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发表于 2015-5-5 09:11:14
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本帖最后由 胡杨 于 2015-8-17 11:57 编辑
对您的质疑，我再次查阅了出处和原文，这是开始对原文理解有误导致，原文的意思是“波及”，而不是“感染”，抱歉，需要更正。事实是“该不良操作波及4490人，感染12人。”谢谢您的关注与质疑，做学问需要这种精神，向您学习。
附原文释疑：
Content source: Centers for Disease Control and Prevention ；National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)；Division of Healthcare Quality Promotion (DHQP)
Outbreaks and Patient Notifications in Outpatient Settings；September 1, 2011
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Multiple Gastroenterology Clinics [14] 2007 Hepatitis C Virus, Hepatitis B Virus Hepatitis Yes (4,490) 1) Syringe reuse (i.e., double dipping) 2) Contents from single-dose vials used for >1 patient
注：Patient notification performed (4,490)
原文献出处：
Gastroenterology. 2010 Jul;139(1):163-70. doi: 10.1053/j.gastro.2010.03.053. Epub 2010 Mar 27.
Multiple clusters of hepatitis virus infections associated with anesthesia for outpatient endoscopy procedures.
Gutelius B1, Perz JF, Parker MM, Hallack R, Stricof R, Clement EJ, Lin Y, Xia GL, Punsalang A, Eramo A, Layton M, Balter S.
Author information
Abstract
BACKGROUND & AIMS:
Hepatitis B virus (HBV) and hepatitis C virus (HCV) can be transmitted during administration of intravenous anesthesia when medication vials are used for multiple patients using incorrect technique. We investigated an outbreak of acute HBV and HCV infections among patients who received anesthesia during endoscopy procedures from the same anesthesiologist (anesthesiologist 1), in 2 different gastroenterology clinics.
METHODS:
Chart reviews, patient interviews, clinic site visits and infection control assessments, and molecular sequencing of patient isolates were performed. Patients treated by anesthesiologist 1 on specific procedure days were offered testing for blood-borne pathogens. Endoscopy and anesthesia procedures were reviewed; HCV quasispecies analysis was performed.
RESULTS:
Six cases of outbreak-associated HCV infection and 6 cases of outbreak-associated HBV infection were identified in clinic 1. One outbreak-associated HCV infection was identified in clinic 2. HCV quasispecies sequences from the patients were nearly identical (96.9%-100%) to those from source patients with chronic viral hepatitis. All affected patients in both clinics received propofol from anesthesiologist 1, who inappropriately used a single-patient-use vial of propofol for multiple patients. Reuse of syringes to redose patients, with resulting contamination of medication vials used for subsequent patients, likely resulted in viral transmission.
CONCLUSIONS:
Twelve persons acquired HBV and HCV infections (6 hepatitis C, 5 hepatitis B, and 1 coinfection) in 2 separate offices as a result of receiving anesthesia from anesthesiologist 1. Gastroenterologists are urged to review carefully the injection, medication handling, and other infection control practices of all staff under their supervision, including providers of anesthesia services.
Copyright 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.
AbstractSend:
原文简译：
《胃肠病学》2010年7月,2010(1):163 - 70。
门诊病人内镜检查麻醉的多例群聚的肝炎病毒感染案例
目的: 使用不正确的技术注射静脉麻 醉 药 物能够感染乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)。我们调查了某麻醉师在两个不同的胃肠诊所给病人实施内镜检查前麻醉导致的急性乙肝病毒和丙肝病毒感染暴发事件。
方法: 回顾麻醉师的病人登记表，回访病人，查阅诊所网站和感染控制评估，对病人血源性病原体进行检测，检出病人做分子测序。对内镜检查麻醉操作评估，丙肝病毒亚种进行分析。
结果: 暴发相关丙肝病毒感染6例和乙肝病毒感染6例。一个暴发相关丙肝病毒感染被确认。从患者丙肝病毒亚种序列相似度96.9%-100%。所有受影响的病人在两个诊所均接受麻醉医师异丙酚注射【注：4490人】，不当单剂量瓶异丙酚用于多个病人。病人复用的注射器污染药物瓶用于随后的病人，可能导致本次病毒传播。
结论: 该麻醉师不当操作导致12人获得性乙肝病毒和丙肝病毒感染(6例 丙型肝炎, 5例乙型肝炎,1例合并感染)的结果。肠胃诊所务必仔细检查注射药物处理,和包括麻 醉过程的其他感染控制实践督查。
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