Avtor/Urednik		Lešničar, Gorazd
Naslov		Pogostost incidentov pri zdravstvenih delavcih in drugih osebah na Celjskem, njihovo preprečevanje in poizpostavitvena zaščita
Prevedeni naslov		The frequency of incidental injuries related infections in health care workers and other persons in Celje region, their prevention and postexposure prophylaxis
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 74, št. 4
Leto izdaje		2005
Obseg		str. 211-20
Jezik		slo
Abstrakt		Background. Injuries with sharp, potentially infected objects represent a danger, particularly due to the possibility of viral transmission, such as hepatitis B, hepatitis C and human immunodeficiency virus, and consequentially, the possibility of infections with these viruses. The possibility of a tetanus infection should always be excluded as well. In percutaneous exposure of patient's blood to hepatitis B the possibility of infection ranges between 5-30%, while in exposure to hepatitis C it is 3-10% and in exposure to human immunodeficiency virus this rate is 0.3% (in exposure of mucous membranes 0.09%). Methods. The prospective investigation carried out in the period from 1997 to July 2004 was aimed at establishing the frequency and type of incidents as well as the categories of the affected health care workers along with the procedures and types of sharp objects involved in those incidents. A protocol with 20 incident-related questions was prepared. Post-exposure prophylaxis (immunoprophylaxis) against hepatitis B (specific anti-hepatitis B immunoglobulin and/or anti-hepatitis B virus vaccine) and against human immunodeficiency virus infection (chemoprophylaxis) was carried out by infectologists according to state-of-the-art doctrine. Considering the possibility of infection with hepatitis B virus, hepatitis C virus and human immunodeficiency virus, the injured persons were subjected to a clinical, laboratory and serological follow up for at least 6 months or more following the incident. Exactly the same follow-up approach after injury was used also in the rest of the injured persons from Celje region. (Abstract truncated at 2000 characters).
Izvleček		Izhodišča. Poškodbe z ostrimi, morda okuženimi predmeti pomenijo nevarnost zlasti zaradi možnosti prenosa virusa hepatitisa B, virusa hepatitisa C in virusa človeške imunske pomanjkljivosti ter morebitnih posledičnih okužb s temi virusi. Vselej je potrebno izključiti tudi možnost okužbe s povzročiteljem tetanusa. Pri perkutani izpostavitvi krvi bolnika s hepatitisom B je možnost okužbe pri poškodovancu 5 - 30%, krvi bolnika s hepatitisom C 3-10% in krvi bolnika z navzočnostjo virusa človeške imunske pomanjkljivosti 0,3% (pri izpostavitvi sluzničnih membran 0, 09%). Metode. S prospektivno raziskavo od l. 1997 do julija 2004 smo želeli ugotoviti pogostost in vrsto incidentov, kategorije poškodovanih zdravstvenih delavcev ter postopke in vrste ostrih predmetov, s katerimi je prišlo do poškodb. Pripravili smo tudi protokol z dvajsetimi vprašanji o incidentu. Poizpostavitveno zdravstveno zaščito (imunoprofilakso) proti hepatitisu B (imunoglobulin proti hepatitisu B in/ali cepivo proti virusu hepatitisa B) in proti okužbi z virusom človeške imunske pomanjkljivosti (kemoprofilaksa) smo izvajali infektologi po sodobni strokovni doktrini. Klinično, laboratorijsko in serološko smo nadzorovali poškodovance zaradi možnosti okužbe z virusom hepatitisa B, virusom hepatitisa C in virusom človeške imunske pomanjkljivosti tudi več kot 6 mesecev po incidentu. Na povsem enak način smo vodili po incidentu tudi druge poškodovance iz celjske zdravstvene regije. Infektologi smo skupaj s Komisijo za obvladovanje bolnišničnih okužb pripravili pisna navodila o poizpostavitveni zdravstveni zaščiti delavcev v bolnišnici s tveganjem za prenos virusa hepatitisa B, virusa hepatitisa C in virusa človeške imunske pomanjkljivosti, sodelovali pa smo tudi pri izvajanju programa imunoprofilakse proti hepatitisu B. (Izvleček prekinjen pri 2000 znakih).
Deskriptorji		OCCUPATIONAL EXPOSURE NEEDLESTICK INJURIES HEALTH MANPOWER HEPATITIS B HEPATITIS C ACQUIRED IMMUNODEFICIENCY SYNDROME ENZYME-LINKED IMMUNOSORBENT ASSAY POLYMERASE CHAIN REACTION PROSPECTIVE STUDIES QUESTIONNAIRES