Shriyan Amrita, Roche R
Department of Microbiology, A. J. Institute of Medical Sciences, Kuntikan, Mangalore, Karnataka, India.
Indian J Sex Transm Dis AIDS. 2012 Jul;33(2):91-7. doi: 10.4103/0253-7184.102111.
Occupational exposure to Hepatitis B virus (HBV), human immunodeficiency virus (HIV) and Hepatitis C virus (HCV) infection is a cause of concern to all health care workers (HCWs), especially those, in hospitals. Among the HCWs, nurses, interns, technicians, resident doctors and housekeeping staff have the highest incidence of occupational exposure.
To analyze the cases of needle stick injuries and other exposures to patient's blood or body fluids among health care workers.
A detailed account of the exposure is documented which includes incidence of needle stick injuries (NSI) and implementation of post-exposure prophylaxis (PEP) as per the hospital guidelines. We report a two-year continuing surveillance study where 255 health care workers (HCWs) were included. PEP was given to HCWs sustaining NSI or exposures to blood and body fluids when the source is known sero-positive or even unknown where the risk of transmission is high. Follow-up of these HCW's was done after three and six months of exposure.
Of the 255 HCWs, 59 sustained needle stick injuries and two were exposed to splashes. 31 of the NSI were from known sources and 28 from unknown sources. From known sources, thirteen were seropositive; seven for HIV, three for HCV and three for HBV. Nineteen of them sustained needle stick during needle re-capping, six of them during clean up, six of them while discarding into the container, 17 during administration of injection, eight of them during suturing, two occurred in restless patient, 17 during needle disposal.
So far, no case of sero-conversion as a result of needle stick injuries was reported at our center.
医护人员职业暴露于乙肝病毒（HBV）、人类免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV）感染是所有医护人员，尤其是医院医护人员关注的问题。在医护人员中，护士、实习生、技术人员、住院医生和保洁人员职业暴露的发生率最高。
分析医护人员针刺伤及其他接触患者血液或体液的案例。
记录详细的暴露情况，包括针刺伤（NSI）的发生率以及按照医院指南实施的暴露后预防（PEP）措施。我们报告了一项为期两年的持续监测研究，共纳入255名医护人员。当源为已知血清阳性或传播风险高但来源不明时，对发生针刺伤或接触血液和体液的医护人员给予PEP。在暴露后三个月和六个月对这些医护人员进行随访。
在255名医护人员中，59人发生针刺伤，2人接触到飞溅物。31例针刺伤的源为已知，28例来源不明。已知源中，13例血清阳性；7例为HIV，3例为HCV，3例为HBV。其中19人在针头重新盖帽时发生针刺伤，6人在清理过程中发生，6人在丢弃到容器时发生，17人在注射给药时发生，8人在缝合时发生，2人在患者躁动时发生，17人在针头处理时发生。
到目前为止，我们中心尚未报告因针刺伤导致血清转化的病例。
