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呼吸道合胞病毒在老年医院爆发的分子研究。

Molecular investigation of a RSV outbreak in a geriatric hospital.

机构信息

AP-HP, Université Paris Saclay, Hôpital Ambroise Paré, Laboratoire de Microbiologie, Boulogne-Billancourt, France.

AP-HP, Université Paris Saclay, Hôpital Sainte Perrine, Equipe opérationnelle d'hygiène, Paris, France.

出版信息

BMC Geriatr. 2021 Feb 12;21(1):120. doi: 10.1186/s12877-021-02064-6.

Abstract

BACKGROUND

Acquired infections in hospitalized elderly people are a growing concern. In long-term care facilities with multiple staff and visitor contacts, virus outbreaks are a common challenge for infection prevention teams. Although several studies have reported nosocomial RSV outbreaks in long term care facilities, molecular epidemiology data are scarce.

METHODS

RSV RNA was detected in respiratory samples from 19 patients in a long-term care hospital for elderly in Paris in March 2019 over a 3 weeks period. Genotyping was performed using nucleotide sequencing. Sociodemographic and clinical characteristics of cases part of a unique cluster, were retrospectively reviewed.

RESULTS

Molecular investigation of theses RSV cases, revealed a unique cluster of 12 nosocomial cases in 2 adjacent wards. Mean age of these outbreak's cases was 89. All patients had underlying medical conditions. Seven exhibited lower respiratory symptoms and three experienced decompensation of underlying chronic heart condition. Two patients died.

CONCLUSIONS

This case report highlights the importance of RSV in causing substantial disease in elderly in case of nosocomial outbreak and the contributions of molecular epidemiology in investigation and management of such outbreak.

摘要

背景

住院老年人获得性感染是一个日益令人关注的问题。在有多名工作人员和访客接触的长期护理机构中,病毒爆发是感染预防团队面临的共同挑战。尽管有几项研究报告了长期护理机构中发生的呼吸道合胞病毒(RSV)暴发,但分子流行病学数据却很少。

方法

2019 年 3 月,在巴黎的一家老年长期护理医院的 19 名患者的呼吸道样本中检测到了 RSV RNA,持续了 3 周。使用核苷酸测序进行基因分型。回顾性分析了属于独特集群的病例的社会人口统计学和临床特征。

结果

对这些 RSV 病例的分子研究揭示了 2 个相邻病房中 12 例医院获得性病例的独特集群。这些暴发病例的平均年龄为 89 岁。所有患者均有基础疾病。7 例患者出现下呼吸道症状,3 例患者慢性心脏基础疾病恶化。两名患者死亡。

结论

本病例报告强调了呼吸道合胞病毒在导致老年人发生严重疾病方面的重要性,以及分子流行病学在调查和管理此类暴发方面的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8aee/7881482/e98406112552/12877_2021_2064_Fig1_HTML.jpg

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