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COVID-19 无症状医护人员 RT-PCR 检测对大流行期间缺勤和医院传播的影响。

Impact of COVID-19 RT-PCR testing of asymptomatic health care workers on absenteeism and hospital transmission during the pandemic.

机构信息

Center for Life Sciences, Postgraduate Program in Health Sciences, Av John Boyd Dunlop, Pontifical Catholic University of Campinas (PUC-Campinas), Campinas, SP, Brazil.

Centro de Pesquisa São Lucas, Av John Boyd Dunlop, Pontifical Catholic University of Campinas (PUC-Campinas), Campinas, SP, Brazil.

出版信息

Am J Infect Control. 2023 Mar;51(3):248-254. doi: 10.1016/j.ajic.2022.10.014. Epub 2022 Nov 12.

Abstract

BACKGROUND

Reducing the transmission of SARS-CoV-2 from asymptomatic and pre-symptomatic patients is critical in controlling the circulation of the virus.

METHODS

This study evaluated the prevalence of Reverse transcription polymerase chain reaction (RT-PCR) positivity in serial tests in 429 asymptomatic health care workers (HCW) and its impact on absenteeism. HCW from a COVID-19 reference hospital were tested, screened, and placed on leave. A time-series segmented regression of weekly absenteeism rates was used, and cases of infection among hospitalized patients were analyzed. Viral gene sequencing and phylogenetic analysis were performed on samples from HCW who had a positive result.

RESULTS

A significant decrease in absenteeism was detected 3-4 weeks after the intervention at a time of increased transmission within the city. The prevalence of RT-PCR positivity among asymptomatic professionals was 17.3%. Phylogenetic analyses (59 samples) detected nine clusters, two of them strongly suggestive of intrahospital transmission with strains (75% B.1.1.28) circulating in the region during this period.

CONCLUSIONS

Testing and placing asymptomatic professionals on leave contributed to control strategy for COVID-19 transmission in the hospital environment, and in reducing positivity and absenteeism, which directly influences the quality of care and exposes professionals to an extra load of stress.

摘要

背景

降低无症状和出现症状前患者的 SARS-CoV-2 传播率对于控制病毒的传播至关重要。

方法

本研究评估了在 429 名无症状医护人员(HCW)的连续检测中逆转录聚合酶链反应(RT-PCR)阳性的发生率及其对缺勤的影响。对来自 COVID-19 参考医院的 HCW 进行检测、筛查和休假。使用每周缺勤率的时间序列分段回归,并分析住院患者的感染情况。对 RT-PCR 检测结果阳性的 HCW 样本进行病毒基因测序和系统发育分析。

结果

在城市传播增加的情况下,干预 3-4 周后缺勤率显著下降。无症状专业人员 RT-PCR 阳性率为 17.3%。系统发育分析(59 个样本)检测到 9 个聚类,其中 2 个聚类强烈提示存在医院内传播,且在此期间该地区存在(75% B.1.1.28)的流行株。

结论

对无症状专业人员进行检测和休假有助于控制医院环境中的 COVID-19 传播策略,并降低阳性率和缺勤率,这直接影响护理质量,并使专业人员承受额外的压力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a2c/9671504/ab41458dce25/gr1_lrg.jpg

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