Lot F, Séguier J C, Fégueux S, Astagneau P, Simon P, Aggoune M, van Amerongen P, Ruch M, Cheron M, Brücker G, Desenclos J C, Drucker J
Réseau National de Santé Publique, Saint-Maurice, France.
Ann Intern Med. 1999 Jan 5;130(1):1-6. doi: 10.7326/0003-4819-130-1-199901050-00002.
Transmission of HIV from infected health care workers to patients has been documented in only one cluster involving 6 patients of a dentist in Florida. In October 1995, the French Ministry of Health offered HIV testing to patients who had been operated on by an orthopedic surgeon in whom AIDS was recently diagnosed.
To determine whether the surgeon transmitted HIV to patients during operations.
Epidemiologic investigation.
The practice of an orthopedic surgeon in a French public hospital.
1 surgeon and 983 of his former patients.
3004 patients who had undergone invasive procedures were contacted by mail for counseling and HIV testing. One HIV-positive patient was interviewed, and DNA sequence analysis was performed to compare the genetic relation of the patient's and the surgeon's viruses. Infection-control precautions and the surgeon's practices were assessed.
Of 983 patients in whom serologic status was ascertained, 982 were HIV negative and 1 was HIV positive. The HIV-positive patient, a woman born in 1925, tested negative for HIV before placement of a total hip prosthesis with bone graft (a prolonged operation) performed by the surgeon in 1992. She had no identified risk for HIV exposure. Molecular analysis indicated that the viral sequences obtained from the surgeon and the HIV-infected woman were closely related. Infection-control precautions were in accordance with recommendations, but blood contact between the surgeon and his patients occurred commonly during surgical procedures.
An HIV-infected surgeon may have transmitted HIV to one of his patients during surgery.
有文献记载，仅在佛罗里达州一名牙医感染艾滋病毒并传染给6名患者这一群体感染事件中，出现过受感染医护人员将艾滋病毒传染给患者的情况。1995年10月，法国卫生部为一名最近被诊断出患有艾滋病的骨科外科医生的手术患者提供了艾滋病毒检测。
确定该外科医生在手术过程中是否将艾滋病毒传染给了患者。
流行病学调查。
法国一家公立医院的一名骨科外科医生的诊所。
1名外科医生及其983名曾接受其治疗的患者。
通过邮件联系了3004名接受过侵入性操作的患者，为其提供咨询和艾滋病毒检测。对一名艾滋病毒呈阳性的患者进行了访谈，并进行了DNA序列分析，以比较该患者与外科医生的病毒的基因关系。评估了感染控制预防措施和外科医生的操作规范。
在983名确定血清学状态的患者中，982名艾滋病毒呈阴性，1名艾滋病毒呈阳性。这名艾滋病毒呈阳性的患者是一名1925年出生的女性，1992年由该外科医生为其进行全髋关节置换术并植骨（一项长时间手术）前艾滋病毒检测呈阴性。她没有明确的艾滋病毒暴露风险。分子分析表明，从外科医生和感染艾滋病毒的女性身上获得的病毒序列密切相关。感染控制预防措施符合建议，但外科医生与患者在手术过程中经常发生血液接触。
一名感染艾滋病毒的外科医生可能在手术过程中将艾滋病毒传染给了他的一名患者。
