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医务人员接触丙型肝炎病毒污染体液后的血清转换率:匹兹堡大学 13 年的经验。

Seroconversion rates among health care workers exposed to hepatitis C virus-contaminated body fluids: The University of Pittsburgh 13-year experience.

机构信息

Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.

University of Pittsburgh School of Medicine, Pittsburgh, PA.

出版信息

Am J Infect Control. 2017 Sep 1;45(9):1001-1005. doi: 10.1016/j.ajic.2017.03.011. Epub 2017 Apr 24.

Abstract

BACKGROUND

Hepatitis C virus (HCV) transmission to health care personnel (HCP) after exposure to a HCV-positive source has been reported to occur at an average rate of 1.8% (range, 0%-10%). We aimed to determine the seroconversion rate after exposure to HCV-contaminated body fluid in a major U.S. academic medical center.

METHODS

A longitudinal analysis of a prospectively maintained database of reported occupational injuries occurring between 2002 and 2015 at the University of Pittsburgh Medical Center was performed. Data collected include type of injury and fluid, injured body part, contamination of sharps, resident physicians' involvement, and patients' hepatitis B virus (HBV), HCV, and HIV status.

RESULTS

A total of 1,361 cases were included in the study. Most exposures were caused by percutaneous injuries (65.0%), followed by mucocutaneous injuries (33.7%). Most (63.3%) were injuries to the hand, followed by the face and neck (27.6%). Blood exposure accounted for 72.7%, and blood-containing saliva accounted for 3.4%. A total of 6.9% and 3.7% of source patients were coinfected with HIV and HBV, respectively. The HCV seroconversion rate was 0.1% (n = 2) because of blood exposure secondary to percutaneous injuries.

CONCLUSIONS

This study provides the largest and most recent cohort from a major U.S. academic medical center. The seroconversion rates among HCP exposed to HCV-contaminated body fluids was found to be lower than most of the data found in the literature.

摘要

背景

据报道,在接触 HCV 阳性源后,医护人员(HCP)感染丙型肝炎病毒(HCV)的平均传播率为 1.8%(范围为 0%-10%)。我们旨在确定在美国一家主要学术医疗中心,接触 HCV 污染体液后的血清转化率。

方法

对 2002 年至 2015 年期间匹兹堡大学医学中心报告的职业伤害前瞻性维护数据库进行了纵向分析。收集的数据包括损伤类型和液体、受伤部位、锐器污染、住院医师参与情况以及患者乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)和 HIV 状态。

结果

共有 1361 例病例纳入研究。大多数暴露是由锐器伤引起的(65.0%),其次是黏膜皮肤损伤(33.7%)。大多数(63.3%)是手部损伤,其次是面部和颈部(27.6%)。血液暴露占 72.7%,含血液的唾液占 3.4%。共有 6.9%和 3.7%的源患者分别合并感染 HIV 和 HBV。由于锐器伤引起的血液暴露,HCV 血清转化率为 0.1%(n=2)。

结论

本研究提供了来自美国主要学术医疗中心的最大和最新队列。接触 HCV 污染体液的 HCP 中血清转化率低于文献中的大多数数据。

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