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关于 COVID-19 医院获得性(医院内)感染控制的观点:病房和空气隔离单元之间空间隔离的有用性。

A perspective on hospital-acquired (nosocomial) infection control of COVID-19: usefulness of spatial separation between wards and airborne isolation unit.

机构信息

Department of General Internal Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan.

Center for Advanced Emergency Medicine and Critical Care, Saitama Medical Center, Saitama Medical University, Saitama, Japan.

出版信息

J Breath Res. 2021 Jul 30;15(4). doi: 10.1088/1752-7163/ac1721.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has imposed a considerable burden on hospitals and healthcare workers (HCWs) worldwide, increasing the risk of outbreaks and nosocomial transmission to 'non-COVID-19' patients, who represent the highest-risk population in terms of mortality, and HCWs. Since HCWs are at the interface between hospitals on the one hand and the community on the other, they are potential reservoirs, carriers, or victims of severe acute respiratory syndrome coronavirus 2 cross-transmission. In addition, there has been a paradigm shift in the management of viral respiratory outbreaks, such as the widespread testing of patients and HCWs, including asymptomatic individuals. In hospitals, there is a risk of aerosol transmission in poorly ventilated spaces, and when performing aerosol-producing procedures, it is imperative to take measures against aerosol transmission. In particular, spatial separation of the inpatient ward for non-COVID-19 patients from that designated for patients with suspected or confirmed COVID-19 as well as negative-pressure isolation on the floor of the ward, using an airborne infection isolation device could help prevent nosocomial infection.

摘要

2019 年冠状病毒病(COVID-19)大流行给全世界的医院和医护人员(HCWs)带来了相当大的负担,增加了爆发和医院内传播给“非 COVID-19”患者的风险,这些患者在死亡率方面是最高风险人群,并且 HCWs 也是如此。由于 HCWs 处于医院与社区之间的界面,因此他们是严重急性呼吸系统综合征冠状病毒 2 交叉传播的潜在储主、携带者或受害者。此外,病毒呼吸道爆发的管理模式发生了转变,例如对患者和 HCWs(包括无症状个体)进行广泛的检测。在医院中,在通风不良的空间中存在气溶胶传播的风险,并且在进行产生气溶胶的程序时,必须采取措施防止气溶胶传播。特别是,将非 COVID-19 患者的住院病房与疑似或确诊 COVID-19 患者的病房空间分开,并在病房地板上使用空气传播感染隔离设备进行负压隔离,有助于防止医院感染。

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