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阿根廷布宜诺斯艾利斯大学医院中感染新型甲型H1N1流感病毒的医护人员。

Healthcare personnel infected with novel influenza A H1N1 virus in university hospitals in Buenos Aires, Argentina.

作者信息

Querci Marcia, Stryjewski Martin E, Herrera Fabián, Temporiti Elena, Alcalá Wanda, Chavez Natalia, Figueras Laura, Barberis Fernanda, Echavarría Marcela, Videla Cristina, Martínez Alfredo, Carballal Guadalupe, Bonvehí Pablo

机构信息

Division of Infectious Diseases, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC), Buenos Aires, Argentina.

出版信息

Scand J Infect Dis. 2011 Jan;43(1):70-4. doi: 10.3109/00365548.2010.515244. Epub 2010 Sep 21.

Abstract

Data on the clinical presentation, risk factors, and outcomes for healthcare personnel (HCP) infected with influenza A H1N1 virus (H1N1) are limited. From June to July 2009, a prospective study was conducted among HCP with influenza-like illness (ILI) at university hospitals in Buenos Aires. A reverse transcription polymerase chain reaction (RT-PCR) was used to diagnose H1N1. A logistic regression model was developed to identify factors associated with H1N1. Among 1519 HCP, 96 (6.3%) were diagnosed with an ILI. Of these, 85 (88.5%) were swabbed for H1N1 detection, with 43 positive cases (2.8%). Seasonal influenza immunization was recorded in 76%. Comparison of H1N1-positive vs. H1N1-negative cases showed that H1N1-positive cases more frequently had asthenia (72% vs. 48%, p = 0.03) and cough (79% vs. 43%, p = 0.008) and less frequently had diarrhoea (9% vs. 29%, p = 0.03) and prior prophylaxis with oseltamivir (5% vs. 31%, p = 0.002). The logistic regression model showed that presence of cough (odds ratio (OR) 6.93, 95% confidence interval (CI) 2.24, 21.4) was associated with an increased risk of H1N1. Prior prophylaxis with oseltamivir (OR 0.08, 95% CI 0.01, 0.43) was associated with a lower probability of H1N1 infection. A high proportion of HCP with an ILI were infected with H1N1. Complication rates were relatively low. Prior prophylaxis with oseltamivir was associated with a lower risk of developing H1N1.

摘要

关于感染甲型H1N1流感病毒(H1N1)的医护人员的临床表现、危险因素及预后的数据有限。2009年6月至7月,在布宜诺斯艾利斯的大学医院对出现流感样疾病(ILI)的医护人员进行了一项前瞻性研究。采用逆转录聚合酶链反应(RT-PCR)诊断H1N1。建立了逻辑回归模型以确定与H1N1相关的因素。在1519名医护人员中,96人(6.3%)被诊断为ILI。其中,85人(88.5%)接受了H1N1检测拭子采样,43例呈阳性(2.8%)。76%的人记录了季节性流感疫苗接种情况。H1N1阳性病例与H1N1阴性病例的比较显示,H1N1阳性病例更常出现乏力(72%对48%,p = 0.03)和咳嗽(79%对43%,p = 0.008),较少出现腹泻(9%对29%,p = 0.03)和先前使用奥司他韦进行预防(5%对31%,p = 0.002)。逻辑回归模型显示,咳嗽的存在(比值比(OR)6.93,95%置信区间(CI)2.24,21.4)与H1N1风险增加相关。先前使用奥司他韦进行预防(OR 0.08,95% CI 0.01,0.43)与较低的H1N1感染概率相关。很大一部分出现ILI的医护人员感染了H1N1。并发症发生率相对较低。先前使用奥司他韦进行预防与较低的发生H1N1风险相关。

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