江苏省耐药结核病定点医院结核病实验室感染控制项目评估

Assessment of the infection control program in tuberculosis laboratories of drug-resistant tuberculosis-designated hospitals in Jiangsu Province

目的 通过开展感染控制项目,提升结核病实验室感染控制水平,减少工作人员感染及环境污染风险。方法 根据世界卫生组织(WHO)《结核感染预防控制指南(2019年更新版)》等文件制定评估方案,选取江苏省南、中、北部共6家耐药定点医院的结核病实验室,从行政管理、环境工程以及个人防护等三方面,共计20项指标,持续开展评估;针对评估中的问题,不断提出并落实整改方案;收集基线评估、5次季度评估、终末评估资料进行分析。结果 6家实验室基线评估结果显示,感染控制项目总体执行率为(68.33±1.68)%,干预后5次季度评估,总体执行率依次为(80.49±1.63)%、(83.35±2.53)%、(87.93±2.91)%、(88.63±2.90)%、(89.32±3.05)%,终末评估总体执行率为(92.66±4.33)%,第3~5次季度及终末评估均高于基线水平,差异均有统计学意义(t值为4.49~5.05,P值均<0.05);与基线评估时相比,各实验室在行政管理、环境工程和个人防护三级控制层级指标均显著提升,差异均有统计学意义(t值为2.68~5.06,P值均<0.05)。结论 感染控制项目可显著提高结核病实验室感染控制水平,有效减少实验室内感染事故的发生,具有可操作性强、成本低的特点,适合向各类生物安全实验室推广。

Objective To implement infection control programs,so as to improve infection control in tuberculosis laboratories and reduce the risk of human infections and environmental contamination.Methods The protocol for assessment of tuberculosis infection control was formulated according to the World Health Organization(WHO)guidelines on tuberculosis infection prevention and control(2019 update).Tuberculosis laboratories were sampled from six drug-resistant tuberculosis-designated hospitals in southern,central and northern Jiangsu Province.A total of 20 indicators covering administrative management,environmental engineering and individual protection of tuberculosis were used for assessment of tuberculosis infection control.Revised protocols were continuously proposed and implemented based on the problems during the assessment,and all data captured from the baseline assessment,five seasonal assessments and final assessment were collected and analyzed.Results Baseline assessment showed that the overall complete rate of the tuberculosis infection control programs was 68.33%in six tuberculosis laboratories.During the five seasonal assessments,the over-all complete rates of the tuberculosis infection control programs were 80.49%,83.35%,87.93%,88.63%and 89.32%,respectively.During the final assessment,the overall complete rate of the tuberculosis infection control programs was 92.66%,which increased by 24.33%relative to baseline assessment(t=4.49,P<0.05).In addition,the indicators pertaining to administrative management,envi-ronmental engineering and individual protection of tuberculosis all increased significantly during the final assessment than during the baseline assessment(t=2.68 to 5.06,all P values<0.05).Conclusion Infection control programs may remarkably improve infection control in tuberculosis laboratories and effectively reduce the risk of tuberculosis infections in laboratories.The programs are character-ized by high operability and low cost,which is suitable for widespread applications in biosafety laboratories.