摘要
目的了解结核病定点医疗机构卫生人员结核分枝杆菌的感染状况,探讨引发感染的风险因素。方法 2021年9月至2022年6月通过整群分层抽样的方法对4家结核病定点医疗机构相关科室的卫生人员进行问卷调查,内容包含医疗机构院内感染控制措施的实施、医务人员结核分枝杆菌职业暴露情况,同时行外周血γ-干扰素释放试验(interferon gamma release assays,IGRAs)和肺部影像学检查,判定结核分枝杆菌感染情况。将单因素分析有统计学意义的因素纳入多因素logistic回归,分析结核分枝杆菌感染的风险因素。结果共有657人完成肺部影像学检查和调查问卷,其中654人行外周血IGRAs检测,结核病潜伏感染率为39.45%(258/654)。单因素分析显示,基本情况方面年龄、性别、婚姻状况、经济收入、职业类别、职称等级、工龄等变量卫生人员结核病潜伏感染情况差异均有统计学意义(P<0.05);个人健康状况方面本人结核病史、直系亲属结核病史、既往接受结核菌素皮肤试验等的卫生人员结核病潜伏感染情况分布差异均有统计学意义(P<0.05)。多因素分析显示,共有4种与结核病相关的风险因素,分别为职称等级(X1)、从事与肺结核相关工作年限(X2)、结核病史(X3)和既往结核菌素皮肤试验情况(X4),则卫生人员发生结核病概率的回归方程为y=-1.920+0.246X1+0.046X2+1.231X3+0.478X4。结论结核病定点医疗机构卫生人员结核病潜伏感染率较高,应加强感染控制工作的管理,开展定期筛查,提升卫生人员的自我防护意识,降低卫生人员的结核分枝杆菌暴露及感染风险。
Objective To understand the infection status of mycobacterium tuberculosis among health workers in tuberculosis designated medical institutions and explore the risk factors of infection.Methods From September 2021 to June 2022,a questionnaire survey was conducted among health workers in relevant departments of 4 tuberculosis designated medical institutions by cluster stratified sampling,including the implementation of hospital infection control measures in medical institutions and occupational exposure of medical staff to mycobacterium tuberculosis.Peripheral blood interferon gamma release assays(IGRAs)and lung imaging examination were performed to determine the mycobacterium tuberculosis infection.Factors with statistical significance in univariate analysis were included in multivariate logistic regression to analyze the risk factors of mycobacterium tuberculosis infection.Results A total of 657 people completed the lung imaging examination and questionnaire,of which 654 people had peripheral blood IGRAs detection,and the latent infection rate of tuberculosis was 39.45%(258/654).Univariate analysis showed that age,sex,marital status,economic income,occupational category,professional title,length of service,and other variables had statistical significances in tuberculosis latent infection(P<0.05).In terms of personal health status,there were statistically significant differences in the distribution of health workers in terms of their tuberculosis history,tuberculosis history of their immediate family members,previous tuberculin skin test(TST)(P<0.05).Multivariate analysis showed that there were four risk factors related to tuberculosis,including professional title(X1),years of tuberculosis related works(X2),tuberculosis history(X3)and previous TST(X4).The regression equation of the probability of tuberculosis among health workers was y=-1.920+0.246X1+0.046X2+1.231X3+0.478X4.Conclusion The latent infection rate of tuberculosis among health workers in tuberculosis designated medical institutions is high.It is necessary to strengthen the management of infection control,carry out regular screening,enhance the self-protection awareness of health workers,and reduce their exposure to mycobacterium tuberculosis and infection risk.
作者
何琳
戚巍
唐诗邈
曹宏伟
蒋轶文
He Lin;Qi Wei;Tang Shimiao;Cao Hongwei;Jiang Yiwen(Department of Tuberculosis Control and Prevention,Liaoning Provincial Center for Disease Control and Prevention,Shenyang 110000,China)
出处
《中华劳动卫生职业病杂志》
CAS
CSCD
北大核心
2024年第2期96-101,共6页
Chinese Journal of Industrial Hygiene and Occupational Diseases
基金
职业健康风险评估与国家职业卫生标准制定项目(131031109000160004)。
关键词
职业暴露
结核病
卫生人员
潜伏性感染
潜伏性结核病
感染控制
Occupational exposure
Tuberculosis
Health personnel
Latent infection
Latent tuberculosis
Infection control
