王宇, 向妮娟, 倪大新, 李群, 冯子健. 安徽省两所地市级医院不明原因肺炎监测系统运行情况调查[J]. 疾病监测, 2017, 32(5): 428-432. DOI: 10.3784/j.issn.1003-9961.2017.05.018
引用本文: 王宇, 向妮娟, 倪大新, 李群, 冯子健. 安徽省两所地市级医院不明原因肺炎监测系统运行情况调查[J]. 疾病监测, 2017, 32(5): 428-432. DOI: 10.3784/j.issn.1003-9961.2017.05.018
WANG Yu, XING Ni-juan, NI Da-xin, LI Qun, FENG Zi-jian. Performance of surveillance system of pneumonia with unknown etiology in two hospitals at municipal (prefecture) level in Anhui province[J]. Disease Surveillance, 2017, 32(5): 428-432. DOI: 10.3784/j.issn.1003-9961.2017.05.018
Citation: WANG Yu, XING Ni-juan, NI Da-xin, LI Qun, FENG Zi-jian. Performance of surveillance system of pneumonia with unknown etiology in two hospitals at municipal (prefecture) level in Anhui province[J]. Disease Surveillance, 2017, 32(5): 428-432. DOI: 10.3784/j.issn.1003-9961.2017.05.018

安徽省两所地市级医院不明原因肺炎监测系统运行情况调查

Performance of surveillance system of pneumonia with unknown etiology in two hospitals at municipal (prefecture) level in Anhui province

  • 摘要: 目的 通过对住院急性呼吸道感染病例中符合不明原因肺炎(PUE)定义的病例进行筛查和调查,了解PUE监测系统在地市级医院内的运行情况,为PUE监测方案修订提供科学依据。方法 选择安徽省2所地市级医院,利用医院信息系统筛查新入院的符合PUE定义的病例,采集其临床标本进行病原学检测;通过查阅病历资料和面对面访谈,收集病历记录和患者回顾的两方面流行病学危险因素暴露史信息并进行比较。结果 2家医院共筛查出可能与PUE诊断相关的病例2 619例,其中335例(13%)被判断为PUE病例,仅1例以PUE病例进行了上报。筛查出的符合PUE定义的患者主要来自儿科(50%)和呼吸内科(30%);重症监护室筛查出的PUE病例数占该科室筛查总数的48%,高于其他科室。有病原学检测结果的311例PUE病例中,18例(6%)呈阳性,且全部为季节性流感。303例(97%,303/311)病历中记录有流行病学危险因素暴露史信息,但与人禽流感等新发呼吸道传染病相关的流行病学危险因素暴露史记录较少。结论 目前的PUE监测系统病例上报率较低,运转不良,需对监测方案进行调整,以提高监测工作质量。

     

    Abstract: Objective To understand the performance of surveillance system of pneumonia with unknown etiology (PUE) in medical institutions and provide scientific evidence for the improvement of the system. Methods Newly admitted patients who met the PUE definition in 2 hospitals at municipal (prefecture) level in Anhui province were screened out by using hospital information system. Clinical specimen of PUE cases were collected for etiological detection. The difference in exposure history between the recorded by clinicians and the recalled by PUE cases were compared through medical record review and face to face interview. Results A total of 2 619 cases related to PUE were screened in the two hospitals, of whom 335 (13%) were classified as PUE cases. Only one case was reported as PUE to municipal CDC. The detected cases of PUE were mainly from pediatric ward (50%) and respiratory ward (30%). The cases of PUE detected in intensive care unit accounted for 48% of the total screening cases in that ward, higher than other wards. Among the 311 laboratory detected cases of PUE, 18 (6%) had positive results, all were seasonal influenza cases. Up to 97% of cases of PUE (303/311) had epidemiological exposure history records, but the records about epidemiological risk factors associated with emerging respiratory infectious diseases were limited. Conclusion The reporting rate of the cases of PUE by the surveillance system was low, indicating the unsatisfied performance of the system. The quality of PUE surveillance needs to be improved by means of the revision of the surveillance protocol.

     

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