学龄前家庭接触者作为医护人员病毒性呼吸道感染的一个风险因素

Preschool-Aged Household Contacts as a Risk Factor for Viral Respiratory Infections in Healthcare Personnel.

作者信息

Most Zachary M, Nyquist Ann-Christine, Radonovich Lewis J, Rodriguez-Barradas Maria C, Price Connie Savor, Simberkoff Michael S, Bessesen Mary T, Cummings Derek A T, Rattigan Susan M, Warren-Gash Charlotte, Gaydos Charlotte A, Gibert Cynthia L, Gorse Geoffrey J, Perl Trish M

机构信息

Pediatric Infectious Diseases Program, Children's Health System of Texas, Dallas, Texas, USA.

Division of Infectious Disease, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

出版信息

Open Forum Infect Dis. 2023 Feb 8;10(2):ofad057. doi: 10.1093/ofid/ofad057. eCollection 2023 Feb.

DOI:10.1093/ofid/ofad057

PMID:36824623

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9942663/

Abstract

BACKGROUND

Viral respiratory infections (VRIs) are common and are occupational risks for healthcare personnel (HCP). VRIs can also be acquired at home and other settings among HCPs. We sought to determine if preschool-aged household contacts are a risk factor for VRIs among HCPs working in outpatient settings.

METHODS

We conducted a secondary analysis of data from a cluster randomized trial at 7 medical centers in the United States over 4 influenza seasons from 2011-2012 to 2014-2015. Adult HCPs who routinely came within 6 feet of patients with respiratory infections were included. Participants were tested for respiratory viruses whenever symptomatic and at 2 random times each season when asymptomatic. The exposure of interest was the number of household contacts 0-5 years old (preschool-aged) at the beginning of each HCP-season. The primary outcome was the rate of polymerase chain reaction-detected VRIs, regardless of symptoms. The VRI incidence rate ratio (IRR) was calculated using a mixed-effects Poisson regression model that accounted for clustering at the clinic level.

RESULTS

Among the 4476 HCP-seasons, most HCPs were female (85.4%) and between 30 and 49 years of age (54.6%). The overall VRI rate was 2.04 per 100 person-weeks. In the adjusted analysis, HCPs having 1 (IRR, 1.22 [95% confidence interval {CI}, 1.05-1.43]) and ≥2 (IRR, 1.35 [95% CI, 1.09-1.67]) preschool-aged household contacts had higher VRI rates than those with zero preschool-aged household contacts.

CONCLUSIONS

Preschool-aged household contacts are a risk factor for developing VRIs among HCPs working in outpatient settings.

摘要

背景

病毒性呼吸道感染（VRIs）很常见，是医护人员（HCP）的职业风险。VRIs也可能在家庭和医护人员的其他场所感染。我们试图确定学龄前家庭接触者是否是门诊环境中工作的医护人员发生VRIs的危险因素。

方法

我们对2011 - 2012年至2014 - 2015年期间美国7个医疗中心在4个流感季节进行的一项整群随机试验的数据进行了二次分析。纳入了经常与呼吸道感染患者保持6英尺以内距离的成年医护人员。有症状时对参与者进行呼吸道病毒检测，无症状时每个季节随机检测2次。感兴趣的暴露因素是每个医护人员季节开始时0 - 5岁（学龄前）的家庭接触者数量。主要结局是聚合酶链反应检测到的VRIs发生率，无论有无症状。使用考虑了诊所层面聚类的混合效应泊松回归模型计算VRI发病率比（IRR）。

结果

在4476个医护人员季节中，大多数医护人员为女性（85.4%），年龄在30至49岁之间（54.6%）。总体VRI发生率为每100人周2.04例。在调整分析中，有1名（IRR，1.22 [95%置信区间{CI}，1.05 - 1.43]）和≥2名（IRR，1.35 [95% CI，1.09 - 1.67]）学龄前家庭接触者的医护人员的VRI发生率高于无学龄前家庭接触者的医护人员。