Investigation of a scabies infection outbreak in an ICU and its resolution

Songsong Yuan; Wentao Zhu; Tianxin Xiang; Ying Zhu; Wangguo Wang; Xiaoping Wu

摘要：Objectives To study the characteristics of a scabies infection outbreak and its associated factors in a hospital intensive care unit(ICU).And to explore the prompt and precise diagnosis and intervention strategies. Methods Based on the epidemiological and clinical symptoms,microscopy examine was performed to study the morphology of rashes and metagenomics next-generation sequencing was used to identify pathogens.In the meantime,medical intervention measures and comprehensive environmental disinfection were carried out to control the outbreak. Results Between March 8 and May 10,2022,one patient and 30 ICU personnels(two doctors,24 nursing staffs,and six family members)suffered a rash on their limbs and trunks involving scattered red papules,her-pes-like lesions,scabs,and desquamation,with intensive itching.The source of the scabies infection was traced back to an elderly hospitalized patient who had been paralyzed and bed-ridden for many years.The pathogen was identified as Sarcoptes scabiei,which is mainly transmitted through direct contact and indirect contact via environmental objects.After comprehensive prevention and control measures were taken,including the isola-tion of infected subjects,the effective disinfection of the clothing of the infected persons and environmental items in the duty room and ward,and active treatment,no new cases were found. Conclusions Scabies infection should be considered when there is a nosocomial outbreak of an unknown rash in the hospital.Metagenomics next-generation sequencing is a powerful tool for pathogen identification.Train-ing and education of medical personnel are dispensable and hospital infection intervention strategies are to be setup to effectively block and control nosocomial parasite infections.