Unité de Prévention du Risque Infectieux, Service de Microbiologie clinique, Groupe Hospitalier Paris Seine Saint-Denis, Université Sorbonne Paris Nord, Bobigny, France; Réanimation Polyvalente, Groupe Hospitalier Paris Seine Saint-Denis, Université Sorbonne Paris Nord, Bobigny, France; INSERM UMR 1137 IAME, Université de Paris and Université Sorbonne Paris Nord, Bobigny, France.
Réanimation Polyvalente, Groupe Hospitalier Paris Seine Saint-Denis, Université Sorbonne Paris Nord, Bobigny, France; INSERM UMR 1137 IAME, Université de Paris and Université Sorbonne Paris Nord, Bobigny, France; Pneumologie & Infectiologie, CH St Denis, Saint Denis, France; INSERM UMR 1272 Hypoxie & Poumon, Bobigny, Université Sorbonne Paris Nord, Bobigny, France.
J Hosp Infect. 2022 Aug;126:116-122. doi: 10.1016/j.jhin.2022.05.003. Epub 2022 May 13.
Data on the transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) remain conflicting. Airborne transmission is still debated. However, hospital risk control requires better understanding of the different modes of transmission. This study aimed to evaluate the frequency of, and factors associated with, environmental air and surface contamination in the rooms of patients with coronavirus disease 2019 in the acute phase of the disease.
Sixty-five consecutive patients were included in this study. For each patient, seven room surfaces, air 1 m and 3 m from the patient's head, the inner surface of the patient's mask, and the outer surface of healthcare workers' (HCW) masks were sampled. Environmental contamination was assessed by quantitative reverse transcription polymerase chain reaction (RT-qPCR) for SARS-CoV-2 RNA on surfaces, air and masks. A viral isolation test was performed on Vero cells for samples with an RT-qPCR cycle threshold (Ct) ≤37.
SARS-CoV-2 RNA was detected by RT-qPCR in 34%, 12%, 50% and 10% of surface, air, patient mask and HCW mask samples, respectively. Infectious virus was isolated in culture from two samples among the 85 positive samples with Ct ≤37. On multi-variate analysis, only a positive result for SARS-CoV-2 RT-qPCR for patients' face masks was found to be significantly associated with surface contamination (odds ratio 5.79, 95% confidence interval 1.31-25.67; P=0.025).
This study found that surface contamination by SARS-CoV-2 was more common than air and mask contamination. However, viable virus was rare. The inner surface of a patient's mask could be used as a marker to identify those at higher risk of contamination.
关于严重急性呼吸综合征冠状病毒 2 型（SARS-CoV-2）传播的数据仍存在争议。空气传播仍存在争议。然而，医院风险控制需要更好地了解不同的传播方式。本研究旨在评估新型冠状病毒疾病急性期患者病房环境空气和表面污染的频率和相关因素。
本研究纳入了 65 例连续患者。对每位患者，分别对 7 个房间表面、患者头部 1 m 和 3 m 处的空气、患者口罩的内表面和医护人员（HCW）口罩的外表面进行采样。通过定量逆转录聚合酶链反应（RT-qPCR）对 SARS-CoV-2 RNA 对表面、空气和口罩进行环境污染评估。对 RT-qPCR 循环阈值（Ct）≤37 的样本进行了 Vero 细胞病毒分离试验。
通过 RT-qPCR 在 34%、12%、50%和 10%的表面、空气、患者口罩和 HCW 口罩样本中检测到 SARS-CoV-2 RNA。在 85 个 Ct≤37 的阳性样本中，有两个样本在培养中分离到传染性病毒。多变量分析显示，只有患者口罩 SARS-CoV-2 RT-qPCR 阳性结果与表面污染显著相关（比值比 5.79，95%置信区间 1.31-25.67；P=0.025）。
本研究发现，SARS-CoV-2 的表面污染比空气和口罩污染更为常见。然而，活病毒很少见。患者口罩的内表面可用作识别污染风险较高者的标志物。
