Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, Georgia, USA.
Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA.
Clin Infect Dis. 2021 Oct 5;73(7):e1790-e1794. doi: 10.1093/cid/ciaa1880.
Previous research has shown that rooms of patients with coronavirus disease 2019 (COVID-19) present the potential for healthcare-associated transmission through aerosols containing severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). However, data on the presence of these aerosols outside of patient rooms are limited. We investigated whether virus-containing aerosols were present in nursing stations and patient room hallways in a referral center with critically ill COVID-19 patients.
Eight National Institute for Occupational Safety and Health BC 251 2-stage cyclone samplers were set up throughout 6 units, including nursing stations and visitor corridors in intensive care units and general medical units, for 6 h each sampling period. Samplers were placed on tripods which held 2 samplers positioned 102 cm and 152 cm above the floor. Units were sampled for 3 days. Extracted samples underwent reverse transcription polymerase chain reaction for selected gene regions of the SARS-CoV-2 virus nucleocapsid and the housekeeping gene human RNase P as an internal control.
The units sampled varied in the number of laboratory-confirmed COVID-19 patients present on the days of sampling. Some of the units included patient rooms under negative pressure, while most were maintained at a neutral pressure. Of 528 aerosol samples collected, none were positive for SARS-CoV-2 RNA by the estimated limit of detection of 8 viral copies/m3 of air.
Aerosolized SARS-CoV-2 outside of patient rooms was undetectable. While healthcare personnel should avoid unmasked close contact with each other, these findings may provide reassurance for the use of alternatives to tight-fitting respirators in areas outside of patient rooms during the current pandemic.
先前的研究表明,2019 年冠状病毒病(COVID-19)患者的病房存在通过含有严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的气溶胶进行医源性传播的潜在风险。然而,关于这些气溶胶在病房外存在的数据有限。我们调查了在一家拥有危重症 COVID-19 患者的转诊中心,病毒是否存在于护理站和病房走廊中。
在 6 个单位(包括重症监护病房和普通医疗病房的护理站和访客走廊)中设置了 8 个国家职业安全与健康研究所 BC 251 2 级旋风采样器,每个采样周期采集 6 小时。采样器放置在三脚架上,三脚架上放置了 2 个采样器,距离地面 102 厘米和 152 厘米。单位采样持续 3 天。提取的样本经过逆转录聚合酶链反应,对 SARS-CoV-2 病毒核衣壳的选定基因区域和管家基因人 RNase P 进行检测,作为内部对照。
采样日各单位存在的经实验室确诊的 COVID-19 患者数量不同。一些单位包括负压病房,而大多数单位则保持中性压力。在采集的 528 个气溶胶样本中,没有一个样本的 SARS-CoV-2 RNA 呈阳性,估计空气中的病毒拷贝数为 8 拷贝/立方米。
病房外的气溶胶化 SARS-CoV-2 无法检测到。虽然医护人员应避免无口罩的近距离接触,但这些发现可能为当前大流行期间在病房外区域使用替代紧配合式呼吸器提供保证。