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推荐的预防程序可保护医护人员免受克里米亚-刚果出血热病毒感染。

Recommended precaution procedures protect healthcare workers from Crimean-Congo hemorrhagic fever virus.

机构信息

Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Cumhuriyet University, 58140 Sivas, Turkey.

出版信息

Int J Infect Dis. 2013 Nov;17(11):e1046-50. doi: 10.1016/j.ijid.2013.05.005. Epub 2013 Jun 29.

Abstract

OBJECTIVES

The Crimean-Congo hemorrhagic fever (CCHF) virus can spread from person to person and may cause nosocomial outbreaks among healthcare workers (HCWs). The US Centers for Disease Control and Prevention have recommended the use of personal protective equipment (PPE). We investigated the compliance of HCWs with PPE usage during the follow-up of patients, and also the number of risky contacts that occurred between patients and HCWs. We also aimed to determine the seroprevalence of CCHF virus in HCWs.

METHODS

This study was conducted at Cumhuriyet University Education and Research Hospital, a medical center located in a highly endemic area for CCHF where a total of 1284 confirmed CCHF patients were followed-up between 2002 and 2012. All HCWs who were at risk of CCHF virus contact and infection were included in the study. The compliance of the HCWs with PPE usage and the number of contacts that had occurred were recorded. HCW serum samples were analyzed for CCHF virus IgM and IgG by ELISA.

RESULTS

The total rates of PPE usage were 93.7% for gowns, 77.4% for gloves, and 38.9% for masks; the highest compliance was detected in the infectious diseases ward: 100%, 88.6%, and 82.9%, respectively. A total of four HCWs had a history of high-risk contact with contaminated material (two percutaneous exposure and two mucosal contacts), but the number of low-risk contacts was quite high. The total seroprevalence rate was only 0.53%.

CONCLUSIONS

Although the HCWs at our medical center have dealt with an extremely high number of CCHF patients during the last decade, the total seropositivity for CCHFV IgG was only 0.53%. This low rate may be a result of high compliance with PPE usage and also regular education programs.

摘要

目的

克里米亚-刚果出血热(CCHF)病毒可在人与人之间传播,可能导致医护人员(HCWs)发生医院感染。美国疾病控制与预防中心(CDC)建议使用个人防护装备(PPE)。我们调查了 HCWs 在对患者进行随访期间对 PPE 使用的依从性,以及患者与 HCWs 之间发生的危险接触次数。我们还旨在确定 HCWs 中 CCHF 病毒的血清流行率。

方法

这项研究在 Cumhuriyet 大学教育与研究医院进行,该医学中心位于克里米亚-刚果出血热高度流行地区,在 2002 年至 2012 年间共对 1284 例确诊的 CCHF 患者进行了随访。所有有接触和感染 CCHF 病毒风险的 HCWs 均纳入研究。记录 HCWs 对 PPE 使用的依从性和发生的接触次数。通过 ELISA 分析 HCW 血清样本以检测 CCHF 病毒 IgM 和 IgG。

结果

gown(手术衣)的 PPE 使用总率为 93.7%,手套为 77.4%,口罩为 38.9%;传染病病房的依从性最高:分别为 100%、88.6%和 82.9%。共有 4 名 HCWs 有接触受污染材料的高风险史(2 例为经皮暴露,2 例为粘膜接触),但低风险接触次数相当高。总血清阳性率仅为 0.53%。

结论

尽管我们的医疗中心的 HCWs 在过去十年中处理了大量的 CCHF 患者,但 CCHFV IgG 的总血清阳性率仅为 0.53%。这种低比率可能是由于对 PPE 使用的高度依从性和定期的教育计划。

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