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山东大学学报 (医学版) ›› 2022, Vol. 60 ›› Issue (4): 107-112.doi: 10.6040/j.issn.1671-7554.0.2021.1352

• • 上一篇    

山东省部分结核病定点医院护理人员潜伏感染现状及风险因素分析

李艳丽1,李燕2,佘凯丽3,刘盈3,刘伟娟1,李秀君3,刘英慧1   

  • 发布日期:2022-04-22
  • 通讯作者: 刘英慧. E-mail:290984072@qq.com李秀君. E-mail:xjli@sdu.edu.cn
  • 基金资助:
    山东省医药卫生科技发展计划面上项目(2017WS290)

Prevalence and risk factors of latent tuberculosis infection among nursing staff in some designated hospitals in Shandong Province

LI Yanli1, LI Yan2, SHE Kaili3, LIU Ying3, LIU Weijuan1, LI Xiujun3, LIU Yinghui1   

  1. 1. Department of Nursing, Shandong Public Health Clinical Center, Jinan 250013, Shandong, China;
    2. Department of Infection, Shandong Public Health Clinical Center, Jinan 250013, Shandong, China;
    3. Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China
  • Published:2022-04-22

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摘要： 目的 探讨山东省部分结核病定点医院护理人员潜伏结核感染(LTBI)现状及风险因素,为LTBI高危人群管理和减少职业感染提供科学依据。 方法 以抽样点2018年1月至2019年12月在结核病定点医院工作的631名护理人员为调查对象,设计调查问卷,进行横断面调查。 结果 山东省部分定点医院护理人员LTBI率为17.43%。单因素分析结果显示,文化程度、单位类型、从事结核病防治工作年限、家庭中有人患过结核、工作地点有统计学意义(P<0.05);多因素二分类 Logistic回归分析结果显示,随着从事结核病防治工作年限的增加,感染结核菌的风险增加,以工作2年以内的人员为参考,工作6~10年其风险增加3.12倍(OR=3.12, 95%CI: 1.21~8.03),10年以上其风险增加5.33倍(OR=5.33, 95%CI: 2.17~13.09);若家庭中有人患过结核,其感染的风险增加4.10倍(OR=4.10, 95%CI: 2.26~7.41)。 结论 山东省部分定点医院护理人员LTBI率接近普通人群,LTBI风险随着护理人员从事结核病防治工作年限增加以及家庭中有人患结核病而上升,作为职业暴露人群,应对这部分LTBI人员优先实施干预性预防措施,阻断其发展为活动性结核病。

关键词: 结核病, 潜伏结核感染, 感染控制, γ-干扰素释放试验

Abstract: Objective To investigate the prevalence and risk factors of latent tuberculosis infection(LTBI)among nursing staff in some designated hospitals in Shandong Province and provide scientific basis for the management of LTBI high-risk groups and reduction of occupational infection. Methods A questionnaire was designed for 631 nurses working in the designated tuberculosis hospitals from January 2018 to December 2019 and a cross-sectional survey was conducted. Results The latent infection rate was 17.43%. Univariate analysis indicated that education level, unit type, working years related to tuberculosis control, family members having history of tuberculosis and working place had statistical significance(P<0.05). Multivariate binary Logistic regression analysis indicated that the risk of tuberculosis infection increased with the increase of working years related to tuberculosis control. With 2-year as a reference, the risk of working for 6-10 years increased by 3.12 times(OR=3.12, 95%CI: 1.21-8.03), and the risk of working for more than 10 years increased by 5.33 times(OR=5.33, 95%CI: 2.17-13.09); if there were TB cases in family, the risk of infection could be 4.10 times higher(OR=4.10, 95%CI: 2.26-7.41). Conclusion The latent infection rate of nurses in some designated hospitals in Shandong Province is close to that of the general population. LTBI risk increases significantly as caregivers increase their years of tuberculosis control and have family members who have a history of tuberculosis. Preventive measures should be givn priority to the occupational exposed group to block the development of active tuberculosis.

