Pei Li-ying, Gao Zhan-cheng, Yang Zhen, Wei Dong-guang, Wang Shi-xin, Ji Jian-min, Jiang Bao-guo
Department of Emergency, Peking University People's Hospital, Beijing 100044, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2006 Jun 18;38(3):271-5.
To investigate the protective factors and risk factors of nosocomial infection of severe acute respiratory syndrome (SARS) among health care workers (HCWs), and thus provide the scientific basis for prevention and control of nosocomial infection.
With the case-control study, a standardized questionnaire was used for data collection in three general hospitals where nosocomial infection had occurred. Univariate analysis was done at first. All concerned factors about SARS infection were scanned by using Chi-square test and Fisher's exact test one by one, and determined as to whether they were risk factors or protective factors according to odd ratio (OR) score. Then, multivariate unconditional logistic regression analysis was used to re-analyze the picked-out factors for finding out which factors played independent roles.
Twenty-two factors (nineteen protective factors and three risk factors), among the total fifty-six factors, were significantly associated with SARS infection. Multivariate unconditional logistic regression revealed that factors such as double exposure suits (OR=0.053), education (OR=0.072), gloves (OR=0.102), hands sterilized by iodine (OR=0.231), room air ventilation (OR=0.32), were significantly protective; conversely, tracheal intubation (OR=30.793) was a significant risk factor.
Strict defense and antisepsis measures were pivotal in preventing SARS infection among high-risk medical personnel. Education about associated knowledge and effective air ventilation were also important factors.
探讨医护人员严重急性呼吸综合征(SARS)医院感染的保护因素和危险因素,为医院感染的预防与控制提供科学依据。
采用病例对照研究,在3所发生医院感染的综合医院,使用标准化问卷收集资料。首先进行单因素分析,将所有与SARS感染有关的因素逐一用卡方检验和Fisher确切概率法进行筛选,根据比值比(OR)值确定其为危险因素或保护因素。然后,采用多因素非条件logistic回归分析对筛选出的因素进行再分析,找出起独立作用的因素。
56个因素中,有22个因素(19个保护因素和3个危险因素)与SARS感染有显著关联。多因素非条件logistic回归显示,双层防护服(OR=0.053)、学历(OR=0.072)、手套(OR=0.102)、碘液洗手(OR=0.231)、病房通风(OR=0.32)等因素有显著保护作用;相反,气管插管(OR=30.793)是显著危险因素。
严格的防护和消毒措施对预防高危医务人员感染SARS至关重要。相关知识教育和有效的空气流通也是重要因素。