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利用普遍可获得的材料对 N95 呼吸器进行微波蒸汽消毒。

Microwave-Generated Steam Decontamination of N95 Respirators Utilizing Universally Accessible Materials.

机构信息

Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

Harvard Medical School, Boston, Massachusetts, USA.

出版信息

mBio. 2020 Jun 25;11(3):e00997-20. doi: 10.1128/mBio.00997-20.

DOI:10.1128/mBio.00997-20
PMID:32587063
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7317796/
Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused a severe, international shortage of N95 respirators, which are essential to protect health care providers from infection. Given the contemporary limitations of the supply chain, it is imperative to identify effective means of decontaminating, reusing, and thereby conserving N95 respirator stockpiles. To be effective, decontamination must result in sterilization of the N95 respirator without impairment of respirator filtration or user fit. Although numerous methods of N95 decontamination exist, none are universally accessible. In this work, we describe a microwave-generated steam decontamination protocol for N95 respirators for use in health care systems of all sizes, geographies, and means. Using widely available glass containers, mesh from commercial produce bags, a rubber band, and a 1,100-W commercially available microwave, we constructed an effective, standardized, and reproducible means of decontaminating N95 respirators. Employing this methodology against MS2 phage, a highly conservative surrogate for SARS-CoV-2 contamination, we report an average 6-log plaque-forming unit (PFU) (99.9999%) and a minimum 5-log PFU (99.999%) reduction after a single 3-min microwave treatment. Notably, quantified respirator fit and function were preserved, even after 20 sequential cycles of microwave steam decontamination. This method provides a valuable means of effective decontamination and reuse of N95 respirators by frontline providers facing urgent need. Due to the rapid spread of coronavirus disease 2019 (COVID-19), there is an increasing shortage of protective gear necessary to keep health care providers safe from infection. As of 9 April 2020, the CDC reported 9,282 cumulative cases of COVID-19 among U.S. health care workers (CDC COVID-19 Response Team, MMWR Morb Mortal Wkly Rep 69:477-481, 2020, https://doi.org/10.15585/mmwr.mm6915e6). N95 respirators are recommended by the CDC as the ideal method of protection from COVID-19. Although N95 respirators are traditionally single use, the shortages have necessitated the need for reuse. Effective methods of N95 decontamination that do not affect the fit or filtration ability of N95 respirators are essential. Numerous methods of N95 decontamination exist; however, none are universally accessible. In this study, we describe an effective, standardized, and reproducible means of decontaminating N95 respirators using widely available materials. The N95 decontamination method described in this work will provide a valuable resource for hospitals, health care centers, and outpatient practices that are experiencing increasing shortages of N95 respirators due to the COVID-19 pandemic.

摘要

严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)大流行导致 N95 呼吸器严重短缺,这对于保护医护人员免受感染至关重要。鉴于当前供应链的限制,当务之急是确定有效的方法对 N95 呼吸器进行消毒、再利用,从而节约 N95 呼吸器的库存。要达到有效消毒的目的,必须对 N95 呼吸器进行灭菌,同时不影响呼吸器的过滤效果或使用者的贴合度。虽然有许多 N95 消毒方法,但并非所有方法都普遍适用。在这项工作中,我们为各种规模、地理位置和资源的医疗保健系统描述了一种用于 N95 呼吸器的微波蒸汽消毒方案。我们使用了广泛可用的玻璃容器、商业生产袋中的网眼、橡皮筋和一个 1100W 市售微波炉,构建了一种有效、标准化且可重复的 N95 呼吸器消毒方法。我们使用这种方法对抗 MS2 噬菌体,这是一种对 SARS-CoV-2 污染具有高度保守性的替代物,报告平均有 6 个对数噬菌斑形成单位(PFU)(99.9999%),并且经过单次 3 分钟微波处理后,有最低 5 个对数 PFU(99.999%)的减少。值得注意的是,即使经过 20 次连续的微波蒸汽消毒循环,也能保持定量的呼吸器贴合度和功能。这种方法为面临迫切需求的一线医护人员提供了一种有效的 N95 呼吸器消毒和再利用的方法。由于 2019 年冠状病毒病(COVID-19)的迅速传播,保护医护人员免受感染所需的防护装备日益短缺。截至 2020 年 4 月 9 日,美国疾病控制与预防中心(CDC)报告了 9282 例美国医护人员累计 COVID-19 病例(CDC COVID-19 应对小组,MMWR Morb Mortal Wkly Rep 69:477-481,2020,https://doi.org/10.15585/mmwr.mm6915e6)。CDC 建议使用 N95 呼吸器作为预防 COVID-19 的理想方法。尽管 N95 呼吸器传统上是一次性使用的,但短缺情况已经需要重复使用。不会影响 N95 呼吸器贴合度或过滤能力的有效 N95 消毒方法至关重要。有许多 N95 消毒方法,但并非所有方法都普遍适用。在这项研究中,我们使用广泛可用的材料描述了一种有效、标准化且可重复的 N95 呼吸器消毒方法。这项工作中描述的 N95 呼吸器消毒方法将为因 COVID-19 大流行而面临 N95 呼吸器日益短缺的医院、保健中心和门诊实践提供宝贵的资源。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4260/7317796/5f21e3abfd1b/mBio.00997-20-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4260/7317796/003c0c38ee03/mBio.00997-20-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4260/7317796/693468ab5b2a/mBio.00997-20-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4260/7317796/5f21e3abfd1b/mBio.00997-20-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4260/7317796/003c0c38ee03/mBio.00997-20-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4260/7317796/693468ab5b2a/mBio.00997-20-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4260/7317796/5f21e3abfd1b/mBio.00997-20-f0003.jpg

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