Yuan X N, Meng Q Y, Shen N, Li Y X, Liang C, Cui M, Ge Q G, Li X G, Tan K, Chen Q, Wang J, Zeng X Y
Department of Hospital Infection Control, Peking University Third Hospital, Beijing 100191, China.
Institute of Sports Medicine, Peking University Third Hospital, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Oct 18;52(5):803-808. doi: 10.19723/j.issn.1671-167X.2020.05.002.
To determine the environmental contamination degree of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in corona virus disease 2019 (COVID-19) wards, to offer gui-dance for the infection control and to improve safety practices for medical staff, by sampling and detecting SARS-CoV-2 nucleic acid from the air of hospital wards, the high-frequency contact surfaces in the contaminated area and the surfaces of medical staff's protective equipment in a COVID-19 designated hospital in Wuhan, China.
From March 11 to March 19, 2020, we collected air samples from the clean area, the buffer room and the contaminated area respectively in the COVID-19 wards using a portable bioaerosol concentrator WA-15. And sterile premoistened swabs were used to sample the high-frequency contacted surfaces in the contaminated area and the surfaces of medical staff's protective equipment including outermost gloves, tracheotomy operator's positive pressure respiratory protective hood and isolation clothing. The SARS-CoV-2 nucleic acid of the samples were detected by real-time fluorescence quantitative PCR. During the isolation medical observation period, those medical staff who worked in the COVID-19 wards were detected for SARS-CoV-2 nucleic acid with oropharyngeal swabs, IgM and IgG antibody in the sera, and chest CT scans to confirm the infection status of COVID-19.
No SARS-CoV-2 nucleic acid was detected in the tested samples, including the 90 air samples from the COVID-19 wards including clean area, buffer room and contaminated area, the 38 high-frequency contact surfaces samples of the contaminated area and 16 surface samples of medical staff's protective equipment including outermost gloves and isolation clothing. Moreover, detection of SARS-CoV-2 nucleic acid by oropharyngeal swabs and IgM, IgG antibodies in the sera of all the health-care workers who participated in the treatment for COVID-19 were all negative. Besides, no chest CT scan images of medical staff exhibited COVID-19 lung presentations.
Good ventilation conditions, strict disinfection of environmental facilities in hospital wards, guidance for correct habits in patients, and strict hand hygiene during medical staff are important to reduce the formation of viral aerosols, cut down the aerosol load, and avoid cross-infection in isolation wards. In the face of infectious diseases that were not fully mastered but ma-naged as class A, it is safe for medical personnel to be equipped at a high level.
通过对中国武汉一家新冠肺炎定点医院的病房空气、污染区域高频接触表面以及医务人员防护用品表面进行采样并检测严重急性呼吸综合征冠状病毒2(SARS-CoV-2)核酸,以确定新型冠状病毒肺炎(COVID-19)病房的环境污染程度,为感染控制提供指导,提高医务人员的安全防护措施。
2020年3月11日至3月19日,我们使用便携式生物气溶胶浓缩器WA-15分别从COVID-19病房的清洁区、缓冲间和污染区采集空气样本。并使用无菌预湿拭子对污染区域的高频接触表面以及医务人员防护用品表面进行采样,包括最外层手套、气管切开术操作人员的正压呼吸防护头罩和隔离衣。通过实时荧光定量PCR检测样本中的SARS-CoV-2核酸。在隔离医学观察期间,对在COVID-19病房工作的医务人员进行咽拭子SARS-CoV-2核酸检测、血清中IgM和IgG抗体检测以及胸部CT扫描,以确认COVID-19的感染状况。
在检测的样本中未检测到SARS-CoV-2核酸,包括来自COVID-19病房清洁区、缓冲间和污染区的90份空气样本、污染区域的38份高频接触表面样本以及16份医务人员防护用品表面样本,包括最外层手套和隔离衣。此外,对所有参与COVID-19治疗的医护人员进行咽拭子SARS-CoV-2核酸检测以及血清中IgM、IgG抗体检测均为阴性。此外,医务人员的胸部CT扫描图像均未显示COVID-19肺部表现。
良好的通风条件、严格消毒病房环境设施、指导患者养成正确习惯以及医务人员严格的手卫生对于减少病毒气溶胶的形成、降低气溶胶负荷以及避免隔离病房内的交叉感染至关重要。面对尚未完全掌握但按甲类管理的传染病,高水平配备医务人员是安全的。