Nosocomial infections after acupuncture and related therapies: a systematic review of case reports and case series
针灸相关疗法后医院感染：病例报告和病例系列的系统回顾

Chao-Yue ZHANG（张超月）^a, Jun XU（徐俊）^a, Xiao-Hong GU（顾晓红）^a, Xuan YIN（殷萱）^a, Shan-Shan LI（李珊珊)^a, Li-Xing LAO（劳力行）^b,c, Shi-Fen XU（徐世芬）^a, Yi-Qun MI（宓轶群）^a

^a Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China (上海市中医医院，上海中医药大学，上海200071，中国)

^b School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong999077, China(香港大学李嘉诚医学院中医学院，香港999077，中国)

^c Virginia University of Integrative Medicine, Fairfax, VA 22031, USA (弗吉尼亚综合医学大学，费尔法克斯VA 22031，美国)

Abstract

Background: Acupuncture and its related therapies, as an important part of traditional Chinese medicine, have been widely accepted by the public and healthcare professionals all over the world. According to previous reviews, the department of acupuncture is a potential place where nosocomial infection might occur.

Objective: To investigate the common pathogens and possible risk factors for nosocomial infection, figure out the measures and strategies for control and prevention, and provide general reporting guideline for future cases.

Methods: A systematic literature search of 6 libraries (EMBASE, CINAHL, PubMed, VIP, CNKI, SinoMed) was carried out on nosocomial infection (NIs) after acupuncture and its related therapies (e.g., moxibustion, cupping, massage, dry needling) published from January 1, 2012 to August 31, 2023. Studies providing primary data were included; reviews, comments, and non-primary data studies were excluded to prevent duplicate case analysis. Data on bibliographic details, study characteristics, and clinical information were extracted. Results were synthesized through tabulation and categorized by therapy type, country income level, symptoms/diagnoses, pathogens, risk factors, treatments, and outcomes.

Conclusion: Nosocomial infections after acupuncture and its related therapies are possible but preventable. Prevention measures can be carried out in terms of the risk factors listed above. Future case reports are suggested to provide specific details of infection, including the setting, qualification, treatment, disinfection, and causal evidence.

【摘要】

背景：针灸及其相关疗法作为中医药的重要组成部分，已被全球公众及医疗工作者广泛接受。既往综述表明，针灸科是院内感染发生的潜在场所。

目的：探究针灸相关疗法后院内感染的常见病原体及危险因素，提出防控策略，并为未来病例报告提供规范框架。

方法：系统检索EMBASE、CINAHL、PubMed、维普、中国知网、中国生物医学文献服务系统六大数据库中2012年1月1日至2023年8月31日发表的针灸及相关疗法（如艾灸、拔罐、推拿、干针疗法）后院内感染的文献。纳入提供原始数据的研究，排除综述、评论及非原始数据文献以避免病例重复分析。提取文献信息、研究特征及临床数据，通过表格化整合结果，并按疗法类型、国家收入水平、症状/诊断、病原体、危险因素、治疗及结局分类。

结果：11年间共纳入来自19个国家及地区的86篇文献，累计报告126例感染病例。常见病原体包括分枝杆菌属、葡萄球菌属及链球菌属。感染风险涉及患者因素（如免疫状态）、操作因素（如消毒不规范）及从业者资质因素（如培训缺失）等多维度诱因。

结论：针灸及相关疗法后院内感染可防可控，需针对上述风险因素制定预防措施。建议未来病例报告详细描述感染场景、操作者资质、治疗流程、消毒方法及因果证据。