Condition of Persons in a Hospital with SARS nosocomial infection and its Implications to Hospital Managements.
|Keywords:||院內感染;工作環境;個人特性;醫院管理;感染控制;抗原;抗體;SARS;nosocomial infection;hospital management||Issue Date:||2005||Abstract:||
Background. SARS was a severe infectious disease that caused marked damage worldwide. SARS also challenged the infection control system and hospital management. From the infectious condition of the persons in a hospital that was attacked by SARS, we analyzed the role of personal characteristics and environment on the infection control managements.
Material and methods. The data about all the personns that were involved in the SARS infection of the hospital was collected, including the age, sex, working unit, working floor, and occupation. The result of antigen(PCR) and antibody studies, the mortality, the clinical classification of probable or suspect cases, and the time of being reported as infected, were collected from health care workers (HCWs) who were infected by SARS. The distribution and correlation among variables of the infected HCWs were analyzed.
Seven hundred and seventy-seven asymptomatic HCWs received antibody survey about one month after the onset of the event to study the epidemiological of the nosocomial infection. Thirty-two HCWs received 3 times of antibody surveys follow up within one year.
Result. There were 1539 persons involved in the SARS nosocomial infection, including 976 hospital employees (63.4%), 38 outsourcing employees (2.5%), 366 patients and their family members (23.8%), 159 members of rescue team from other institutes (10.3%). Totally 108 persons were reported as been infected, 75 (4.9% of all involved persons) were classified as probable and 33 were classified as suspect SARS patients. Twenty-four probable cases expired (case fatality rate 32%).
Sixty-two colleagues were reported as infected among 1014 HCWs. Persons in ward B8 and emergency room as well as being nurses had the largest number of HCW being reported as the SARS victim. Reported cases were significantly correlated to working floor, occupation and working unit, and not correlated to age and sex.
Fifty-nine colleagues that were reported and had complete data were further analyzed. There were 42 probable and 17 suspect cases. Among the 42 probable cases, 21 had positive PCR, 32 had positive antibody. Among the 17 suspect cases, none had positive PCR, 12 had positive antibody.
Thirty-two colleagues who had initially positive antibody received followed up at 6 months interval. The result revealed a 100% of positive rate at 6 months, and a 69.4% positive rate at 12 months. There were 4 positive antibody results in the asymptomatic HCWs.
Conclusion: SARS caused a high infection rate and mortality at the study hospital. Working unit and occupation significantly affected the infection rate. The environment control and the education about personal protection, as well as the improvement of ventilation system, are important measures to reduce the severity and the extend of nosocomial viral infection.
|Appears in Collections:||健康政策與管理研究所|
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