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

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

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。

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.