Institut für Labormedizin, Mikrobiologie und Krankenhaushygiene, Krankenhaus der Barmherzigen Brüder Regensburg, Regensburg, Germany.
Notfallzentrum, Krankenhaus Barmherzige Brüder, Germany.
J Infect Public Health. 2020 Dec;13(12):1862-1867. doi: 10.1016/j.jiph.2020.10.005. Epub 2020 Oct 20.
During the novel coronavirus disease (COVID-19) pandemic it is crucial for hospitals to implement infection prevention strategies to reduce nosocomial transmission to the lowest possible number. This is all the more important because molecular tests for identifying SARS-CoV-2 infected patients are uncertain, and the resources available for them are limited. In this view, a monocentric, retrospective study with an interventional character was conducted to investigate the extent to which the introduction of a strict hygiene bundle including a general mask requirement and daily screening for suspicious patients has an impact on the SARS-CoV-2 nosocomial rate in the pandemic environment.
All inpatients from a maximum care hospital in Regensburg (Bavaria) between March 1st and June 10th 2020 were included. Patient with respiratory symptoms were tested for SARS-CoV-2 at admission, patients were managed according to a standard hygiene protocol. At the end of March a strict hygiene bundle was introduced including a general mask obligation and a daily clinical screening of inpatients for respiratory symptoms. Nosocomial infection rate for COVID-19 and the risk for infection transmission estimated by the nosocomial incidence density before and after introduction the hygiene bundle were compared. The infection pressure for the hospital during the entire observational period was characterized by the infection reports in the region in relation to the number of hospitalized COVID-19 patients and the number of infected employees.
In fact, after the introduction of a strict hygiene bundle including a general mouth and nose protection obligation and a daily clinical screening of suspicious patients, a significant reduction of the nosocomial rate from 0.28 to 0.06 (p = 0.026) was observed. Furthermore, the risk of spreading hospital-acquired infections also decreased dramatically from 0.0007 to 0.00018 (p = 0.031; rate ratio after/before 0.25 (95%CI 0.06, 1.07) despite a slow decrease of the hospital COVID 19-prevalence and an increase of infected employees.
The available data underline that a strict hygiene bundle seem to be associated with a decrease of nosocomial SARS-CoV-2 transmission in the pandemic situation.
在新型冠状病毒病（COVID-19）大流行期间，医院实施感染预防策略以将医院内传播降至最低至关重要。由于用于识别 SARS-CoV-2 感染患者的分子检测不确定，而且可用于这些检测的资源有限，因此这一点更为重要。基于这一观点，开展了一项以干预为特征的单中心回顾性研究，以调查在大流行环境下，引入包括一般口罩要求和对可疑患者进行日常筛查在内的严格卫生包对 SARS-CoV-2 医院内传播率的影响。
纳入 2020 年 3 月 1 日至 6 月 10 日期间巴伐利亚州雷根斯堡一家重症监护医院的所有住院患者。有呼吸道症状的患者在入院时接受 SARS-CoV-2 检测，患者根据标准卫生方案进行管理。3 月底，引入了严格的卫生包，包括普遍佩戴口罩的要求和对住院患者进行每日呼吸道症状的临床筛查。比较卫生包引入前后 COVID-19 医院感染率和通过医院感染密度估计的感染传播风险。整个观察期间，医院的感染压力通过该地区的感染报告与住院 COVID-19 患者人数和感染员工人数之间的关系来描述。
实际上，在引入包括普遍口鼻保护要求和对可疑患者进行每日临床筛查的严格卫生包后，医院感染率从 0.28 降至 0.06（p = 0.026），观察到显著下降。此外，医院获得性感染传播的风险也从 0.0007 降至 0.00018（p = 0.031；引入后/引入前的风险比 0.25（95%CI 0.06，1.07），尽管医院 COVID-19 患病率下降且感染员工人数增加。
现有数据强调，在大流行情况下，严格的卫生包似乎与 SARS-CoV-2 医院内传播的减少有关。
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