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目的:了解夏季室内游泳引起肺炎支原体感染的流行病学特点,以加强对游泳池的卫生管理和监督。方法:用分层随机抽样的方法随机选择本区同期内无游泳史452人作对照人群,另选本区同期有室外游泳史的人群作为发病组的对照,并对271例发热病人的现场流行病学调查、临床症状特点、实验室检验进行比较分析,说明室内外游泳史暴露与发病的关系。结果:游泳池水细菌总数分别超标5~10倍,绿脓杆菌大量生长,病人以发热为主,兼有咽痛、腹痛、腹泻、结合膜炎。有游泳史的发病率与无游泳史发病率RR=18.01,χ2=179.280,P<0.01。与对照游泳池发病率比较P=0.007<0.01,在暴露不合格游泳池水1个潜伏期后发病到高峰,关闭不合格游泳池1个潜伏期后发病逐渐停止。29名发热病例咽拭子病原学分离,8例病人咽拭子检出肺炎支原体,25.76%的病例检出肺炎支原体和人型支原体抗体,9.1%的病人检出呼吸道合胞病毒抗体,4.5%的病人检出腺病毒抗体。结论:游泳者在同期内接触了不合格的游泳池水,引起了介游泳池水传播为主的肺炎支原体、兼有呼吸道合胞病毒和腺病毒的感染。室内通风不良增加了发病者的感染机会。
OBJECTIVE: To understand the epidemiological characteristics of mycoplasma pneumonia caused by indoor swimming in summer so as to strengthen the hygiene management and supervision of the swimming pool. Methods: Stratified random sampling method was used to select randomly 452 people without swimming history in the same area as the control group. Another group with the history of outdoor swimming in the same district was selected as the control group. 271 cases of febrile patients were prevalent Medical investigation, clinical features, laboratory tests for comparative analysis, indicating the relationship between indoor and outdoor swimming history exposure and incidence. Results: The total number of bacteria in swimming pool exceeded 5 ~ 10 times respectively. Pseudomonas aeruginosa grew in large numbers. The patients mainly suffered from fever, which included sore throat, abdominal pain, diarrhea and conjunctivitis. The incidence of swimming history and no swimming history RR = 18.01, χ2 = 179.280, P <0.01. Compared with the control swimming pool incidence P = 0.007 <0.01, exposure to unqualified swimming pool after a latent period of onset to the peak, shut down a swimming pool after a latency onset gradually stopped. Throat swabs were isolated from 29 febrile cases, mycoplasma pneumoniae was detected in throat swabs of 8 patients, mycoplasma pneumoniae and mycoplasma hominis were detected in 25.76% of cases, antibodies of respiratory syncytial virus were detected in 9.1% of patients, 4.5% Of patients detected adenovirus antibody. Conclusions: Swimmers exposed to unqualified swimming pool water during the same period, causing Mycoplasma pneumoniae, which is mainly caused by water in the swimming pool of mediating swimming pool, has both respiratory syncytial virus and adenovirus infection. Poor indoor ventilation increases the chances of infection.