Almuneef M A, Memish Z A, Balkhy H H, Otaibi B, Helmi M
Department of Infection Prevention and Control, National Guard Health Affairs, King Abdulaziz Medical City-King Fahad National Guard Hospital, Riyadh, Saudi Arabia.
Infect Control Hosp Epidemiol. 2006 Nov;27(11):1178-83. doi: 10.1086/508826. Epub 2006 Oct 17.
To determine the prevalence of the vaccine-preventable diseases caused by varicella, measles, rubella, and hepatitis A and B viruses in a multinational healthcare workforce.
Prospective cohort study.
A 750-bed tertiary care center located in Riyadh, Saudi Arabia.
In compliance with hospital policy, newly recruited healthcare workers (HCWs) were enrolled in the study from September 2001 to March 2005. Serum samples were collected from all HCWs during the initial hiring process and tested for IgG antibodies against each of the 5 viral agents. Nonimmune HCWs were subsequently vaccinated at the earliest opportunity.
A total of 4,006 newly hired (international and local) employees were included in the study. All underwent serologic testing for IgG antibodies against varicella, measles, rubella, hepatitis A, and hepatitis B viruses. Of the total, 63% were female and 37% were male. Middle Eastern employees comprised 47% of the total, followed by employees from the Far East (35%), the West (10%), and Africa (8%). Forty-two percent were nurses, 27% were in administration, 18% were medical technicians, and 13% were physicians. Among the 4,006 newly hired HCWs, 14% had negative IgG antibody test results for varicella virus, 13% for measles virus, 10% for rubella virus, 33% for hepatitis A virus, and 43% for hepatitis B virus. More women than men were susceptible to hepatitis A (40% vs. 24%; P<.001), whereas more men were susceptible to hepatitis B (55% vs. 35%; P<.001). Varicella susceptibility was more common among HCWs from the Far East (19%), whereas susceptibility to measles, rubella, hepatitis A, and hepatitis B was highest among HCWs from the Middle East. Both relative youth and male sex were associated with lack of antibodies against hepatitis B virus and rubella virus. In contrast, female sex and younger age were associated with lack of antibodies against hepatitis A virus (P<.001).
Seroprevalence surveys of vaccine-preventable diseases among HCWs, although labor intensive, are invaluable in caring for a multinational workforce.
确定多国医护人员中由水痘、麻疹、风疹以及甲型和乙型肝炎病毒引起的可通过疫苗预防疾病的流行情况。
前瞻性队列研究。
位于沙特阿拉伯利雅得的一家拥有750张床位的三级护理中心。
按照医院政策，2001年9月至2005年3月期间新招聘的医护人员纳入本研究。在最初招聘过程中采集所有医护人员的血清样本，检测针对5种病毒病原体中每一种的IgG抗体。随后，对无免疫力的医护人员尽早进行疫苗接种。
本研究共纳入4006名新招聘（国际和本地）员工。所有人都接受了针对水痘、麻疹、风疹、甲型肝炎和乙型肝炎病毒的IgG抗体血清学检测。其中，63%为女性，37%为男性。中东地区员工占总数的47%，其次是远东地区员工（35%）、西方员工（10%）和非洲员工（8%）。42%为护士，27%从事行政工作，18%为医学技术人员，13%为医生。在4006名新招聘的医护人员中，14%的人水痘病毒IgG抗体检测结果为阴性，麻疹病毒为13%，风疹病毒为10%，甲型肝炎病毒为33%，乙型肝炎病毒为43%。女性比男性更易感染甲型肝炎（40%对24%；P<0.001），而男性更易感染乙型肝炎（55%对35%；P<0.001）。水痘易感性在远东地区的医护人员中更为常见（19%），而麻疹、风疹、甲型肝炎和乙型肝炎的易感性在中东地区的医护人员中最高。相对年轻和男性性别均与缺乏乙型肝炎病毒和风疹病毒抗体有关。相反，女性性别和较年轻年龄与缺乏甲型肝炎病毒抗体有关（P<0.001）。
医护人员中可通过疫苗预防疾病的血清流行率调查虽然劳动强度大，但对于照顾多国医护人员群体非常重要。
