Impact of Bordetella pertussis exposures on a Massachusetts tertiary care medical system
Impact of Bordetella pertussis exposures on a Massachusetts tertiary care medical system
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DOI：
10.1086/518352
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发表时间：
2007-06-01
影响因子：
4.5
通讯作者：
Ellison, Richard T.
中科院分区：
文献类型：
--
作者：
Zivna, Iva;Bergin, Diana;Ellison, Richard T.
目标。评估百日咳杆菌感染暴发对三级护理医疗系统的影响。回顾研究。设置。学术三级护理医疗中心及附属门诊护理设施。2003年10月1日至2004年9月30日期间与实验室确诊的百日咳杆菌感染患者有密切接触的所有患者和医护人员。干预。确定了直接和间接医疗中心成本，包括在实验室确认的百日咳暴发病例暴发调查期间评估和管理暴露患者和医务工作者所花费的时间的低和高估计。在此期间，发生了20例初级百日咳杆菌感染和3例经实验室确认的继发性百日咳病例，其中2例初级百日咳病例和1例继发性病例发生在卫生院。疫情调查促使353名医疗中心员工进行了筛查。对296名医务工作者进行了可能或确定的暴露，287人随后接受了百日咳杆菌感染的治疗或预防。医疗中心用于治疗和预防的直接成本为13,416美元，人员时间成本为19,500-31,190美元。间接医疗中心因工作时间损失造成的成本为51,300-52,300美元。这些调查的总成本估计为85,066-98,456美元。百日咳杆菌的频繁暴露对我们的设施产生了重大影响。鉴于暴露对医疗机构的影响，对卫生工作者进行常规疫苗接种可能是有益的。
Objective. To assess the impact of outbreaks of Bordetella pertussis infection on a tertiary care medical system.Design. Retrospective study.Setting. Academic tertiary care medical center and affiliated ambulatory care settings.Subjects. All patients and healthcare workers (HCWs) who were in close contact with patients with laboratory-confirmed cases of B. pertussis infection from October 1, 2003, through September 30, 2004.Intervention. Direct and indirect medical center costs were determined, including low and high estimates of time expended in the evaluation and management of exposed patients and HCWs during outbreak investigations of laboratory-confirmed cases of B. pertussis infection.Results. During this period, 20 primary and 3 secondary laboratory-confirmed cases of B. pertussis infection occurred, with 2 primary pertussis cases and 1 secondary case occurring in HCWs. Outbreak investigations prompted screening of 353 medical center employees. Probable or definitive exposure was identified for 296 HCWs, and 287 subsequently received treatment or prophylaxis for B. pertussis infection. Direct medical center costs for treatment and prophylaxis were $13,416 and costs for personnel time were $19,500-$31,190. Indirect medical center costs for time lost from work were $51,300-$52,300. The total cost of these investigations was estimated to be $85,066-$98,456.Conclusions. Frequent B. pertussis exposures had a major impact on our facility. Given the impact of exposures on healthcare institutions, routine vaccination for HCWs may be beneficial.