华南恶性肿瘤防治全国重点实验室//广东省恶性肿瘤临床医学研究中心//中山大学肿瘤防治中心,广东 广州 510060
张媛媛,第一作者,研究方向:医院感染防控,E-mail:zhangyuany@sysucc.org.cn
纸质出版日期:2024-07-20,
收稿日期:2024-03-13,
录用日期:2024-06-24
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张媛媛,朱浩智,许南松等.肿瘤专科医院2022年就诊患者常见传染病感染状况分析[J].中山大学学报(医学科学版),2024,45(04):666-672.
ZHANG Yuanyuan,ZHU Haozhi,XU Nansong,et al.Infection Status of Common Infectious Diseases among Patients in Specialized Cancer Hospital[J].Journal of Sun Yat-sen University(Medical Sciences),2024,45(04):666-672.
张媛媛,朱浩智,许南松等.肿瘤专科医院2022年就诊患者常见传染病感染状况分析[J].中山大学学报(医学科学版),2024,45(04):666-672. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2024.0419.
ZHANG Yuanyuan,ZHU Haozhi,XU Nansong,et al.Infection Status of Common Infectious Diseases among Patients in Specialized Cancer Hospital[J].Journal of Sun Yat-sen University(Medical Sciences),2024,45(04):666-672. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2024.0419.
目的
2
了解华南地区某肿瘤专科医院就诊患者的艾滋病病毒(HIV)、梅毒螺旋体(TP)、丙型肝炎病毒(HCV)、乙型肝炎病毒(HBV)感染现状,分析确诊检查完成情况,为加强常见传染病管理和制定医院感染防控策略提供参考。
方法
2
对2022年华南地区某肿瘤专科医院就诊的门诊、住院患者的传染病初筛项目HIV抗原抗体联合检测(HIV-comb)、梅毒螺旋体特异抗体(Anti-TP)、丙肝抗体(Anti-HCV)、乙肝表面抗原(HBsAg)的阳性检出率及进一步完成确诊项目检查的检测率进行统计分析。
结果
2
2022年就诊患者的HIV
-comb阳性率为0.07%,100%患者进一步完成HIV补充确证试验,HIV总体患病率为0.06%;Anti-TP阳性率为1.99%,100%患者进一步完成梅毒螺旋体颗粒凝集试验(TPPA)及甲苯胺红不加热血清试验(TRUST)检测,梅毒总体患病率为0.51%;Anti-HCV阳性率为0.90%,仅26.61%患者进一步完成丙肝RNA定量检测,其中26.44%患者丙肝RNA高于检出下限;HBsAg阳性率为21.06%,仅54.40%患者进一步完成乙肝DNA定量检测,其中51.60%患者乙肝DNA高于检出下限。其中,门诊疑似肝炎患者核酸检测完善率低于住院(
P
<
0.05),肝癌收治科室核酸检测完善率高于全院(
P
<
0.05)。
结论
2
该肿瘤专科医院患者HIV、梅毒感染水平与一般人群相近,且100%完成确诊项目检查;丙肝、乙肝的感染处于较高水平,但核酸检测率较低,无法准确反映病毒复制水平。肿瘤专科医院应加强医务工作人员对肿瘤患者常见传染病初步筛查和确诊项目检查的重视,对传染病确诊病例提供抗肿瘤治疗的同时积极转介其到定点或综合性医院治疗,以改善其预后,提高医疗服务质量。
Objective
2
To understand the current status of human immunodeficiency virus (HIV), Treponema pallidum (TP), hepatitis C virus (HCV) and hepatitis B virus (HBV) infections among patients undergoing screening tests in a specialized cancer hospital in South China, and to analyze the completion of further testing for confirmation, so as to provide a reference for management of common infectious diseases and prevention of nosocomial infections.
Methods
2
We analyzed the positive rates of HIV antigen/antibody combination assay (HIV-comb), TP antibody (anti-TP), HCV antibody (anti-HCV) and hepatitis B surface antigen (HBsAg) among the outpatients and inpatients who underwent the screening tests in 2022. Then we examined the percentage of those patients with seropositivity for further confirmation.
