Ippolito G, Puro V, Heptonstall J, Jagger J, De Carli G, Petrosillo N
Centro di Riferimento AIDS e Servizio di Epidemiologia delle Malattie Infettive IRCCS Lazzaro Spallanzani, Rome, Italy.
Clin Infect Dis. 1999 Feb;28(2):365-83. doi: 10.1086/515101.
The average estimated risk of human immunodeficiency virus (HIV) infection for health care workers following a percutaneous or mucous exposure is <0.5% in incidence studies, although a case-control study suggests it is much higher for highest-risk percutaneous exposure. To characterize exposures resulting in HIV transmission, we reviewed available data on occupational cases reported worldwide, identifying 94 documented and 170 possible cases. The majority of documented infections occurred in nurses, after contact with the blood of a patient with AIDS by means of percutaneous exposure, with a device placed in an artery or vein. High-exposure job categories, e.g., midwives and surgeons, are represented mostly among possible cases. Transmission occurred also through splashes, cuts, and skin contaminations, and in some cases despite postexposure prophylaxis with zidovudine. Health care workers could benefit if these data were incorporated in educational programs designed to prevent occupational bloodborne infections.
在发病率研究中,医护人员经皮或黏膜暴露后感染人类免疫缺陷病毒(HIV)的平均估计风险<0.5%,尽管一项病例对照研究表明,最高风险的经皮暴露感染风险要高得多。为了描述导致HIV传播的暴露情况,我们回顾了全球报告的职业病例的现有数据,确定了94例有记录的病例和170例可能的病例。大多数有记录的感染发生在护士身上,他们通过经皮暴露,使用放置在动脉或静脉中的器械接触艾滋病患者的血液。高暴露工作类别,如助产士和外科医生,大多出现在可能的病例中。传播也通过飞溅、切割和皮肤污染发生,在某些情况下,尽管暴露后使用齐多夫定进行了预防。如果将这些数据纳入旨在预防职业性血源感染的教育项目中,医护人员可能会从中受益。