Child Health Evaluative Sciences, Research Institute of the Hospital for Sick Children, Toronto, Ontario, Canada.
Infect Control Hosp Epidemiol. 2009 Nov;30(11):1084-9. doi: 10.1086/644755.
To examine the impact of different acellular pertussis booster vaccination strategies on the probability of a nosocomial pertussis outbreak occurring and the distribution of outbreak sizes observed for each intervention strategy.
Neonatal intensive care unit.
We developed a stochastic, agent-based simulation model to examine the impact of booster vaccination strategies for pertussis on health care-related transmission.
Our results demonstrate that healthcare worker booster vaccination decreases the probability of secondary transmission from 49% (base case, no boosting) to 2% (if 95% of healthcare workers are boosted) and decreases final outbreak size. Boosting family caregivers did not have a clinically significant impact on nosocomial disease transmission.
The provision of booster vaccine to healthcare workers in the neonatal intensive care unit substantially reduces the risk of hospital-centered pertussis outbreaks in a manner that enhances the health of hospitalized children. A formal health economic analysis of this finding is currently under way. Policies to protect patient safety in pediatric facilities should include compliance with the United States Advisory Committee on Immunization Practices, which recommends provision of pertussis booster vaccination to healthcare workers.
研究不同的无细胞百日咳加强免疫接种策略对医院百日咳暴发概率和观察到的暴发规模分布的影响。
新生儿重症监护病房。
我们开发了一个随机的、基于代理的模拟模型，以研究加强免疫接种策略对与保健相关的传播的影响。
我们的研究结果表明，医护人员加强免疫接种将继发传播的概率从 49%（基础情况，不加强）降低到 2%（如果 95%的医护人员加强），并降低最终暴发规模。加强对家庭照顾者的免疫接种对医院内疾病传播没有明显的临床影响。
为新生儿重症监护病房的医护人员提供加强疫苗可显著降低以增强住院儿童健康的方式发生医院为中心的百日咳暴发的风险。目前正在对这一发现进行正式的健康经济分析。保护儿科设施中患者安全的政策应包括遵守美国免疫实践咨询委员会的建议，即向医护人员提供百日咳加强免疫接种。
