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目的调查某诊所发生的一起结核杆菌医院感染事件,分析其流行特点和发生原因,为加强医院感染管理提供依据。方法对某医院结核杆菌感染事件开展现场调查,描述流行状况,采用病例对照研究分析流行病学病因,采集感染灶脓液标本检测结核杆菌。结果采集46例患者78份感染局部病灶脓液标本进行结核杆菌检测,其中32例感染者的48份标本结核杆菌阳性。59例病例及其124处感染部位均有过针灸治疗。病例对照研究结果显示,针灸治疗经历次数差异有统计学意义(P<0.05);感染发生与针灸频次有关联(P<0.05);药物醋酸曲安奈德使用差异有统计学意义(P<0.05)。结论本事件是一起医疗过程引起的结核杆菌群体性感染事件,针灸治疗和药物醋酸曲安奈德使用是可能的危险因素。加强医疗过程消毒和规范用药,避免交叉感染,是防制此类医源性感染事件发生的重要措施。
Objective To investigate a nosocomial infection of Mycobacterium tuberculosis in a clinic, analyze its epidemiological characteristics and causes, and provide basis for strengthening the management of nosocomial infection. Methods A field investigation on Mycobacterium tuberculosis infection in a hospital was conducted to describe the epidemic situation. A case-control study was conducted to analyze the etiological factors of the epidemic, and the specimens of pus of infection were collected to detect Mycobacterium tuberculosis. Results Totally 78 samples of 46 patients with local lesions were collected for the detection of Mycobacterium tuberculosis, of which 48 were positive for Mycobacterium tuberculosis in 32 cases. Fifty-nine cases and 124 infected sites had acupuncture treatment. The results of case-control study showed that there was significant difference in the number of experiences of acupuncture treatment (P <0.05), incidence of infection was related to the frequency of acupuncture and moxibustion (P <0.05), and the use of triamcinolone acetonide was statistically significant (P0.05) . Conclusion This incident is a group of TB infection caused by medical process. Acupuncture treatment and drug use of triamcinolone acetonide are possible risk factors. To strengthen the medical process of disinfection and standardize medication to avoid cross-infection is an important measure to prevent such iatrogenic incidents.