Rao Suchitra, Nyquist Ann-Christine
aDepartment of Pediatrics (Infectious Diseases), University of Colorado School of Medicine bDepartment of Community and Behavioral Health, Colorado School of Public Health, Aurora, Colorado, USA.
Curr Opin Infect Dis. 2014 Aug;27(4):342-7. doi: 10.1097/QCO.0000000000000079.
As viral respiratory infections are responsible for significant morbidity and mortality, and are associated with numerous challenges for infection control, we provide an overview of the most recent publications on healthcare-associated respiratory infections.
Populations most susceptible to respiratory viruses include neonates, immunocompromised and elderly populations. Newer polymerase chain reaction-based assays are more sensitive and are able to detect multiple respiratory viruses. The significance of virus detection among asymptomatic individuals, however, remains unclear. There is more evidence of airborne transmission of influenza, but currently N95 masks are recommended only for aerosol generating procedures. Transocular transmission of influenza has been demonstrated in the experimental setting, but further research is needed of transocular transmission of other respiratory viruses. Mandatory vaccination of healthcare workers against influenza has been shown to reduce influenza rates and patient mortality.
Infection control measures can be supplemented with use of polymerase chain reaction testing to determine causes, but the cornerstone of prevention relies on enforcing appropriate isolation measures for patients: hand hygiene; appropriate use of personal protective equipment by healthcare workers; illness screening of visitors; and influenza vaccination of healthcare workers, patients and families.
由于病毒性呼吸道感染会导致严重的发病和死亡,并给感染控制带来诸多挑战,我们对医疗保健相关呼吸道感染的最新出版物进行了概述。
最易感染呼吸道病毒的人群包括新生儿、免疫功能低下者和老年人。基于聚合酶链反应的新型检测方法更灵敏,能够检测多种呼吸道病毒。然而,无症状个体中病毒检测的意义仍不明确。有更多证据表明流感可通过空气传播,但目前仅建议在产生气溶胶的操作中使用N95口罩。在实验环境中已证实流感可通过眼结膜传播,但其他呼吸道病毒的眼结膜传播还需要进一步研究。已证明医护人员强制接种流感疫苗可降低流感发病率和患者死亡率。
可通过使用聚合酶链反应检测来补充感染控制措施以确定病因,但预防的基石在于对患者实施适当的隔离措施:手部卫生;医护人员正确使用个人防护设备;对访客进行疾病筛查;以及医护人员、患者和家属接种流感疫苗。