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血液肿瘤患儿呼吸道合胞病毒暴发的分子特征及成功管理。

Molecular characteristics and successful management of a respiratory syncytial virus outbreak among pediatric patients with hemato-oncological disease.

机构信息

1Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.

2Institute for Experimental Virology; Twincore- Centre for Experimental and Clinical Infection Research; a joint venture of Hannover Medical School (MHH) and Helmholtz Centre for Infection Research (HZI), Hannover, Germany.

出版信息

Antimicrob Resist Infect Control. 2018 Feb 13;7:21. doi: 10.1186/s13756-018-0316-2. eCollection 2018.

Abstract

BACKGROUND

Respiratory syncytial virus (RSV) is responsible for upper and lower respiratory tract infection in adults and children. Especially immunocompromised patients are at high risk for a severe course of infection, and mortality is increased. Moreover RSV can spread in healthcare settings and can cause outbreaks. Herein we demonstrate the successful control and characteristics of a RSV outbreak that included 8 patients in our Department of Pediatric Hematology and Oncology.

METHODS

We performed an epidemiologic investigation and a molecular analysis of the outbreak strains. Moreover we present the outbreak control bundle and our concept for RSV screening in the winter season.

RESULTS

RSV A and B strains caused the outbreak. RSV B strains affected 3 patients, 2 of whom were co-infected with RSV A. Exactly this RSV A strain was detected in another 5 patients. Our multimodal infection control bundle including prophylactic RSV screening was able to rapidly stop the outbreak.

CONCLUSION

An infection control bundle in RSV outbreaks should address all potential transmission pathways. In pediatric settings the restriction of social activities might have a temporal negative impact on quality of life but helps to limit transmission opportunities. Molecular analysis allows better understanding of RSV outbreaks and, if done in a timely manner, might be helpful for guidance of infection control measures.

摘要

背景

呼吸道合胞病毒(RSV)可引起成人和儿童的上呼吸道和下呼吸道感染。特别是免疫功能低下的患者,感染的严重程度风险较高,死亡率增加。此外,RSV 可在医疗机构中传播,并可引起暴发。在此,我们展示了我们儿科血液肿瘤科成功控制和暴发特征,该暴发共涉及 8 例患者。

方法

我们对暴发株进行了流行病学调查和分子分析。此外,我们还介绍了暴发控制包以及我们在冬季进行 RSV 筛查的概念。

结果

RSV A 和 B 株引起了暴发。RSV B 株感染了 3 例患者,其中 2 例合并感染 RSV A。另外 5 例患者中也检测到了这种 RSV A 株。我们的多模式感染控制包包括预防性 RSV 筛查,能够迅速阻止暴发。

结论

RSV 暴发的感染控制包应针对所有潜在的传播途径。在儿科环境中,限制社交活动可能会暂时对生活质量产生负面影响,但有助于限制传播机会。分子分析有助于更好地了解 RSV 暴发,如果及时进行,可能有助于指导感染控制措施。

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