职业安全权利:卫生保健工作者潜伏性结核感染的流行。意大利莱切医院1年回顾性调查

Gabriele d’Ettorre, Stela Karaj, Prisco Piscitelli, Osvaldo Maiorano, Carmen Attanasi, Roberta Tornese, Eugenia Carluccio, Paolo Giannuzzi, Enrico Greco, Giancarlo Ceccarelli, Gabriella d’Ettorre, Giambattista Lobreglio, Pierpaolo Congedo, Francesco Broccolo, Alessandro Miani
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摘要

背景:预防卫生保健工作者(HCWs)的潜伏性结核病感染(LTBI)以确保“职业安全权利”是全球面临的一项特殊挑战,因为卫生保健工作者由于经常近距离接触结核病患者,在医院环境中感染结核病的风险较高。方法:回顾性研究意大利某大医院医护人员LTBI患病率与人口统计学和职业危险因素的关系。本研究纳入1461名HCWs,通过Mantoux结核菌素皮肤试验(TST)筛选LTBI,然后在阳性情况下进行干扰素γ释放试验(IGRA)验证。免疫抑制和接种bgc的工人直接进行IGRA检测。结果:4.1%的卫生保健工作者被诊断为LTBI,其患病率低于在低结核病发病率国家进行的其他研究。与较高感染频率显著相关的变量为:年龄≥40岁(OR = 3.14;95% ci: 1.13-8.74;p & lt;0.05),工作年限≥15年(OR = 4.11;95% ci: 1.48-11.43;p & lt;0.05),未接受结核病预防培训(OR = 3.46;95% ci: 1.85-6.46;p & lt;0.05)。与受过训练的医护人员相比,未受过训练的医护人员在调整年龄和服务年限后也表现出更高的LTBI风险。结论:在常规职业监测中应始终考虑对卫生保健工作者进行LTBI筛查,以便早期诊断感染并防止其发展。医院环境中的安全政策以工作人员的结核病预防培训为中心,这对于最大限度地减少卫生保健中心的LTBI发生至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Right to Occupational Safety: Prevalence of Latent Tuberculosis Infection in Healthcare Workers. A 1-Year Retrospective Survey Carried out at Hospital of Lecce (Italy)
Background: Prevention of latent tuberculosis infection (LTBI) in healthcare workers (HCWs) to ensure the “Right to Occupational Safety” is a special challenge globally, as HCWs have a higher risk of acquiring the infection in hospital settings because of frequent close exposure to patients suffering from tuberculosis (TB). Methods: Aretrospective study was performed with the aim of assessing the prevalence of LTBI related to demographical and occupational risk factors among HCWs employed in a large hospital in Italy. The study involved 1461 HCWs screened for LTBI by Mantoux tuberculin skin test (TST) and then confirmed with Interferon Gamma Release Assay (IGRA) test in case of positivity. Immunosuppressed and BGC-vaccinated workers were tested directly with IGRA. Results: LTBI was diagnosed in 4.1% of the HCWs and the prevalence resulted lower than other studies conducted in low TB incidence countries. The variables significantly linked with higher frequency of the infection were: age ≥40 years (OR = 3.14; 95% CI: 1.13–8.74; p < 0.05), length of service ≥15 years (OR = 4.11; 95% CI: 1.48–11.43; p < 0.05) and not being trained on TB prevention (OR = 3.46; 95% CI: 1.85–6.46; p < 0.05). Not trained HCWs presented a higher risk of LTBI also after adjustment for age and length of service, compared to trained HCWs. Conclusions: screening of HCWs for LTBI should be always considered in routinely occupational surveillance in order to early diagnose the infection and prevent its progression. Safety policies in hospital settings centered on workers’ training on TB prevention is crucial to minimize LTBI occurrence in HCWs.
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