A contact investigation of the transmission of Mycobacterium tuberculosis from a nurse working in a newborn nursery and maternity ward
A contact investigation of the transmission of Mycobacterium tuberculosis from a nurse working in a newborn nursery and maternity ward
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DOI：
10.1007/s10156-007-0565-0
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发表时间：
2008-02-01
影响因子：
2.2
通讯作者：
Miyanomae, Ken
中科院分区：
文献类型：
--
作者：
Ohno, Hitoshi;Ikegami, Yumiko;Miyanomae, Ken
一名在新生儿托儿所和产科病房工作的护士患上了3+涂片阳性肺结核。医院感染控制委员会与当地公共卫生和福利中心合作，进行了接触调查。感染期定义为2006年4月至8月。调查包括109对婴儿和母亲，28名10岁以下的儿童及其监护人，62名同事和63名家庭访客。婴儿和5岁以下儿童的结核感染主要通过结核菌素皮肤试验（TST）确定，而5岁或以上的受试者则使用QuantiFERON-TB Gold（QFT）进行测试。第一次调查于2006年8月在所有对象中进行，第二次调查于2006年10月针对选定的对象进行。无婴儿TST阳性。两名1岁或1岁以下的儿童接种卡介苗后，根据日本防结核协会的标准，TST呈阳性;然而，其他结核病检查呈阴性。在13名QFT阳性成人受试者中，1名母亲和2名同事可能通过接触索引护士感染结核分枝杆菌。54名婴儿和6名儿童接受了“窗口期”预防治疗，4名成人完成了6个月的异烟肼预防治疗。迄今为止，没有发生继发性结核病病例。
A nurse working in a newborn nursery and maternity ward developed 3+ smear-positive lung tuberculosis. The hospital infection control committee, in collaboration with the local public health and welfare center, conducted a contact investigation. The infection period was defined as April to August 2006. The investigation included 109 infant and mother pairs, 28 children aged under 10 years and their guardians, 62 coworkers, and 63 household visitors to the ward. Tuberculosis infection in infants and children aged under 5 years was primarily determined by tuberculin skin test (TST), while subjects aged 5 years or more were tested using QuantiFERON-TB Gold (QFT). The first investigation, in August 2006, was conducted in all subjects, and the second investigation, in October 2006, targeted selected subjects. No infants were TST-positive. Two children aged 1 year or under, vaccinated with bacillus Calmette-Guerin, were positive for TST, as determined by the criteria of the Japan Anti-Tuberculosis Association; however, other tests for tuberculosis were negative. Of the 13 QFT-positive adult subjects, 1 mother and 2 coworkers could have become infected with Mycobacterium tuberculosis through exposure to the index nurse. Fifty-four infants and 6 children underwent "window-period" prophylaxis, and 4 adults completed 6-month prophylactic treatment with isoniazid. To date, no secondary cases of tuberculosis disease have occurred.