Pediatrics. 1999 Aug;104(2 Pt 1):318-24. doi: 10.1542/peds.104.2.318.
Current recommendations of the American Academy of Pediatrics (AAP) for infection control practices to prevent transmission of blood-borne pathogens, including human immunodeficiency virus (HIV) in hospitals, other medical settings, schools, and child care facilities, are reviewed and explained. Hand-washing is essential, whether or not gloves are used, and gloves should be used when contact with blood or blood-containing body fluids may occur. In hospitalized children, the 1996 recommendations of the Centers for Disease Control and Prevention (CDC) should be implemented as modified in the 1997 Red Book. The generic principles of Standard Precautions in the CDC guidelines generally are applicable to children in all health care settings, schools, child care facilities, and the home. However, gloves are not required for routine changing of diapers or for wiping nasal secretions of children in most circumstances. This AAP recommendation differs from that in the CDC guidelines. Current US Public Health Service guidelines for the management of potential occupational exposures of health care workers to HIV are summarized. As previously recommended by the AAP, HIV-infected children should be admitted without restriction to child care centers and schools and allowed to participate in all activities to the extent that their health and other recommendations for management of contagious diseases permit. Because it is not required that the school be notified of HIV infection, it may be helpful if the pediatrician notify the school that he or she is operating under a policy of nondisclosure of infection with blood-borne pathogens. Thus, it is possible that the pediatrician will not report the presence of such infections on the form. Because HIV infection occurs in persons throughout the United States, these recommendations for prevention of HIV transmission should be applied universally.
本文回顾并解释了美国儿科学会（AAP）目前关于感染控制措施的建议，这些措施旨在预防包括医院、其他医疗场所、学校和儿童保育机构中的人类免疫缺陷病毒（HIV）在内的血源性病原体传播。无论是否戴手套，洗手都是必不可少的，并且在可能接触血液或含血体液时应戴手套。对于住院儿童，应实施疾病控制与预防中心（CDC）1996年的建议，并根据1997年《红皮书》进行修改。CDC指南中的标准预防措施的一般原则通常适用于所有医疗环境、学校、儿童保育机构和家庭中的儿童。然而，在大多数情况下，日常更换尿布或擦拭儿童鼻分泌物时不需要戴手套。AAP的这一建议与CDC指南中的建议不同。本文总结了美国公共卫生服务局目前关于医护人员潜在职业暴露于HIV的管理指南。正如AAP先前建议的那样，感染HIV的儿童应不受限制地进入儿童保育中心和学校，并在其健康状况及其他传染病管理建议允许的范围内参与所有活动。由于学校无需被告知HIV感染情况，如果儿科医生告知学校其遵循不透露血源性病原体感染情况的政策，可能会有所帮助。因此，儿科医生有可能不会在表格上报告此类感染的存在。由于美国各地都有人感染HIV，这些预防HIV传播的建议应普遍适用。
