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医院内传播和 2019 年冠状病毒病的爆发:需要保护患者和医护人员。

Nosocomial transmission and outbreaks of coronavirus disease 2019: the need to protect both patients and healthcare workers.

机构信息

Infection Control Programme, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.

Health Protection Research Unit, Imperial College London, London, UK.

出版信息

Antimicrob Resist Infect Control. 2021 Jan 6;10(1):7. doi: 10.1186/s13756-020-00875-7.

DOI:10.1186/s13756-020-00875-7
PMID:33407833
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7787623/
Abstract

OBJECTIVES

To compile current published reports on nosocomial outbreaks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), evaluate the role of healthcare workers (HCWs) in transmission, and evaluate outbreak management practices.

METHODS

Narrative literature review.

SHORT CONCLUSION

The coronavirus disease 2019 (COVID-19) pandemic has placed a large burden on hospitals and healthcare providers worldwide, which increases the risk of nosocomial transmission and outbreaks to "non-COVID" patients or residents, who represent the highest-risk population in terms of mortality, as well as HCWs. To date, there are several reports on nosocomial outbreaks of SARS-CoV-2, and although the attack rate is variable, it can be as high as 60%, with high mortality. There is currently little evidence on transmission dynamics, particularly using genomic sequencing, and the role of HCWs in initiating or amplifying nosocomial outbreaks is not elucidated. There has been a paradigm shift in management practices of viral respiratory outbreaks, that includes widespread testing of patients (or residents) and HCWs, including asymptomatic individuals. These expanded testing criteria appear to be crucial in identifying and controlling outbreaks.

摘要

目的

编译目前关于严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2)医院感染暴发的已发表报告,评估医护人员(HCWs)在传播中的作用,并评估暴发管理实践。

方法

叙述性文献回顾。

简短结论

2019 年冠状病毒病(COVID-19)大流行给全球医院和医疗保健提供者带来了巨大负担,这增加了“非 COVID”患者或居民的医院内传播和暴发的风险,这些患者或居民的死亡率最高,而医护人员也是如此。迄今为止,已有几篇关于 SARS-CoV-2 医院感染暴发的报告,尽管发病率各不相同,但高达 60%,死亡率很高。目前,关于传播动态的证据很少,特别是使用基因组测序,而且医护人员在引发或放大医院感染暴发中的作用尚未阐明。病毒呼吸道暴发的管理实践已经发生了范式转变,包括广泛测试患者(或居民)和医护人员,包括无症状个体。这些扩展的测试标准似乎对于识别和控制暴发至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3211/7789322/79783ef921c8/13756_2020_875_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3211/7789322/79783ef921c8/13756_2020_875_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3211/7789322/79783ef921c8/13756_2020_875_Fig1_HTML.jpg

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