Andrés M, García M-C, Fajardo A, Grau L, Pagespetit L, Plasencia V, Martínez I, Abadía C, Sanahuja A, Bella F
Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital de Terrassa (Consorci Sanitari de Terrassa), Tarrassa (Barcelona), España.
Equipo de Control de Infecciones, Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital de Terrassa (Consorci Sanitari de Terrassa) , Tarrassa (Barcelona), España.
Rev Clin Esp. 2022 Dec;222(10):578-583. doi: 10.1016/j.rce.2022.04.001. Epub 2022 May 6.
Despite the increasing evidence supporting the importance of airborne transmission in SARS-CoV-2 infection, it has not been considered relevant in the vast majority of reported nosocomial outbreaks of COVID-19. The aim of this study is to describe a nosocomial outbreak of SARS-CoV-2 infection whose features suggest that aerosol transmission had an important role.
This is a descriptive analysis of a nosocomial outbreak of SARS-CoV-2 infection in an internal medicine ward that occurred in December 2020. All cases were confirmed by a positive PCR test for SARS-CoV-2.
From December 5 to December 17, 21 patients and 44 healthcare workers developed a nosocomial SARS-CoV-2 infection. Fifty-one of the 65 cases (78.5%) were diagnosed between December 6 and 9. The attack rate in patients was 80.8%. Among workers, the attack rate was higher in those who had worked at least one full working day in the ward (56.3%) than in those who had occasionally been in the ward (25.8%, = 0.005). Three days before the first positive case was detected, 2 extractor fans were found to be defective, affecting the ventilation of 3 rooms. Sixteen cases were asymptomatic, 48 cases had non-severe symptoms, and 2 cases required admission to the intensive care unit. All patients eventually recovered.
The high attack rate, the explosive nature of the outbreak, and the coincidence in time with the breakdown in air extractors in some rooms of the ward suggest that airborne transmission played a key role in the development of the outbreak.
尽管越来越多的证据支持空气传播在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染中的重要性，但在绝大多数已报告的新型冠状病毒肺炎（COVID-19）医院感染暴发中，空气传播并未被认为是相关因素。本研究的目的是描述一次SARS-CoV-2感染的医院感染暴发，其特征表明气溶胶传播起到了重要作用。
这是一项对2020年12月发生在内科病房的SARS-CoV-2感染医院感染暴发的描述性分析。所有病例均通过SARS-CoV-2核酸检测阳性确诊。
从12月5日至12月17日，21名患者和44名医护人员发生了医院获得性SARS-CoV-2感染。65例病例中的51例（78.5%）在12月6日至9日被诊断。患者的感染率为80.8%。在工作人员中，在病房至少工作一个完整工作日的人员感染率（56.3%）高于偶尔进入病房的人员（25.8%，P = 0.005）。在检测到首例阳性病例的三天前，发现2台抽气扇有故障，影响了3个房间的通风。16例无症状，48例有非严重症状，2例需要入住重症监护病房。所有患者最终均康复。
高感染率、暴发的突发性以及与病房部分房间抽气扇故障在时间上的巧合表明，空气传播在此次暴发的发生中起了关键作用。
