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应用全血干扰素释放试验评估韩国医护工作者中潜伏性结核的流行情况和危险因素。

Prevalence and risk factors of latent tuberculosis among Korean healthcare workers using whole-blood interferon-γ release assay.

机构信息

Infection Control Unit, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.

出版信息

Sci Rep. 2018 Jul 4;8(1):10113. doi: 10.1038/s41598-018-28430-w.

Abstract

Because healthcare workers (HCWs) are at high risk for tuberculosis (TB) infection, it is essential to research the prevalence of latent TB infection (LTBI) and to implement health interventions including early treatment of LTBI and TB infection control measures. The purpose of the study was to determine the prevalence and risk factors for LTBI using interferon-γ release assay (IGRA) among HCWs in South Korea. The cross-sectional study was carried in the National Health Insurance Service Ilsan Hospital, which is a 740-bed general hospital, South Korea. HCWs who participated in this survey were required to complete a questionnaire and IGRA was performed. Of the 1,655 HCWs, 271 results were positive and the prevalence of LTBI was 16% (95% CI; 15-18%). In the multivariate analysis, age (OR; 2.201, 95% CI; 1.911-2.536, P < 0.001), male sex (OR; 1.523, 95% CI; 1.133-2.046, P = 0.005), contact active TB patients (OR; 1.461, 95% CI; 1.061-2.010, P = 0.02) and diabetes (OR; 2.837, 95% CI; 1.001-8.044, P = 0.05) were significant risk factors for LTBI. LTBI among HCWs in Korea, although prevalent, might not exceed the background level of the general population. Because contact with active TB patients has been identified as a risk factor for LTBI, more effective TB infection control measures are essential in healthcare facilities and congregate settings.

摘要

由于医护人员(HCWs)感染结核病(TB)的风险较高,因此研究潜伏性结核病感染(LTBI)的流行情况并实施健康干预措施,包括早期治疗 LTBI 和结核病感染控制措施,至关重要。本研究旨在使用干扰素-γ释放试验(IGRA)确定韩国 HCWs 中的 LTBI 患病率和危险因素。这项横断面研究在韩国一家拥有 740 张病床的综合医院——韩国保健福祉部国立健康保险服务 Ilsan 医院进行。参与该调查的 HCWs 需要完成一份问卷,并进行 IGRA 检测。在 1655 名 HCWs 中,有 271 人结果呈阳性,LTBI 的患病率为 16%(95%CI;15-18%)。在多变量分析中,年龄(OR;2.201,95%CI;1.911-2.536,P<0.001)、男性(OR;1.523,95%CI;1.133-2.046,P=0.005)、接触活动性结核病患者(OR;1.461,95%CI;1.061-2.010,P=0.02)和糖尿病(OR;2.837,95%CI;1.001-8.044,P=0.05)是 LTBI 的显著危险因素。韩国 HCWs 中的 LTBI 虽然流行,但可能并未超过一般人群的背景水平。由于接触活动性结核病患者已被确定为 LTBI 的危险因素,因此在医疗机构和聚集场所需要采取更有效的结核病感染控制措施。

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