Results
2
In patients who underwent the screening tests, the positive rate, percentage of patients for further confirmation test and overall prevalence for HIV-comb were were 0.07%, 100% and 0.06%, respectively; for Anti-PT 1.99%, 100% and 0.51%, respectively. Positive rate of anti-HCV was 0.90% and 26.61% of patients completed further HCV RNA quantitative assay, in 26.44% of whom, HCV RNA levels were above the detection limit. Positive rate of HBsAg was 21.06% and 54.40% of patients completed further HBV DNA quantitative assay, in 51.60% of whom, HBV DNA levels were above the detection limit. As for the nucleic acid testing among the suspected hepatitis patients, we found smaller coverage in outpatients than in inpatients and larger coverage in liver cancer patients than in other patients.
Conclusions
2
Compared with general population, patients in this specialized cancer hospital had similar infection levels of HIV and syphilis, and 100% of them completed further confirmation testing. Hepatitis C and hepatitis B infections were at a relatively high level, but which could not accurately reflect the level of virus replication due to insufficient coverage of nucleic acid testing. Specialized cancer hospitals should prompt medical staff to attach more importance to screening and further confirmation of common infectious diseases among tumor patients. While offering anti-cancer treatment, hospitals should also actively refer the confirmed cases with infectious diseases to designated or general hospitals for a better outcome and quality of medical services.
肿瘤专科医院患者传染病感染状况筛查诊断
specialized cancer hospitalpatientsinfectious diseasesinfection statusscreeningdiagnosis
涂东晋,林海娟. 单采血小板献血者输血相关传染病标志物筛查结果分析[J]. 检验医学与临床,2022,19(15):2101-2104.
Tu DJ, Lin HJ. Analysis of the screening results of transfusion-associated infectious disease markers in apheresis platelets blood donors[J]. Lab Med & Clinic, 2022,19(15):2101-2104.
李广波,轩乾坤,羽晓瑜,等. 核酸检测在血液传染病筛查的应用价值[J]. 重庆医学,2021,50(12):2034-2037.
Li GB, Xuan QK, Yu XY, et al. Application value of nucleic acid detection in screening blood infectious diseases[J].Chongqing Med J, 2021, 50(12):2034-2037.
周丽萍,王佳,王思瑶,等. 传染病突发公共卫生事件中疫情筛查防控管理[J]. 海军医学杂志,2020,41(4):370-372.
Zhou LP, Wang J, Wang SY, et al. Epidemic screening, prevention and control and management in public health emergencies for infectious diseases[J]. J Navy Med, 2020,41(4):370-372.
胡伟琼,阮聪,王祺茹,等.抗肿瘤药物与乙肝再激活风险的研究进展[J].中国临床药学杂志,2023,32(8):634-640.
Hu WQ, Ruan C, Wang QR, et al. Progress in antitumor drugs and the risk of hepatitis B reactivation[J]. Chin J clinic pharm, 2023,32(8):634-640.
雷海科,李小升,李杰平等.艾滋病合并恶性肿瘤患者临床特点及预后影响因素[J].肿瘤防治研究,2022,49(5):412-417.
Lei HK, Li XS, Li JP, et al. Clinial characteristics and prognostic influence factors of patients with AIDS-related malignant tumor [J].Cancer Res Prevent & Treat, 2022,49(5):412-417.
李小龙,沈飞,李金娜.肿瘤合并艾滋病患者医院感染现状分析[J].肿瘤基础与临床,2022,35(4):332-334.
Li XL, Shen F, Li JN. Analysis of nosocomial infection in the tumor patients complicated with acquired immunodeficiency syndrome[J]. J Basic & Clin Oncol,2022,35(4):332-334.
田雨可,刘红梅,韩德前,等.抗肿瘤治疗相关丙肝病毒再激活的诊治现状[J].肿瘤防治研究,2016,43(12):1081-1084.
Tian YK, Liu HM, Han DQ, et al. Diagnosis and treatment of hepatitis C virus reactivation after anti-cancer therapies[J].Cancer Res Prevent & Treat,2016,43(12):1081-1084.
严菊兰.妇科宫颈癌与苍白密螺旋体感染的相关性研究[J].中华医院感染学杂志,2013,23(12):2913-2915.
Yan JL. Correlation between gynecological cervical cancer and treponema pallidum infections[J]. Chin J Nosocomiol, 2013,23(12):2913-2915.
