Implementation of tuberculosis infection control measures in designated hospitals in Zhejiang Province, China: are we doing enough to prevent nosocomial tuberculosis infections?
Implementation of tuberculosis infection control measures in designated hospitals in Zhejiang Province, China: are we doing enough to prevent nosocomial tuberculosis infections?
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DOI：
10.1136/bmjopen-2015-010242
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发表时间：
2016-03-03
期刊：
影响因子：
2.9
通讯作者：
Jiang J
中科院分区：
文献类型：
--
作者：
Chen B;Liu M;Gu H;Wang X;Qiu W;Shen J;Jiang J
结核病(TB)感染控制措施对于预防医院内传播和保护医院医护人员非常重要。东南部中国地区结核病治疗机构结核病感染控制情况此前未见研究。因此，本研究的目的是调查浙江省结核病定点医院结核病感染控制措施的落实情况，中国说。横断面调查采用观察法和访谈法。浙江省所有结核病定点医院(n=88)，中国，2014年。采用描述性分析和单因素Logistic回归分析对管理、行政、环境和个人感染控制措施进行评估。结核病指定医院每年平均治疗3030名门诊患者(IQR764-7094)和279名确诊结核病患者(IQR154-459)，160名结核病患者(IQR79-426)在结核病病房住院。大多数感染控制措施是由结核病指定的医院执行的。一些措施有时被忽视，包括定期监测高危地区的结核病感染控制(49%)、缩短等待时间(42%)以及为疑似结核病患者提供单独的候诊区(46%)。85家医院(97%)提供了N95呼吸器，但只有44家医院(50%)检查是否合适。拥有更多结核病工作人员和更高结核病患者入院率的医院更有可能设立专门的痰收集区域，并每年进行呼吸器适配性测试。结核病控制措施一般由结核病定点医院实施。应加强措施，包括隔离疑似患者，定期监测感染控制做法，以及定期对呼吸器进行适合性测试。在肺结核病人入院率较低的医院，应加强痰标本采集和呼吸机适合性检测的感染措施。
Tuberculosis (TB) infection control measures are very important to prevent nosocomial transmission and protect healthcare workers (HCWs) in hospitals. The TB infection control situation in TB treatment institutions in southeastern China has not been studied previously. Therefore, the aim of this study was to investigate the implementation of TB infection control measures in TB-designated hospitals in Zhejiang Province, China. Cross-sectional survey using observation and interviews. All TB-designated hospitals (n=88) in Zhejiang Province, China in 2014. Managerial, administrative, environmental and personal infection control measures were assessed using descriptive analyses and univariate logistic regression analysis. The TB-designated hospitals treated a median of 3030 outpatients (IQR 764–7094) and 279 patients with confirmed TB (IQR 154–459) annually, and 160 patients with TB (IQR 79–426) were hospitalised in the TB wards. Most infection control measures were performed by the TB-designated hospitals. Measures including regular monitoring of TB infection control in high-risk areas (49%), shortening the wait times (42%), and providing a separate waiting area for patients with suspected TB (46%) were sometimes neglected. N95 respirators were available in 85 (97%) hospitals, although only 44 (50%) hospitals checked that they fit. Hospitals with more TB staff and higher admission rates of patients with TB were more likely to set a dedicated sputum collection area and to conduct annual respirator fit testing. TB infection control measures were generally implemented by the TB-designated hospitals. Measures including separation of suspected patients, regular monitoring of infection control practices, and regular fit testing of respirators should be strengthened. Infection measures for sputum collection and respirator fit testing should be improved in hospitals with lower admission rates of patients with TB.