Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece.
J Hosp Infect. 2013 Dec;85(4):243-8. doi: 10.1016/j.jhin.2013.09.009. Epub 2013 Oct 2.
Pertussis remains a public health concern in many countries despite high vaccination coverage rates. Nosocomial outbreaks of pertussis continue to occur in neonatal units. Neonates and young infants admitted to neonatal intensive care units constitute a pool of susceptible high-risk patients given their prematurity, inadequate immune response and the fact that they are too young to have completed their primary vaccination series against pertussis. This article reviews nosocomial pertussis in neonates and infants, focusing on the role of healthcare workers (HCWs). Outbreaks in neonatal units are often traced to HCWs and are associated with serious morbidity or even a fatal outcome among susceptible young infants. A high index of suspicion is required for early recognition and isolation of patients admitted with suspected or proven pertussis, as well as for HCWs with a compatible clinical syndrome, regardless of vaccination status. Contact investigation is also essential in order to guide administration of post-exposure prophylaxis. Recommendations for a booster vaccination for HCWs are in place in several countries; however, the need of HCWs for lifelong immunity against pertussis cannot be fulfilled by the current vaccine.
尽管接种率很高，但百日咳在许多国家仍然是一个公共卫生关注点。在新生儿病房中，仍会发生百日咳的医院感染暴发。由于早产儿、免疫反应不足以及年龄太小而无法完成针对百日咳的基础疫苗系列接种，因此入住新生儿重症监护病房的新生儿和婴儿构成了易感高危患者群体。本文回顾了新生儿和婴儿的医院内百日咳，重点介绍了医护人员（HCWs）的作用。新生儿病房的暴发通常可追溯到 HCWs，并与易感婴儿中严重的发病率甚至致命后果有关。对于因疑似或确诊百日咳而入院的患者，以及具有类似临床综合征的 HCWs，无论其接种状态如何，都需要高度怀疑并进行隔离，以便早期识别。接触者调查对于指导接触后预防措施的实施也至关重要。一些国家已经制定了 HCWs 加强疫苗接种的建议；然而，当前的疫苗无法满足 HCWs 对百日咳终身免疫力的需求。
