结核菌素纯蛋白衍化物检测医院内结核感染风险  

Clinical significance of tuberculin purified protein derivative in test of Mycobacterium tuberculosis infection in hospital

作　　者：周颖[1] 陈娴洁[1] 周志英[1] 

机构地区：[1]上海市徐汇区中心医院医院感染管理科,上海200031

出　　处：《中华医院感染学杂志》2014年第17期4418-4420,共3页Chinese Journal of Nosocomiology

基　　金：上海市徐汇医学科研基金项目(SHXH201204)

摘　　要：目的利用经济、成熟、操作性强的简便技术分析和探讨医院内工作人员结核感染的危险因素,为基层医疗机构结核病医院感染的控制提供科学依据。方法采用分组对照研究方法,观察医院工作人员组与普通人群对照组对结核菌素纯蛋白衍化物(PPD)检测的反应。结果医院工作人员组PPD阳性率73.4%明显高于对照组50.5%(P<0.001);在医院工作人员中,非临床工作者与临床工作者PPD反应差异无统计学意义;涉及呼吸道疾病科室的工作人员PPD阳性率明显高于其他科室(P<0.05);护工PPD强阳性率32.8%明显高于医师14.9%(P<0.05);医院工作≥11年组的PPD反应明显强于≤2年(P<0.05)。结论基层医疗机构工作人员感染结核的危险性高于普通人群,不同科室、工作岗位的医院工作人员受结核感染的危险性不同;在医院内,无论是否从事临床工作,其受结核感染的概率基本相同;随着医院工作年限增长,结核感染危险性增加;PPD检测方法成熟、简单、经济,易于在基层医疗机构执行。OBJECTIVE To analyze the risk factors for tuberculosis infections among healthcare workers by using economical, mature, and highly workable technique so as to provide scientific basis for control of nosocomial infections in the grass-roots medical institutions. METHODS By means of case-control study, the health care workers and common population＇s reactions to the tuberculin purified protein derivative （PPD） were observed. RESULTS The positive rate of PPD of the health care workers group was 73.4%, significantly higher than 50.5% of the control group （P〈0. 001）; among the health care workers, there was no significant difference in the reaction to PPD between the clinical staff and the non-clinical staff. The positive rate of PPD of the health care worker in the involving respiratory diseases departments was significantly higher than that of the health care workers in other departments （P〈0.05）. The positive rate of PPD of the nursing workers was 32.8%, significantly higher than 14. 9% of the clinicians （P〈0.05）. The reaction to PPD of the health care workers with no less than 11 years of work experience in hospital was significantly stronger than that of those with no more than 2 years of work experience （P〈0.05）. CONCLUSION The health care workers in the grass-roots medical institutions are at higher risk of tuberculosis infection than the common population; the health care workers in different departments and positions vary in the risk of tuberculosis infection. In the hospital, no matter they are engaged in the clinical work, the risk of the tuberculosis infection is basically same. With the increase of work life, the risk of tuberculosis infection is increased. The PPD test is mature, simple, and economical, and it is. easy to be promoted in the grass-roots medical institutions.

关 键 词：结核菌素纯蛋白衍化物 医院工作人员 结核感染 

分 类 号：R446[医药卫生—诊断学]