Pró-reitoria de Saúde, Gama Filho University, Rio de Janeiro, Brazil.
Curr Opin Pulm Med. 2010 May;16(3):226-34. doi: 10.1097/MCP.0b013e328338639b.
In the last decade, descriptions of outbreaks of extensively drug-resistant strains of tuberculosis (TB) have increased concern about the nosocomial transmission of TB - a potentially life-threatening occupational respiratory infection. In addition, outbreaks of avian influenza caused by an H5N1 virus, severe acute respiratory syndrome caused by a coronavirus A and the recent pandemic caused by an H1N1 influenza virus have heightened concern about occupational infectious illnesses among workers in healthcare and agriculture.
The last decade has witnessed extensive research into the modes, patterns, determinants and extent of transmission of these illnesses. The most important findings regarding risk, determinants and preventive measures of these occupational infections and recent guidelines are reviewed in this article.
Administrative, personal and engineering measures to control respiratory infection are effective and should be implemented in healthcare facilities. The use of N95 personal respirators by healthcare workers who are caring for pulmonary TB and viral respiratory infections patients is strongly recommended. Vaccination against influenza (including H1N1) is effective and strongly recommended for healthcare workers. Ultraviolet germicidal irradiation is underused at present, despite good evidence of safety and efficacy in elimination of airborne respiratory infectious agents including TB.
在过去的十年中,广泛耐药结核分枝杆菌(TB)爆发的描述增加了人们对医院内 TB 传播的关注——这是一种潜在的危及生命的职业性呼吸道感染。此外,H5N1 病毒引起的禽流感、冠状病毒 A 引起的严重急性呼吸综合征以及最近由 H1N1 流感病毒引起的大流行,使人们对医疗保健和农业工人中的职业性传染病更加关注。
过去十年中,人们对这些疾病的传播方式、模式、决定因素和范围进行了广泛的研究。本文综述了这些职业性感染的风险、决定因素和预防措施的重要发现,以及最近的指南。
控制呼吸道感染的行政、个人和工程措施是有效的,应在医疗机构中实施。强烈建议护理肺结核和病毒性呼吸道感染患者的医护人员使用 N95 个人呼吸器。接种流感疫苗(包括 H1N1)对医护人员有效,强烈建议接种。尽管紫外线杀菌对消除包括结核分枝杆菌在内的空气传播呼吸道病原体的安全性和有效性有充分的证据,但目前仍未得到充分利用。