College of Osteopathic Medicine, Midwestern University, Glendale, AZ.
Infection Control Department University of Pittsburgh Medical Center (UPMC) Mercy, Pittsburgh, PA.
Am J Infect Control. 2023 Jun;51(6):705-709. doi: 10.1016/j.ajic.2022.10.003. Epub 2022 Oct 13.
Scabies is a skin infection transmitted by close person-to-person contact. Crusted scabies is a more severe type which is more contagious. Delayed diagnosis of scabies could lead to an outbreak.
The outbreak occurred at a 435-bed academic medical center with 76 inpatient rehabilitation beds. The index patient was incarcerated and admitted to our hospital in February 2022. The patient developed crusted scabies after steroids treatment.
The patient was treated with oral ivermectin (200 mcg/kg, maximum dose 15 mg) and topical permethrin 5%. All units were followed for 6 weeks since diagnosis of the index patient. A total of 46 healthcare workers (20 nurses and 26 physical therapists) were exposed. Twenty-nine presented symptoms and were treated with ivermectin and permethrin or only ivermectin. No physicians, other patients, or prison guards were affected. There was no secondary household transmission of those exposed healthcare workers.
Scabies is highly contagious in high-risk patients. Early diagnosis and effective infection control are of vital importance.
疥疮是一种通过密切的人际接触传播的皮肤感染。结痂性疥疮是一种更严重的类型，传染性更强。疥疮的延迟诊断可能导致爆发。
爆发发生在一家拥有 76 张住院康复床位的 435 张病床的学术医疗中心。索引患者被监禁并于 2022 年 2 月入住我院。该患者在接受类固醇治疗后出现结痂性疥疮。
患者接受了口服伊维菌素（200 mcg/kg，最大剂量 15 mg）和 5%的外用扑灭司林。自索引患者确诊以来，所有单位均随访了 6 周。共有 46 名医护人员（20 名护士和 26 名物理治疗师）接触。29 人出现症状并接受伊维菌素和扑灭司林或仅伊维菌素治疗。没有医生、其他患者或狱警受到影响。那些接触过医护人员的人没有发生家庭二次传播。
疥疮在高危患者中具有高度传染性。早期诊断和有效的感染控制至关重要。
