Drusin L M, Sohmer M, Groshen S L, Spiritos M D, Senterfit L B, Christenson W N
Arch Dis Child. 1987 Jul;62(7):690-5. doi: 10.1136/adc.62.7.690.
Seven members of staff in a paediatric intensive care unit and two of their relatives developed hepatitis A over a period of five days. A 13 year old boy who was incontinent of faeces prior to his death, was presumed to be the source of infection. Two hundred and sixty seven other members of staff underwent serological testing and were given prophylactic pooled gamma globulin. Twenty three per cent were immune before exposure. Of people born in the United States, those at highest risk of developing the disease are physicians, dentists, nurses and those under the age of 40. Of those born outside the United States, being white and under the age of 30 are the two main risk factors. Data from a questionnaire sent to 19 nurses at risk (six cases, 13 controls) suggested that sharing food with patients or their families, drinking coffee, sharing cigarettes and eating in the nurses' office in the intensive care unit were associated with an increased incidence of hepatitis. Nurses with three or four of these habits were at particular risk. The costs of screening and prophylaxis were US $64.72 per employee, while prophylaxis alone would have cost US $8.42 per employee. Assessing risk factors on the one hand and costs of prophylaxis on the other are important elements in the control of nosocomial infections.
一家儿科重症监护病房的7名工作人员及其2名亲属在5天内感染了甲型肝炎。一名13岁男孩在死前大便失禁，被认为是传染源。另外267名工作人员接受了血清学检测，并注射了预防性混合丙种球蛋白。23%的人在接触前已有免疫力。在美国出生的人中，患病风险最高的是医生、牙医、护士和40岁以下的人。在美国以外出生的人中，白人以及30岁以下是两个主要风险因素。一份发给19名有风险的护士（6例病例，13名对照）的调查问卷数据显示，与患者或其家属共用食物、喝咖啡、共享香烟以及在重症监护病房的护士办公室就餐与肝炎发病率增加有关。有三到四种这些习惯的护士风险尤其高。筛查和预防的费用为每名员工64.72美元，而仅预防一项每名员工将花费8.42美元。一方面评估风险因素，另一方面评估预防成本，是控制医院感染的重要因素。
