医务人员高暴露人群严重急性呼吸综合征隐性感染与工作强度和工种的相关性研究

目的　了解密切接触严重急性呼吸综合征 (SARS)患者的医护人员隐性感染的发生情况 ,及其与工作强度和工种之间的关系。方法　对北京中日友好医院密切接触SARS患者的 112 7名医务人员和 92名对照者的血清进行冠状病毒抗体 (IgG、IgM)酶联免疫吸附测定法 (ELISA)检测。并调查抗体阳性者周围密切接触者 313名的临床表现。结果　 112 7名SARS病区工作的医务人员 :男2 87名 ,女 84 0名 ;年龄 2 1～ 5 5岁 ,平均年龄 (34± 9)岁。对照组和医务人员上岗前所测冠状病毒抗体均为阴性 ,上岗后冠状病毒抗体阳性者共 2 9名 ,阳性率 2 5 7% (2 9/ 112 7)。特异性抗体的阳性率与工种和病区的关系结果提示 :抗体阳性的护士 2 1名 ,抗体阳性率占护士上岗人数的 3 4 6 % (2 1/ 6 0 7) ;医师、医技人员 6名 ,阳性率占其上岗人数的 1 4 1% (6 / 4 2 6 ) ;督导 2名 ,阳性率占其上岗人数的 2 86 %(2 / 70 )。ICU病区的 130名工作人员中抗体阳性者 10名 ,阳性率为 7 6 9% (10 / 130 ) ,占 2 9名抗体阳性者的 34 5 % (10 / 2 9) ;其他病区人员 19名 ,占 6 5 5 % (19/ 2 9)。 2 9名抗体阳性医务人员的周围密切接触者 313名 ,无一名发病或有临床症状。结论　密切接触SARS患者的医护人员有隐性感染的发生 ,隐性感染者从流行病学

Covert infection of severe acute respiratory syndrome in health-care professionals and its relation to the workload and the type of work

OBJECTIVE: To study severe acute respiratory syndrome (SARS) covert infection in health-care professionals and its relation to work intensity and type of work. METHODS: Specific antibodies to SARS virus in 1 127 serum specimens from health-care professionals who had a close contact history with patients of SARS and 92 healthy persons were assayed with ELISA. RESULTS: The health-care professionals consisted of 287 men and 840 women, aged 21 - 55 years (mean 34 +/- 9 years). The overall positive rate of specific IgG and IgM was 2.57% (29/1 127); the positive rates in nurses, doctors and laboratory workers, and supervisors were 3.46%, 1.41%, 2.86%, respectively. 34.5% of the infected worked in the ICU, and 65.5% in the general wards. None of them presented clinical SARS. Medical examination was also carried out for 313 people who had close contact with the 29 antibody positive health care professionals, but no clinical SARS was found. CONCLUSIONS: Covert infection can be found in the health-care professionals and it showed no contagiousness. The positive rate of specific antibodies was higher in ICU where the work intensity was higher. The positive rate in nurses was higher than in doctors.