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中国苏州医护人员潜伏性结核感染的危险因素与免疫功能

Risk factors of latent tuberculosis infection and immune function in health care workers in Suzhou, China.

作者信息

Shi Cui-Lin, Xu Jun-Chi, Chen Hui, Ye Zhi-Jian, Chen Xin-Nian, Tang Pei-Jun, Ma Li-Ling, Tang Zai-Xiang, Wu Mei-Ying, Xu Ping

机构信息

Key Laboratory of Tuberculosis Prevention and Therapy, The Fifth People's Hospital of Suzhou, Suzhou 215000, China.

Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou 215123, China.

出版信息

J Thorac Dis. 2018 Dec;10(12):6742-6752. doi: 10.21037/jtd.2018.10.112.

DOI:10.21037/jtd.2018.10.112
PMID:30746219
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6344678/
Abstract

BACKGROUND

The Chinese government has pay attention about tuberculosis infection among medical staff in infectious disease hospitals, but the effects have not yet been reported. This study will explore latent infection and immune function in the medical staff and systematically analyze the associated influencing factors.

METHODS

Ninety-four medical staffs were enrolled and 20 medical staffs were defined as low risk group and others were high risk group. We used IFN-γ release assay and flow cytometry to analyze the latent TB infection status and immune function. Logistic regression analyses were performed to identify the independent risk factors of latent TB infection.

RESULTS

This study explored and compared the infection status of medical workers and found that the rate of positive TB-IGRA results was higher among high risk group than in low risk group. Working environment, occupational history and work type were risk factors for TB infection in hospital. This study also found that high risk group had higher IFN-γ expression and a lower ratio of CD4+ to CD8+ T cells and further analysis found that this immune disorder is associated with wards and occupations.

CONCLUSIONS

This study through rigorous sample collection and analysis found the risk factors of latent tuberculosis infection in health care workers. This finding may provide a theoretical basis to be used by the countries with a high TB burden to further improve their strategies for the prevention of TB infections in hospitals and may give an indication for improving the personal health of medical staff in infectious disease hospitals.

摘要

背景

中国政府已关注传染病医院医护人员中的结核病感染情况,但相关影响尚未见报道。本研究将探讨医护人员的潜伏感染及免疫功能,并系统分析相关影响因素。

方法

纳入94名医护人员,将20名医护人员定义为低风险组,其他为高风险组。采用γ-干扰素释放试验和流式细胞术分析潜伏结核感染状况及免疫功能。进行逻辑回归分析以确定潜伏结核感染的独立危险因素。

结果

本研究对医护人员的感染状况进行了探索和比较,发现高风险组结核感染T细胞检测阳性率高于低风险组。工作环境、职业史和工作类型是医院内结核感染的危险因素。本研究还发现,高风险组γ-干扰素表达较高,CD4+与CD8+T细胞比值较低,进一步分析发现这种免疫紊乱与病房及职业有关。

结论

本研究通过严格的样本采集和分析,发现了医护人员潜伏结核感染的危险因素。这一发现可为结核病负担较高的国家进一步完善医院结核病感染预防策略提供理论依据,并为改善传染病医院医护人员的个人健康状况提供参考。