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调查 2019 年冠状病毒病(COVID-19)大流行期间伦敦一家急性医疗机构内严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的表面和空气污染情况。

Investigating Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Surface and Air Contamination in an Acute Healthcare Setting During the Peak of the Coronavirus Disease 2019 (COVID-19) Pandemic in London.

机构信息

Department of Infectious Disease, Imperial College London, London, United Kingdom.

National Institute for Healthcare Research Health Protection Research Unit in Health-care Associated Infection and Antimicrobial resistance, Imperial College London & Public Health England, Hammersmith Hospital, London, United Kingdom.

出版信息

Clin Infect Dis. 2021 Oct 5;73(7):e1870-e1877. doi: 10.1093/cid/ciaa905.

Abstract

BACKGROUND

We evaluated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) surface and air contamination during the coronavirus disease 2019 (COVID-19) pandemic in London.

METHODS

Prospective, cross-sectional, observational study in a multisite London hospital. Air and surface samples were collected from 7 clinical areas occupied by patients with COVID-19 and a public area of the hospital. Three or four 1.0-m3 air samples were collected in each area using an active air sampler. Surface samples were collected by swabbing items in the immediate vicinity of each air sample. SARS-CoV-2 was detected using reverse-transcription quantitative polymerase chain reaction (PCR) and viral culture; the limit of detection for culturing SARS-CoV-2 from surfaces was determined.

RESULTS

Viral RNA was detected on 114 of 218 (52.3%) surfaces and in 14 of 31 (38.7%) air samples, but no virus was cultured. Viral RNA was more likely to be found in areas immediately occupied by COVID-19 patients than in other areas (67 of 105 [63.8%] vs 29 of 64 [45.3%]; odds ratio, 0.5; 95% confidence interval, 0.2-0.9; P = .025, χ2 test). The high PCR cycle threshold value for all samples (>30) indicated that the virus would not be culturable.

CONCLUSIONS

Our findings of extensive viral RNA contamination of surfaces and air across a range of acute healthcare settings in the absence of cultured virus underlines the potential risk from environmental contamination in managing COVID-19 and the need for effective use of personal protective equipment, physical distancing, and hand/surface hygiene.

摘要

背景

我们评估了 2019 年冠状病毒病(COVID-19)大流行期间伦敦严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的表面和空气污染情况。

方法

这是一项在伦敦一家多地点医院进行的前瞻性、横断面、观察性研究。从 7 个有 COVID-19 患者入住的临床区域和医院的一个公共区域采集空气和表面样本。在每个区域使用主动空气采样器采集 3 或 4 个 1.0m3 的空气样本。通过擦拭每个空气样本附近的物品来采集表面样本。使用逆转录定量聚合酶链反应(PCR)和病毒培养法检测 SARS-CoV-2;确定从表面培养 SARS-CoV-2 的检测限。

结果

在 218 个表面样本中的 114 个(52.3%)和 31 个空气样本中的 14 个(38.7%)检测到病毒 RNA,但未培养出病毒。在 COVID-19 患者直接入住的区域中,病毒 RNA 更有可能被发现,而在其他区域则不然(105 个中的 67 个[63.8%]与 64 个中的 29 个[45.3%];比值比,0.5;95%置信区间,0.2-0.9;P=0.025,χ2 检验)。所有样本的高 PCR 循环阈值(>30)表明病毒不可培养。

结论

我们的研究结果表明,在一系列急性医疗保健环境中,广泛存在表面和空气中的病毒 RNA 污染,而在没有培养出病毒的情况下,这凸显了在管理 COVID-19 时环境污染的潜在风险,需要有效使用个人防护设备、保持身体距离以及手部/表面卫生。

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