医、患两者的乙肝病毒医院感染特点分析

目的探讨医务人员和手术患者HBV医院感染特点是否相同。方法在HBsAg携带者传染性定量测定的基础上,比较医、患双方HBV医院感染在易感性和感染预后、传播方式和入体血量、免疫能力和防护方法方面的差异。结果 15.7%手术患者HBsAg阳性者,HBV浓度在0-109ID/ml,9.0%的HBsAg阴性者HBV DNA阳性,病毒浓度在0-104ID/ml;乙肝疫苗接种前HBV经单层手套传播的感染阈值为105ID/ml,经双层手套传播的感染阈值为106ID/ml。乙肝疫苗接种后HBV经单层手套传播的感染阈值为108.5ID/ml,经双层手套传播的感染阈值为109.5ID/ml;使用单层手套时只有0.6%HBsAg阳性者可成为传染源,使用双层手套可使传染性消失。结论医务人员和住院患者HBV医院感染特点存在很大差异,防护措施也应有所区别。

Analysis on Characteristics of Nosocomial Hepatitis B Virus Infection Among Medical Staff and Inpatients

Objective To explore the characteristics of nosocomial HBV infection among the medical staff and patients in hospital. Methods On the basis of quantitative test of infectivity among HBsAg carriers, the different characteristics of nosocomial HBV infection were investigated.We compared the susceptibility and infection predictor,the ways of transmission,the blood volume,the immunity and protective methods between the medical staff and inpatients,respectively. Results 15.7% surgical patients were HBsAg carriers,their concentration of HBV was 0～109 ID/ml.9.0% HBsAg-negative patients were HBV DNA-positive,their concentration of HBV was 0～104 ID/ml.Before hepatitis B vaccination,the infection threshold of HBV by the single-layer gloves was 105 ID/ml,and that by double gloves was 106 ID/ml.After hepatitis B vaccination,the infection threshold of HBV by the single-layer gloves was 108.5 ID/ml,and that by double gloves was 109.5 ID/ml.Only 0.6% HBsAg-positive patients could be the source of infection by the use of single-layer gloves and their infectivity could be disappeared by double gloves. Conclusions The characteristics of HBV nosocomial infection are very different between the medical staff and inpatients and the protective measures should also be differentiated.