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病例报告:墨西哥科利马州一家医院由巨尾阿丽蝇(双翅目,丽蝇科)引起的医院蝇蛆病爆发。

Case Report: Outbreak of Nosocomial Myiasis by Cochliomyia macellaria (Diptera, Calliphoridae) in a Hospital in Colima, Mexico.

机构信息

Hospital Regional Universitario de la Secretaría de Salud, Colima, Mexico.

Facultad de Medicina de la Universidad de Colima, Colima, Mexico.

出版信息

Am J Trop Med Hyg. 2023 Sep 11;109(4):748-751. doi: 10.4269/ajtmh.22-0225. Print 2023 Oct 4.

Abstract

Myiasis in humans is a disease caused by larvae of various fly families. It mainly occurs in communities with poor sanitation and low socioeconomic status. Meanwhile intrahospital or nosocomial myiasis represents a rare phenomenon but is of relevance to public health. Here, we report an outbreak of myiasis caused by Cochliomyia macellaria in five patients hospitalized for several diseases at the Service of Internal Medicine of the Hospital Regional Universitario de Colima, Mexico during June and July 2021. Three patients were males and two were females, aged 37 to 83 years. All were affected by myiasis caused by larvae of the fly C. macellaria. Three patients underwent invasive mechanical ventilation; one had cutaneous basal cell cancer and one had advanced diabetic foot. This event occurred after 4 days of hospitalization and in the same hospital pavilion. Two patients died, and the others were discharged after treatment with antibiotics and ivermectin. We believe that this nosocomial cluster represents a more frequent phenomenon than reported in tropical countries, where authorities should pay attention to its timely detection, especially in vulnerable populations.

摘要

人体蝇蛆病是由各种蝇科幼虫引起的疾病。它主要发生在卫生条件差和社会经济地位低的社区。同时,医院内或院内蝇蛆病是一种罕见的现象,但与公共卫生有关。在这里,我们报告了 2021 年 6 月至 7 月期间,墨西哥科利马州立大学医院内科服务部收治的 5 例因各种疾病住院的患者发生的 Cochliomyia macellaria 引起的蝇蛆病暴发。3 名患者为男性,2 名患者为女性,年龄 37 至 83 岁。所有患者均受到蝇科 C. macellaria 幼虫引起的蝇蛆病的影响。3 名患者接受了有创机械通气;1 名患有皮肤基底细胞癌,1 名患有晚期糖尿病足。这一事件发生在住院 4 天后,且发生在同一医院病房。2 名患者死亡,其余患者经抗生素和伊维菌素治疗后出院。我们认为,这种院内聚集现象比在热带国家报告的更为常见,当局应注意及时发现,尤其是在弱势群体中。

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