期刊论文详细信息
BMC Infectious Diseases
Health care workers causing large nosocomial outbreaks: a systematic review
Ralf-Peter Vonberg2  Frank Schwab1  Petra Gastmeier1  Lisa Danzmann2 
[1] Institute for Hygiene and Environmental Health, Charité – University Medicine Berlin, Berlin, Germany;Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover D-30625, Germany
关键词: Health care associated infection;    Health care workers;    Personnel;    Staff;    Nosocomial outbreak;   
Others  :  1171029
DOI  :  10.1186/1471-2334-13-98
 received in 2012-06-21, accepted in 2013-02-20,  发布年份 2013
PDF
【 摘 要 】

Backgrounds

Staff in the hospital itself may be the source of a nosocomial outbreak (NO). But the role of undetected carriers as an outbreak source is yet unknown.

Methods

A systematic review was conducted to evaluate outbreaks caused by health care workers (HCW). The Worldwide Outbreak Database and PubMed served as primary sources of data. Articles in English, German or French were included. Other reviews were excluded. There were no restrictions with respect to the date of publication.

Data on setting, pathogens, route of transmission, and characteristics of the HCW was retrieved. Data from large outbreaks were compared to smaller outbreaks.

Results

152 outbreaks were included, mainly from surgery, neonatology, and gynecology departments. Most frequent corresponding infections were surgical site infections, infection by hepatitis B virus, and septicemia. Hepatitis B virus (27 NO), S. aureus (49 NO) and S. pyogenes (19 NO) were the predominant pathogens involved. 59 outbreaks (41.5%) derived from physicians and 56 outbreaks (39.4%) derived from nurses. Transmission mainly occurred via direct contact. Surgical and pediatric departments were significantly associated with smaller outbreaks, and gynecology with larger outbreaks. Awareness of carrier status significantly decreased the risk of causing large outbreaks.

Conclusions

As NO caused by HCW represent a rare event, screening of personnel should not be performed regularly. However, if certain species of microorganisms are involved, the possibility of a carrier should be taken into account.

【 授权许可】

   
2013 Danzmann et al; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150418025619278.pdf 282KB PDF download
Figure 3. 34KB Image download
Figure 2. 21KB Image download
Figure 1. 47KB Image download
【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】
  • [1]Vonberg RP, Weitzel-Kage D, Behnke M, Gastmeier P: Worldwide outbreak database: the largest collection of nosocomial outbreaks. Infection 2011, 39:29-34.
  • [2]Centers for Disease Control (CDC): Recommendations for protection against viral hepatitis. MMWR Morb Mortal Wkly Rep 1985, 34:313-335.
  • [3]Centers for Disease Control (CDC): Guidelines for prevention of transmission of human immunodeficiency virus and hepatitis B virus to health-care and public-safety workers. MMWR Morb Mortal Wkly Rep 1989, 38(Suppl 6):1-37.
  • [4]Adams S, Stojkovic SG, Leveson SH: Needlestick injuries during surgical procedures: a multidisciplinary online study. Occup Med (Lond) 2010, 60:139-144.
  • [5]Harpaz R, Von Seidlein L, Averhoff FM, Tormey MP, Sinha SD, Kotsopoulou K, Lambert SB, Robertson BH, Cherry JD, Shapiro CN: Transmission of hepatitis B virus to multiple patients from a surgeon without evidence of inadequate infection control. N Engl J Med 1996, 334:549-554.
  • [6]Dave J, Reith S, Nash JQ, Marples RR, Dulake C: A double outbreak of exfoliative toxin-producing strains of Staphylococcus aureus in a maternity unit. Epidemiol Infect 1994, 112:103-114.
  • [7]Occelli P, Blanie M, Sanchez R, Vigier D, Dauwalder O, Darwiche A, Provenzano B, Dumartin C, Parneix P, Venier AG: Outbreak of staphylococcal bullous impetigo in a maternity ward linked to an asymptomatic healthcare worker. J Hosp Infect 2007, 67:264-270.
  • [8]Graf K, Chaberny IF, Vonberg RP: Beliefs about hand hygiene: a survey in medical students in their first clinical year. Am J Infect Control 2011, 39:885-888.
  • [9]Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S, Perneger TV: Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Infection control programme. Lancet 2000, 356:1307-1312.
  文献评价指标  
  下载次数:37次 浏览次数:39次