Kamal Amany Talaat, Farres Mohamed Nazmy, Eissa Abeer Mohamed, Arafa Naglaa Ahmed, Abdel-Reheem Raafat Saad
Department of Internal Medicine, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Saudi J Kidney Dis Transpl. 2017 Jan-Feb;28(1):107-114. doi: 10.4103/1319-2442.198162.
Egypt has the highest worldwide prevalence of hepatitis C virus (HCV) infection, caused in part by nosocomial transmission. Patients on hemodialysis (HD) are at especially high risk of infection. We aimed to estimate the incidence of seroconversion among HCV-negative patients undergoing regular HD at a unit in a large public hospital in the Nile Delta of Egypt, which implements the Egyptian Ministry of Health guidelines for infection control, and an isolation policy for hepatitis-positive patients. We also assessed the adherence to infection control practices and evaluated nurses and physicians' knowledge and attitude toward infection control procedures. Records of HCV-negative patients undergoing regular HD at the unit from August 2008 to August 2010 were reviewed retrospectively for data on HCV status. Patients were then followed up until September 2011, when polymerase chain reaction was performed for all patients. Infection control practices were evaluated by four checklists applied monthly and analyzed by control charts. Nurses and physicians' knowledge and attitudes toward infection control were assessed by interview questionnaires. Of 60 patients followed up, there was one case of HCV seroconversion giving an incidence rate of 0.676/100 person-years of follow-up (95% confidence interval: 0.017-3.76). There were no cases of hepatitis B virus seroconversion. The mean scores of all the infection control practices' checklists were very high and generally remained above the lower control limit over the 12-month period. Physicians and nurses achieved very high scores on knowledge and attitude on infection control (mean score >95%). This public facility had a low seroconversion rate and high adherence to infection control guidelines.
埃及是全球丙型肝炎病毒（HCV）感染率最高的国家，部分原因是医院内传播。接受血液透析（HD）的患者感染风险尤其高。我们旨在估计在埃及尼罗河三角洲一家大型公立医院的一个科室中，接受定期血液透析的HCV阴性患者的血清转化发生率，该科室执行埃及卫生部的感染控制指南以及对肝炎阳性患者的隔离政策。我们还评估了对感染控制措施的依从性，并评估了护士和医生对感染控制程序的知识和态度。回顾性审查了2008年8月至2010年8月在该科室接受定期血液透析的HCV阴性患者的记录，以获取HCV状态数据。然后对患者进行随访，直到2011年9月，此时对所有患者进行聚合酶链反应检测。通过每月应用的四份检查表评估感染控制措施，并通过控制图进行分析。通过访谈问卷评估护士和医生对感染控制的知识和态度。在随访的60例患者中，有1例发生HCV血清转化，随访的人年发病率为0.676/100（95%置信区间：0.017 - 3.76）。没有乙型肝炎病毒血清转化病例。所有感染控制措施检查表的平均得分都很高，并且在12个月期间总体上保持在控制下限以上。医生和护士在感染控制知识和态度方面的得分非常高（平均得分>95%）。这家公共机构的血清转化率较低，对感染控制指南的依从性较高。
