Vetrugno Giuseppe, Grassi Simone, Clemente Francesco, Cazzato Francesca, Rossi Vittoria, Grassi Vincenzo M, Buonsenso Danilo, Filograna Laura, Sanguinetti Maurizio, Focardi Martina, Valentini Piero, Ozonoff Al, Pinchi Vilma, Oliva Antonio
Section of Legal Medicine, Department of Health Surveillance and Bioethics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Del Sacro Cuore, Rome, Italy.
Section of Forensic Medical Sciences, Department of Health Sciences, University of Florence, Florence, Italy.
Front Pediatr. 2022 Sep 6;10:966901. doi: 10.3389/fped.2022.966901. eCollection 2022.
INTRODUCTION/PURPOSE: Since a significant proportion of SARS-CoV-2 infections occur within healthcare facilities, a multidisciplinary approach is required for careful and timely assessment of the risk of infection in asymptomatic patients or those whose COVID-19 diagnosis has not yet been made. The aim of this study was to investigate whether an adaptative model based on microbiological testing can represent a valid risk management strategy.
We collected data from the risk management unit database of a 1,550-bed tertiary hospital (Fondazione Policlinico Gemelli IRCCS, Rome, Italy) concerning pediatric admissions to the Emergency Department (ED) from 1 March 2020 to 31 December 2021. The study period was subdivided in period A and period B according to the technique used for the microbiological screening, respectively reverse-transcription polymerase chain reaction (RT-PCR) and antigen-detection test.
In Period A, 426 children (mean age: 6 years) underwent microbiological screening at the ED. The total number of molecular tests performed was 463. 459/463 tested negative at the molecular test. In Period B, 887 children (mean age: 6 years) underwent microbiological screening in the ED. The total number of molecular tests performed was 1,154. 1,117/1,154 tested negative at the molecular test. Neither in Period A nor in Period B hospital-acquired SARS-CoV-2 infections were reported.
Despite high volumes, no cases of hospital-acquired SARS-CoV-2 infection have been reported. SARS-CoV-2 antigen-based tests can be used as a first-line option as they provide rapid results compared to RT-PCR, reducing the risk of infection in ED waiting rooms.
引言/目的:由于相当一部分新冠病毒感染发生在医疗机构内,因此需要采取多学科方法,以便对无症状患者或尚未确诊为新冠肺炎的患者进行仔细、及时的感染风险评估。本研究的目的是调查基于微生物检测的适应性模型是否可作为一种有效的风险管理策略。
我们从一家拥有1550张床位的三级医院(意大利罗马的圣心天主教大学综合医院基金会)风险管理部门数据库中收集了2020年3月1日至2021年12月31日期间儿科急诊入院患者的数据。根据微生物筛查所采用的技术,研究期分为A期和B期,分别采用逆转录聚合酶链反应(RT-PCR)和抗原检测试验。
在A期,426名儿童(平均年龄:6岁)在急诊科接受了微生物筛查。共进行了463次分子检测。463次检测中有459次分子检测呈阴性。在B期,887名儿童(平均年龄:6岁)在急诊科接受了微生物筛查。共进行了1154次分子检测。1154次检测中有1117次分子检测呈阴性。A期和B期均未报告医院获得性新冠病毒感染病例。
尽管检测量很大,但未报告医院获得性新冠病毒感染病例。基于新冠病毒抗原的检测可作为一线选择,因为与RT-PCR相比,其结果出得更快,可降低急诊科候诊室的感染风险。