Key words: Tuberculosis, Latent tuberculosis infection, Infection control, Interferon-gamma release assay

中图分类号: 

  • R574
[1] World Health Organization. Global tuberculosis report: executive summary 2020 [EB/OL].(2020-10-14)[2021-09-20]. https://www.who.int/tb/publications/global_report/TB20_Exec_Sum_20201014.pdf.
[2] Shea KM, Kammerer JS, Wineton NCA, et al. Estimated rate of reactivation of latent tuberculosis infection in the United States, overall and by population subgroup [J]. Am J Epidemiol, 2014, 179(2): 216-225.
[3] Gao L, Li X, Liu J, et al. Incidence of active tuberculosis in individuals with latent tuberculosis infection in rural China: follow-up results of a population-based, multicentre, prospective cohort study [J]. Lancet Infect Dis, 2017, 17(10): 1053-1061.
[4] Behr MA, Edelstein PH, Ramakrishnan L. Revisiting the timetable of tuberculosis [J]. BMJ, 2018, 362: k2738. doi: 10.1136/bmj.k2738.
[5] World Health Organization. Guidelines on the management of latent tuberculosis infection [EB/OL].(2015-01)[2021-09-20]. https://apps.who.int/iris/handle/10665/136471.
[6] World Health Organization. Latent tuberculosis infection: updated and consolidated guidelines for programmatic management [EB/OL].(2018-04)[2021-09-20]. https://apps.who.int/iris/handle/10665/260233.
[7] Lalvani A. Diagnosing tuberculosis infection in the 21st century: new tools to tackle an old enemy [J]. Chest, 2007, 131(6): 1898-1906.
[8] 中华人民共和国国家卫生和计划生育委员会. WS 196-2017, 结核病分类[S].北京:中国标准出版社, 2017.
[9] 中华人民共和国国家卫生和计划生育委员会. WS 288-2017. 肺结核诊断[S].北京:中国标准出版社, 2017.
[10] He GX, Wang LX, Chai SJ, et al. Risk factors associated with tuberculosis infection among health care workers in Inner Mongolia, China [J]. Int J Tuberc Lung Dis, 2012, 16(11): 1485-1491.
[11] Zhang LF, Liu XQ, Zhang Y, et al. A prospective longitudinal study evaluating a T-cell-based assay for latent tuberculosis infection in health-care workers in a general hospital in Beijing [J]. Chin Med J(Engl), 2013, 126(11): 2039-2044.
[12] Zhang X, Jia H, Liu F, et al. Prevalence and risk factors for latent tuberculosis infection among health care workers in China: a cross-sectional study [J]. PLoS One, 2013, 8(6): e66412.
[13] Gao L, Lu W, Bai L, et al. Latent tuberculosis infection in rural China: baseline results of a population-based, multicentre, prospective cohort study [J]. Lancet Infect Dis, 2015, 15(3): 310-319.
[14] Li X, Yang Q, Feng B, et al. Tuberculosis infection in rural labor migrants in Shenzhen, China: emerging challenge to tuberculosis control during urbanization [J]. Sci Rep, 2017, 7(1): 4457.
[15] Liu Y, Huang S, Jiang H, et al. The prevalence of latent tuberculosis infection in rural Jiangsu, China [J]. Public Health, 2017, 146: 39-45. doi: 10.1016/j.puhe.2017.01.008.
[16] Chen B, Gu H, Wang X, et al. Prevalence and determinants of latent tuberculosis infection among frontline tuberculosis healthcare workers in southeastern China: a multilevel analysis by individuals and health facilities [J]. Int J Infect Dis, 2019, 79: 26-33. doi: 10.1016/j.ijid.2018.11.010.
[17] 赵冰.医务人员结核分枝杆菌感染状况动态分析及新型ELISA诊断肺结核效能的研究[D]. 北京:中国疾病预防控制中心, 2018.
[18] Nienhaus A, Schablon A, Preisser AM, et al. Tuberculosis in healthcare workers-a narrative review from a German perspective[J]. J Occup Med Toxicol, 2014, 9(1): 9.
