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罗马尼亚医护人员意外暴露于丙型肝炎病毒、乙型肝炎病毒和艾滋病病毒的管理。

Management of accidental exposure to HCV, HBV and HIV in healthcare workers in Romania.

作者信息

Malka Eyal, Streinu-Cercel Anca, Piţigoi Daniela, Bacruban Rodica

机构信息

MD, Rabin Medical Center (RMC), Hasharon Hospital, Petah Tikva, Israel.

MD, PhD, Lecturer, Department of Infectious Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, National Institute for Infectious Diseases "Prof. Dr. Matei Balş", Romania.

出版信息

Germs. 2012 Dec 1;2(4):137-41. doi: 10.11599/germs.2012.1025.

Abstract

INTRODUCTION

Accidental blood exposure in healthcare workers is an important issue worldwide. We present a study which analyzed the route of exposure, the source of infection and the post-exposure prophylaxis treatment administered.

METHOD

We performed retrospective study of occupational exposure to HBV, HCV and HIV and the subsequent post-exposure prophylaxis among healthcare workers at the National Institute of Infectious Diseases "Prof.Dr. Matei Balş", Bucharest, Romania, from December 2002 to December 2011.

RESULTS

Sixty healthcare workers with a mean age of 36 reported an occupational exposure during a period of 9 years, 54 (90%) were females and 6 (10%) were males. 48 (80%) exposed healthcare workers were nurses, 7 (11.6%) were doctors and 5 (8.3%) were medical assisting staff. In 49 (81.6%) cases the exposure was percutaneous and in 11 (18.3%) cases the exposure was mucosal/corneal. Ten (16.6%) exposed healthcare workers had insufficient levels of antibody (HBsAb) response, (below 10 mIU/mL), 6 (10%) had titers between 11 and 500 mIU/mL, 31 (51.6%) between 501-1000 mIU/mL, and 13 (21.6%) above 1000 mIU/mL).

DISCUSSION

The exposure events analysis in this study yielded similar results compared to other previous parallel studies. Minimizing risks to HCWs for acquisition of blood-borne pathogens and correct and rapid post-exposure prophylaxis treatment in case of exposure should be an integral part of the infection control and occupational health programs in all healthcare facilities.

摘要

引言

医护人员意外血液暴露是一个全球性的重要问题。我们开展了一项研究,分析了暴露途径、感染源以及所采取的暴露后预防治疗措施。

方法

我们对罗马尼亚布加勒斯特“马特伊·巴尔什教授”国家传染病研究所的医护人员在2002年12月至2011年12月期间职业暴露于乙肝病毒(HBV)、丙肝病毒(HCV)和艾滋病毒(HIV)以及随后的暴露后预防情况进行了回顾性研究。

结果

60名平均年龄为36岁的医护人员报告在9年期间有职业暴露,其中54名(90%)为女性,6名(10%)为男性。48名(80%)暴露的医护人员为护士,7名(11.6%)为医生,5名(8.3%)为医疗辅助人员。49例(81.6%)暴露为经皮暴露,11例(18.3%)为黏膜/角膜暴露。10名(16.6%)暴露的医护人员抗体(HBsAb)反应水平不足(低于10 mIU/mL),6名(10%)滴度在11至500 mIU/mL之间,31名(51.6%)在501 - 1000 mIU/mL之间,13名(21.6%)高于1000 mIU/mL。

讨论

与之前其他类似研究相比,本研究中的暴露事件分析得出了相似的结果。将医护人员感染血源性病原体的风险降至最低,以及在暴露情况下进行正确、快速的暴露后预防治疗,应成为所有医疗机构感染控制和职业健康计划的一个组成部分。

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