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儿科医院医护人员与百日咳;一项血清流行率研究。

Pediatric hospital healthcare workers and pertussis; a seroprevalence study.

机构信息

Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylul University Faculty of Medicine, İzmir, Turkey.

出版信息

Turk J Pediatr. 2021;63(3):355-362. doi: 10.24953/turkjped.2021.03.002.

Abstract

BACKGROUND

This study aimed to assess pertussis seroprevalence among healthcare workers (HCWs) of a university children`s hospital and to determine their opinions on whether to get the pertussis vaccine booster dose in adulthood.

METHODS

This cross-sectional study was carried out between January 2018 and March 2019. Data recording forms were filled by the face to face interview method. Anti-pertussis toxin IgG (Anti-PT IgG) antibody levels were determined quantitatively from the serum samples using a commercial enzyme-linked immunosorbent assay (ELISA) kit. Anti-PT IgG results were interpreted according to World Health Organization (WHO) recommendations.

RESULTS

Of the 169 HCWs included in the study, 67 (39.6%) were seronegative and susceptible to pertussis. Seropositivity was significantly higher among HCWs who worked 40-80 hours per week. Thirty-six (21.3%) HCWs had high anti-PT IgG levels, indicating recent infection in the past few years. High-level positivity was significantly more common among HCWs using macrolide antibiotics due to prolonged cough. Anti-PT IgG levels of three (1.8%) were compatible with acute infection and they were not followed up with suspicion of whooping cough and were not isolated. While 125 (74.0%) of the participants said they could get the pertussis vaccine booster dose, only three (1.8%) had done so.

CONCLUSIONS

The fact that 39.6% of HCWs were seronegative, emphasized the need for the pertussis booster dose. More than 20% of HCWs have had the acute infection without pertussis diagnosis in the past few years. Adult vaccination awareness in HCWs has not yet created a change in behavior. The high rate of seropositivity in macrolide users also shows that we cannot prevent its spread despite treatment. These findings highlight the fact that pertussis can occur in adult age groups and that eradication cannot be achieved without effective adult immunization and surveillance.

摘要

背景

本研究旨在评估一所大学儿童医院医护人员(HCWs)的百日咳血清流行率,并确定他们对成年后是否接种百日咳加强疫苗的看法。

方法

这是一项横断面研究,于 2018 年 1 月至 2019 年 3 月期间进行。通过面对面访谈的方式填写数据记录表。使用商业酶联免疫吸附试验(ELISA)试剂盒从血清样本中定量测定抗百日咳毒素 IgG(Anti-PT IgG)抗体水平。根据世界卫生组织(WHO)的建议解释 Anti-PT IgG 结果。

结果

在纳入研究的 169 名 HCWs 中,有 67 名(39.6%)血清阴性且易患百日咳。每周工作 40-80 小时的 HCWs 的血清阳性率明显更高。36 名(21.3%)HCWs 具有高水平的 Anti-PT IgG,表明过去几年中有近期感染。由于持续咳嗽而长期使用大环内酯类抗生素的 HCWs 中,高水平阳性更为常见。3 名(1.8%)的 Anti-PT IgG 水平与急性感染相符,他们未被怀疑患有百日咳,也未被隔离。尽管 125 名(74.0%)参与者表示他们可以接种百日咳加强疫苗,但只有 3 名(1.8%)已接种。

结论

39.6%的 HCWs 血清阴性,这一事实强调了接种百日咳加强疫苗的必要性。过去几年中,超过 20%的 HCWs 发生过未被诊断为百日咳的急性感染。HCWs 对成人疫苗接种的认识尚未改变行为。大环内酯类药物使用者的高血清阳性率也表明,尽管进行了治疗,但我们仍无法阻止其传播。这些发现强调了百日咳可能发生在成年人群中,并且如果没有有效的成人免疫和监测,就无法实现百日咳的消除。

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