Dou Z, Luo Y, Zhao Y, et al. Trends in mortality and prevalence of reported HIV/AIDS cases - China, 2002-2021[J]. China CDC Wkly, 2023, 5(42):943-947.
邵树军,李虹,周丽莉,等. 6年肿瘤患者HIV感染率与感染特点分析[J]. 中华医院感染学杂志,2016,26 (9) :2027-2029.
Shao SJ, Li H, Zhou LL, et al. Analysis of HIV infection rate and infection characteristics of tumor patients across 6 years[J]. Chin J Nosocomiol, 2016,26 (9):2027-2029.
李科,洪志鹏,沈丽达,等. 云南省住院肿瘤患者艾滋病感染现状及分析[J]. 现代预防医学,2013 (1):162-163.
Li K, Hong ZP, Shen LD, et al. Prevalence and analysis of HIV infection in hospitalized patients with tumors in Yunnan Province[J]. Mod Prevent Med, 2013 (1):162-163.
吴立春,宋晓玉,张珂,等. 肿瘤医院就诊患者HIV感染状况分析[J]. 实用肿瘤杂志,2012,27(5):502-505.
Wu LC, Song XY, Zhang K, et al. Analysis of HIV infection status in cancer hospital[J].J Pract Oncol,2012,27(5):502-505.
李宏燕,刘波,江源,等. 肿瘤患者艾滋病感染现状与分析[J]. 实用预防医学,2010,17(4):791-792.
Li HY, Liu B, Jiang Y, et al. Prevalence and analysis of HIV infection in tumor patients[J]. Practic Prevent Med, 2010,17(4):791-792.
何莹,蔺咏梅,饶珂萌. 肿瘤患者梅毒螺旋体抗体阳性率调查研究[J]. 中国肿瘤临床与康复,2018,25(6):689-691.
He Y, Lin YM, Rao KM. Positive rate of treponema pallidum antibody in patients with cancer[J]. Chin J Clin Oncol & Rehabilit, 2018,25(6):689-691.
柳霞,徐国宾. 肿瘤专科医院机会性感染筛查患者梅毒螺旋体血清学试验阳性率调查[J]. 标记免疫分析与临床,2022,29(5):753-756.
Liu X, Xu GB. Investigation of positive rate of treponema pallidum serological test in patients with infectious disease from an oncology hospital and consistency between CMIA and TPPA[J]. Label Immun & Clin Med, 2022,29(5):753-756.
庄辉.中国丙型肝炎感染现状及防治对策研究报告[M].北京:人民卫生出版社,2018.
Zhuang H. Research report on the status and prevention countermeasures of hepatitis C infection in China [M]. Beijing: Peoples Health Publishing House, 2018.
Global progress report on HIV, viral hepatitis and sexually transmitted infections,2021[J]. BMC Infect Dis,2021,21 (Suppl 2): 866-866.
Liu Z, Lin C, Mao X, et al. Changing prevalence of chronic hepatitis B virus infection in China between 1973 and 2021: a systematic literature review and meta-analysis of 3740 studies and 231 million people[J]. Gut, 72(12):2354-2363.
Yang T, Chen Q, Li D, et al. High prevalence of syphilis, HBV, and HCV co-infection, and low rate of effective vaccination against hepatitis B in HIV-infected patients in West China hospital[J]. J Med Virol,2018. 90(1):101-108.
国家卫生计生委员会,国家发展和改革委员会,教育部,等.关于印发中国病毒性肝炎防治规划(2017-2020年) 的通知[EB /OL].(2017-10-17) [2023-04-25].
National Health and Family Planning Commission, National Development and Reform Commission, Ministry of Education, etc. Notice on the Issuance of the China Plan for the Prevention and Control of Viral Hepatitis (2017-2020) [EB / OL]. (2017-10-17) [2023-04-25].
孙倩,徐雪勤,郑晶冰. 乙型肝炎病毒DNA、丙型肝炎病毒RNA在原发性肝癌患者中的表达及临床意义[J]. 癌症进展,2023,21(22):2510-2515.
Sun Q, Xu XQ, Zheng JB. Expression and clinical significance of hepatitis B virus DNA and hepatitis C virus RNA in patients with primary liver cancer[J]. Oncol Prog, 2023,21(22):2510-2515.
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