检验科医源性感染的危险因素分析与预防控制

Risk factors for iatrogenic infections in clinical laboratory and control measures

目的探讨检验科医源性感染的危险因素及预防控制措施,指导临床控制检验科医源性感染的发生。方法回顾性分析2007-2012年检验科医源性感染患者41例,详细记录医源性感染患者感染途径及感染性疾病的种类。结果共分析患者1 648例,其中发生检验科医源性感染患者41例,医源性感染的发生率为2.49%,其中检验科医护人员感染8例占19.51%,其他科室医护人员6例占14.63%,患者感染23例占56.10%,保洁员感染4例占9.76%;发生医源性感染的41例患者中18例为体液及粪便感染占43.90%,12例为血源性感染占29.27%,4例为化学试剂感染占9.76%,7例为其他途径感染占17.07%;发生医源性感染的41例患者中甲型肝炎感染12例占29.27%,乙型肝炎感染3例占7.32%,丙型肝炎感染11例占26.83%,戊型肝炎感染6例占14.63%,梅毒感染4例占9.76%,结核分枝杆菌感染5例占12.19%。结论检验科医护人员应加强对各种医源性感染的认识和理解,提高医护工作人员的思想意识,改善检验科的工作环境,加强对医疗废弃物的规范处理,规范检验报告的清洁,防范和控制检验科医源性感染的发生。

OBJECTIVE To explore the risk factors for iatrogenic infections in clinical laboratory and put forward the control measures so as to provide guidance for clinical control of the iatrogenic infections in the clinical laboratory.METHODS From 2007 to 2012,a total of 41 patients with iatrogenic infections in the clinical laboratory were retrospectively analyzed,the routes of infections and the types of infectious diseases were recorded in detail.RESULTS Of totally 1 648 patients investigated,41 cases had the iatrogenic infections in the clinical laboratory,with the incidence of iatrogenic infections of 2.49%,including 8（19.51%）medical staff of clinical laboratory,6（14.63%）health care workers in other departments,23（56.10%）patients,and 4（9.76%）cleaning staff.Among the 41 patients with iatrogenic infections,18（43.90%）cases were infected through body fluid and stools,12（29.27%）cases infected through blood borne,4（9.76%）cases infected through chemical reagents,7（17.07%）cases infected through other routes.Among the 41 patients with iatrogenic infections,there were 12（29.27%）cases of hepatitis A infection,3（7.32%）cases of hepatitis B infection,11（26.83%）cases of hepatitis C infection,6（14.63%）cases of hepatitis E infection,4（9.76%）cases of syphilis infection,and 5（12.19%）cases of Mycobacterium tuberculosis infection.CONCLUSIONIt is necessary for the medical staff in the clinical laboratory to strengthen the awareness and understanding of the iatrogenic infections,raise the ideology of the health care workers,improve the working environment of the clinical laboratory,intensify the standard disposal of medical waste,and standardize the cleaning of inspection report so as to control the iatrogenic infections in the clinical laboratory.