An outbreak of conjunctivitis due to a novel unencapsulated Streptococcus pneumoniae among military trainees
An outbreak of conjunctivitis due to a novel unencapsulated Streptococcus pneumoniae among military trainees
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DOI：
10.1086/424522
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发表时间：
2004-10-15
影响因子：
11.8
通讯作者：
Russell, KL
中科院分区：
文献类型：
--
作者：
Crum, NF;Barrozo, CP;Russell, KL
背景。细菌性结膜炎通常为散发病例；疫情并不常见，通常与校园有关。我们报告一起在军事训练设施爆发的肺炎链球菌结膜炎。进行了疫情调查。使用包括人口统计学和临床资料在内的评估工具对每个结膜炎病例进行评估。取结膜拭子。对肺炎球菌进行标准检测，包括用Quellung反应进行血清分型、荚膜染色和多位点序列分型。序列类型通过树形图的构建与先前报道的爆发菌株进行了比较。在先前未确诊的结膜炎患者中确定肺炎链球菌的携带率，并进行病例对照研究。控制措施包括加强洗手教育、发放含酒精洗手液、及时治疗结膜炎患者。在6周的时间内，3500人中发生92例结膜炎，发病率为每100人月1.75例。肺炎链球菌80例（87%）；确诊病例45例（49%），可能病例35例（38%）。接受调查的新兵中有10%携带爆发菌株。在疫情爆发期间，22%的患者自我报告的症状与结膜炎一致；共用毛巾与结膜炎相关（优势比11.7;P = 0.03）。病原菌对阿奇霉素耐药，对特利霉素敏感。暴发菌株是一种未封装的肺炎链球菌，以前没有描述过；它与2002年达特茅斯学院（Hanover， NH）结膜炎暴发的序列类型关系最为密切。我们报告结膜炎爆发在军事学员引起的一种新的，未封装的链球菌肺炎菌株。
Background. Bacterial conjunctivitis usually occurs as sporadic cases; outbreaks are uncommon and usually are associated with school campuses. We report an outbreak of Streptococcus pneumoniae conjunctivitis at a military training facility.Methods. An outbreak investigation was done. Each case of conjunctivitis was evaluated with an assessment tool including demographic and clinical data. Conjunctival swabs were obtained. Pneumococci underwent standard testing, including serotyping with the Quellung reaction, capsular staining, and multilocus sequence typing. Sequence types were compared with previous reported outbreak strains by construction of dendrograms. Carriage rates of S. pneumoniae were determined among previously undiagnosed case patients with conjunctivitis, and a case-control study was performed. Control measures included education to increase hand washing, distribution of alcohol-based hand gel, and prompt treatment of patients with conjunctivitis.Results. During a 6-week period, 92 cases of conjunctivitis occurred among 3500 persons, with an attack rate of 1.75 cases per 100 person-months. Eighty cases (87%) were due to S. pneumoniae; 45 (49%) were confirmed, and 35 (38%) were probable. Ten percent of recruits surveyed carried the outbreak strain. Twenty-two percent self-reported symptoms consistent with conjunctivitis during the outbreak period; sharing washcloths was associated with conjunctivitis (odds ratio, 11.7; P = .03). The causative organism was resistant to azithromycin but susceptible to telithromycin. The outbreak strain was an unencapsulated S. pneumoniae that has not been previously described; it was most closely related to the sequence type causing the Dartmouth College ( Hanover, NH) outbreak of conjunctivitis in 2002.Conclusions. We report a conjunctivitis outbreak among military trainees caused by a novel, unencapsulated strain of S. pneumoniae.