综合性医院医务工作者结核分枝杆菌感染现状及职业防护

目的了解综合性医院医务工作者结核分枝杆菌（TB）感染现状及职业防护措施,分析影响因素,为综合性医疗机构结核病职业防护管理策略提供科学依据。方法采用横断面研究方法对河南省郑州市中心医院各临床科室医务工作者进行社会人口学特征、健康状况和职业防护方式的问卷调查和结核菌素皮肤试验（TST）。TB感染的影响因素分析采用单变量logistic回归和多变量逐步logistic回归,将单变量logistic回归分析中P〈0.10的变量纳入多变量logistic回归模型。采用SPSS 17.0软件对数据进行统计分析。结果 325名临床相关科室的医务工作者中,结核分枝杆菌感染率为34.2%,未发现现症肺结核患者。经多因素logistic回归分析发现,临床工作岗位（OR=2.26,95%CI：1.33~3.83）、艾滋病门诊、病房工作史（OR=6.39,95%CI：1.26~32.51）和早餐习惯（OR=3.87,95%CI：1.40~10.73）是医务工作者结核分枝杆菌感染的影响因素。结论综合性医疗机构医务工作者是结核分枝杆菌感染的重点人群,尤其应该重视其中某些高风险科室的医院感染预防控制,建立常态化的医务工作者结核分枝杆菌感染状态的体检监测制度和医疗机构内部结核病院内感染控制的评估机制。

Tubercle bacillus infection and occupational protection among health care workers in Central Hospital

Objective To understand the current status of tubercle bacillus（TB）infection and to analyze its influencing factors among health care workers（HCWs）,in order to provide scientific evidence for disease prevention and control. Methods Cross sectional study was conducted and a questionnaire survey was performed among total 325 HCWs from various clinical departments of Zhengzhou Central Hospital in terms of their demographic traits,health status and occupational protection.Tuberculin skin tests（TST）was given to all subjects.Single and multi-variable logistic regression were used for influencing factor analysis.Data was statistically analyzed by SPSS 17.0software. Results The overall TB infection rate was found to be as high as 34.2%among 325HCWs surveyed.No tuberculosis active case was spotted.Multi-variable regression analysis showed that TB infection rate varied among HCWs working in different departments,or having experience of working with patients or with different breakfast habit,which were considered to be major influencing factors of TB infection（OR=2.26,95%CI：1.33-3.83）（OR=6.39,95%CI：1.26-32.51）（OR=3.87,95% CI：1.40-10.73）. Conclusions HCWs are at high risk of TB infection,especially those working in specific departments.Therefore,regular TB check is critical for the prevention of TB transmission.