[19] Hung WT, Lee SS, Sy CL, et al. Prevalence of latent tuberculosis infection in BCG-vaccinated healthcare workers by using an interferon-gamma release assay and the tuberculin skin test in an intermediate tuberculosis burden country [J]. J Microbiol Immunol Infect, 2015, 48(2): 147-152.
[20] 山东省卫生健康委员会.省卫生健康委举行新闻发布会介绍我省结核病防控工作情况[EB/OL].(2021-03-24)[2021-08-01]. http://wsjkwshandonggovcn/ywdt/wndt/202103/t20210324_3558629html.
[21] He GX, van denHof S, van der Werf MJ, et al. Infection control and the burden of tuberculosis infection and disease in health care workers in china: a cross-sectional study [J]. BMC Infect Dis, 2010, 10: 313. doi: 10.1186/1471-2334-10-313.
[22] Deng Y, Liu Y, Li Y, et al. Isolation measures and protection awareness are significant for latent tuberculosis infection: a cross-sectional study based on T-SPOT.TB among health care workers in China [J]. Epidemiol Infect, 2019, 147: e120. doi: 10.1017/S0950268818002777.
[23] Guo LP, Jiang Y, Liu YM, et al. First assessment of interferon gamma release assay results among healthcare workers at a general hospital in China [J]. Clin Respir J, 2018, 12(11): 2581-2589.
[24] Belo C, Naidoo S. Prevalence and risk factors for latent tuberculosis infection among healthcare workers in Nampula Central Hospital, Mozambique [J]. BMC Infect Dis, 2017, 17(1): 408.
[25] Agaya J, Nnadi CD, Odhiambo J, et al. Tuberculosis and latent tuberculosis infection among healthcare workers in Kisumu, Kenya [J]. Trop Med Int Health, 2015, 20(12): 1797-1804.
[26] Lee SJ, Lee SH, Kim YE, et al. Risk factors for latent tuberculosis infection in close contacts of active tuberculosis patients in South Korea: a prospective cohort study [J]. BMC Infect Dis, 2014, 14: 566. doi: 10.1186/s12879-014-0566-4.
[27] Pai M, Gokhale K, Joshi R, et al. Mycobacterium tuberculosis infection in health care workers in rural India: comparison of a whole-blood interferon gamma assay with tuberculin skin testing [J]. JAMA, 2005, 293(22): 2746-2755.
[28] Herzmann C, Sotgiu G, Bellinger O, et al. Risk for latent and active tuberculosis in Germany [J]. Infection, 2017, 45(3): 283-290.
[29] Rueda ZV, Arroyave L, Marin D, et al. High prevalence and risk factors associated with latent tuberculous infection in two Colombian prisons [J]. Int J Tuberc Lung Dis, 2014, 18(10): 1166-1171.
[30] Zhang G, Zhang Y, Zhong D, et al. High prevalence of and risk factors for latent tuberculosis infection among prisoners, Tianjin, China [J]. Emerg Infect Dis, 2020, 26(3): 516-522.
[31] Chen C, Liu Q, Zhu L, et al. Vitamin D receptor gene polymorphisms on the risk of tuberculosis, a meta-analysis of 29 case-control studies [J]. PLoS One, 2013, 8(12): e83843.
[32] Mahasirimongkol S, Yanai H, Mushiroda T, et al. Genome-wide association studies of tuberculosis in Asians identify distinct at-risk locus for young tuberculosis [J]. J Hum Genet, 2012, 57(6): 363-367.
[33] Van der Eijk EA, van de Vosse E, Vandenbroucke JP, et al. Heredity versus environment in tuberculosis in twins: the 1950s United Kingdom Prophit Survey Simonds and Comstock revisited [J]. Am J Respir Crit Care Med, 2007, 176(12): 1281-1288.
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