak of (pneumococcal) infection complicated by concomitant influenza A on an elderly care ward was detected.
CASE PRESENTATION
Thirteen patients with hospital-acquired respiratory infections were investigated during the course of the outbreak investigation. Six had a positive BinaxNOW urinary antigen test and two patients had culture-confirmed pneumococcal bacteraemia and a positive urine antigen test. Five patients gave positive influenza A PCR results of which two were also positive for antigen.
CONCLUSION
The concurrence of influenza and pneumococcal infections made tracking the course of the infection difficult. This case study shows how the use of a sensitive, serotype-specific urine antigen assay, in the absence of cultured isolates, helped determine whether patients were infected with the same pneumococcal serotype. This was particularly useful when additional respiratory symptoms were seen following the administration of chemoprophylaxis.
引言
在一个老年护理病房发现了由甲型流感并发的肺炎球菌感染疫情。
病例报告
在疫情调查过程中，对13例医院获得性呼吸道感染患者进行了调查。6例BinaxNOW尿抗原检测呈阳性，2例患者血培养确诊为肺炎球菌菌血症且尿抗原检测呈阳性。5例患者甲型流感PCR检测结果为阳性，其中2例抗原检测也呈阳性。
结论
流感和肺炎球菌感染同时发生使得追踪感染过程变得困难。本病例研究表明，在没有培养分离株的情况下，使用敏感的、血清型特异性尿抗原检测有助于确定患者是否感染了相同的肺炎球菌血清型。在给予化学预防后出现额外呼吸道症状时，这一点尤为有用。
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