对西非三个国家567名医护人员意外血液暴露情况进行的一项描述性回顾性研究。

A descriptive, retrospective study of 567 accidental blood exposures in healthcare workers in three West African countries.

作者信息

Tarantola A, Koumaré A, Rachline A, Sow P S, Diallo M B, Doumbia S, Aka C, Ehui E, Brücker G, Bouvet E

机构信息

Département International et Tropical, Institut de Veille Sanitaire, Saint-Maurice Cedex, France.

出版信息

J Hosp Infect. 2005 Jul;60(3):276-82. doi: 10.1016/j.jhin.2004.11.025.

DOI:10.1016/j.jhin.2004.11.025

PMID:16021690

Abstract

We conducted a multi-centre study in West African hospital wards to document accidental blood exposure (ABE) risks in these settings, and assessed the incidence of ABE in participating healthcare workers (HCWs) retrospectively. In total, 1241 HCWs participated in the survey from 43 hospital wards. Among them, 567 (45.7%) had sustained at least one ABE with an estimated incidence of 0.33 percutaneous injuries (PCIs) and 0.04 mucocutaneous contacts (MCCs)/HCW/year in medical or intensive care personnel and 1.8 PCIs/HCW/year in surgeons. The ABE was a needlestick in 454 (80.1%) of 567 cases, a cut in 19 cases (3.4%), a splash or contact with non-intact skin in 87 cases (15.3%), and was undocumented in seven cases (1.2%). The source patient's human immunodeficiency virus (HIV) serostatus was positive in 74 cases (13.1%), negative in 65 cases (11.5%), and unknown in 416 cases (73.4%). The ABE was not notified in the ward in 392 cases (69.1%). Healthcare structures can improve HCWs' safety and reduce the stigma against HIV-infected patients by improving access to training, information, primary prevention (ABE prevention equipment) and secondary prevention (postexposure prophylaxis) of occupational infection risks.

摘要

我们在西非医院病房开展了一项多中心研究，以记录这些环境中的意外血液暴露（ABE）风险，并回顾性评估参与研究的医护人员（HCW）中ABE的发生率。共有来自43个医院病房的1241名医护人员参与了调查。其中，567人（45.7%）至少经历过一次ABE，估计医疗或重症监护人员中经皮损伤（PCI）的发生率为0.33次/医护人员/年，黏膜皮肤接触（MCC）的发生率为0.04次/医护人员/年，外科医生中PCI的发生率为1.8次/医护人员/年。在567例病例中，454例（80.1%）的ABE为针刺伤，19例（3.4%）为割伤，87例（15.3%）为飞溅或接触破损皮肤，7例（1.2%）未记录在案。源患者的人类免疫缺陷病毒（HIV）血清学状态为阳性的有74例（13.1%），阴性的有65例（11.5%），未知的有416例（73.4%）。392例（69.1%）的ABE在病房未报告。医疗保健机构可以通过改善职业感染风险的培训、信息、一级预防（ABE预防设备）和二级预防（暴露后预防）的获取途径，提高医护人员的安全性，并减少对HIV感染患者的污名化。