An outbreak of conjunctivitis due to atypical streptococcus pneumoniae
An outbreak of conjunctivitis due to atypical streptococcus pneumoniae
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DOI：
10.1056/nejmoa022521
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发表时间：
2003-03-20
影响因子：
158.5
通讯作者：
Whitney, CG
中科院分区：
文献类型：
--
作者：
Martin, M;Turco, JH;Whitney, CG
背景资料：2002年2月，达特茅斯学院卫生服务处的临床医生发现结膜炎爆发;结膜拭子培养物涉及肺炎链球菌。开始调查，以确定疫情的程度，确认原因，确定传播模式，并实施控制measurement.Methods：调查人员审查了卫生服务的数据库诊断结膜炎。病毒和细菌培养从生病的学生。胆汁可溶性分离株，易受乙基氢化铜（optochin），因此被认为是肺炎球菌进行血清分型，荚膜染色，脉冲场凝胶电泳，DNA探针，和多位点序列分型。使用互联网进行了一项风险因素的队列研究。控制措施包括分发酒精为基础的手凝胶和信息有关prevention.Results：在5060名学生中，698（13.8%）收到了结膜炎的诊断，从2002年1月1日至2002年4月12日，包括22%的一年级学生。从43.3%的结膜拭子（254个中的110个）中分离出假定的肺炎球菌;对85个标本进行的病毒培养为阴性。DNA探针和多位点序列分型证实了该生物体是肺炎球菌，尽管该细菌没有特征性的荚膜。在脉冲场凝胶电泳上，发现菌株与1980年在该国其他地区引起结膜炎爆发的肺炎球菌相同。对1832名学生的调查数据分析表明，与结膜炎学生密切接触、戴隐形眼镜、参加运动队、参加或住在兄弟会或姐妹会的聚会与结膜炎有关。结膜炎的诊断率下降后，实施控制措施，春假后。结论：这一大爆发的结膜炎在大学校园是由一个非典型的，未封装的菌株的S。这种病毒与20年前导致疫情爆发的菌株相同。
Background: In February 2002, clinicians at the Dartmouth College Health Service recognized an outbreak of conjunctivitis; cultures of conjunctival swabs implicated Streptococcus pneumoniae. An investigation was begun to determine the extent of the outbreak, confirm the cause, identify modes of transmission, and implement control measures.Methods: Investigators reviewed the health service's data base for diagnoses of conjunctivitis. Viral and bacterial cultures were obtained from ill students. Bile-soluble isolates that were susceptible to ethylhydrocupreine (optochin) and therefore were presumed to be pneumococci underwent serotyping, capsular staining, pulsed-field gel electrophoresis, a DNA probe, and multilocus sequence typing. A cohort study of risk factors was conducted with the use of the Internet. Control measures included distribution of alcohol-based hand gel and messages about prevention.Results: Among 5060 students, 698 (13.8 percent) received a diagnosis of conjunctivitis from January 1, 2002, through April 12, 2002, including 22 percent of first-year students. Presumed pneumococci were isolated from 43.3 percent of conjunctival swabs (110 of 254); viral cultures performed on 85 specimens were negative. DNA probes and multilocus sequence typing confirmed that the organisms were pneumococci, although the bacteria did not have the characteristic capsule. On pulsed-field gel electrophoresis, strains were found to be identical to pneumococci that caused outbreaks of conjunctivitis in other parts of the country in 1980. Analysis of survey data from 1832 students indicated that close contact with a student with conjunctivitis, wearing contact lenses, membership on a sports team, and attending parties at or living in a fraternity or sorority house were associated with conjunctivitis. The rate of diagnosis of conjunctivitis declined after the implementation of control measures and after spring break.Conclusions: This large outbreak of conjunctivitis on a college campus was caused by an atypical, unencapsulated strain of S. pneumoniae that was identical to strains that had caused outbreaks two decades earlier.