2024年重庆市基层医务人员结核分枝杆菌潜伏感染现状及影响因素分析  

Prevalence and influencing factors of latent tuberculosis infection among grassroots medical staff of Chongqing in 2024

作　　者：庞艳 吴成果 汪清雅 罗建奎 赵静 王嘉涌 冯鑫瑜 PANG Yan;WU Chengguo;WANG Qingya;LUO Jiankui;ZHAO Jing;WANG Jiayong;FENG Xinyu(Institute of Tuberculosis Prevention and Treatment of Chongqing,Chongqing 400050,China;Nanchuan Institute of Tuberculosis Prevention and Treatment,Nanchuan 408400,Chongqing,China;Liangping Center for Disease Control and Prevention,Liangping 405200,Chongqing,China;Fuling Institute of Tuberculosis Prevention and Treatment,Fuling 408000,Chongqing,China;Pengshui Institute of Tuberculosis Prevention and Treatment,Pengshui 409600,Chongqing,China)

机构地区：[1]重庆市结核病防治所,重庆400050 [2]重庆市南川区结核病防治所,重庆南川408400 [3]重庆市梁平区疾病预防控制中心,重庆梁平405200 [4]重庆市涪陵区结核病防治所,重庆陵408000 [5]彭水县结核病防治所,重庆彭水409600

出　　处：《寄生虫病与感染性疾病》2025年第1期1-7,共7页Parasitoses and Infectious Diseases

基　　金：重庆市科卫联合医学科研项目(项目编号:2024MSXM140);重庆市公共卫生重点专科(学科)建设项目。

摘　　要：目的调查2024年重庆市基层医务人员结核分枝杆菌潜伏感染(latent tuberculosis infection,LTBI)现状,分析其影响因素,为制定基层医务人员结核感染防控措施与政策提供依据。方法按照分层随机抽样方法选取重庆市4个基层医疗卫生机构为调查对象,2024年3至6月用重组结核分枝杆菌融合蛋白(recombinant mycobacterium tuberculosis fusion protein,EC)皮肤试验检测LTBI情况,并通过问卷调查获取医务人员LTBI影响因素。采用Excel 2016软件对数据进行清理和汇总,应用SPSS 25.0软件进行统计分析。计数资料的比较采用χ^(2)或χ_(趋势)^(2)检验,将单因素分析中P<0.05的变量纳入多因素Logistic回归方程分析,检验水准α=0.05。结果共纳入358名基层医务人员,LTBI率33.80%,强阳率11.17%。单因素分析结果显示,基层医务人员LTBI率与年龄、是否吸烟、肺结核疫情分区、每年是否进行胸部影像学结核病检查有关(P均<0.05)。多因素Logistic回归分析结果显示,41~50岁(OR=4.229,95%CI:2.035~8.790)、51~60岁(OR=7.218,95%CI:3.062~17.012)、肺结核高疫情区(OR=8.231,95%CI:3.852~17.588)为基层医务人员LTBI的独立危险因素,每年进行胸部影像学结核病检查的医务人员LTBI风险相对较低(OR=0.426,95%CI:0.247~0.734)。结论2024年重庆市基层医务人员LTBI率较高,需重点关注年龄较大、肺结核高疫情区的医务人员,提升基层医务人员结核病认知和防护意识,减少基层医疗卫生机构结核感染和传播。Objective To investigate the status of latent tuberculosis infection(LTBI)among grassroots medical staff in Chongqing in 2024 and analyze its related influencing factors,so as to provide scientific basis for formulating measures and policies on prevention and control of tuberculosis infection for grassroots medical staff.Methods Stratified random sampling method was used to select staff from 4 grassroots medical and health institutions in Chongqing as survey subjects.From March to June in 2024,the recombinant mycobacterium tuberculosis fusion protein(EC)skin test was used to detect LTBI status,and the influencing factors of LTBI among medical staff was obtained through a questionnaire survey.Excel 2016 software was used to clean and summarize the data,and SPSS 25.0 software was applied for statistical analysis.The comparison of count data was conducted by using either χ^(2)or χ_(trend)^(2).Variables with P<0.05 were included in the multivariate Logistic regression equation analysis,with a test level ofα=0.05.Results A total of 358grassroots medical personnel were included,the LTBI rate was 33.80%,and the strong positive rate was 11.17%.The results of univariate analysis showed that the LTBI rate of grassroots medical staff was related to age,whether they smoked,division of tuberculosis epidemic situation,and whether it was carrired out annual chest imaging tuberculosis examination(all P<0.05).The results of multivariate Logistic regression analysis showed that age 41-50 years old(OR=4.229,95%CI:2.035-8.790),51-60 years old(OR=7.218,95%CI:3.062-17.012),and areas with high tuberculosis prevalence(OR=8.231,95%CI:3.852-17.588)were independent risk factors for LTBI among grassroots medical staff.The risk of LTBI of medical staff who perform annual chest imaging tuberculosis examination was relatively low(OR=0.426,95%CI:0.247-0.734).Conclusions The grassroots medical staff's LTBI rate was high in Chongqing in 2024.It is necessary to focus on medical staff in the elderly and high epidemic areas,improve tuberculosis a

关 键 词：肺结核 潜伏感染 医务人员 影响因素 

分 类 号：R52[医药卫生—内科学] R181.3[医药卫生—临床医学]