Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Respir Care. 2023 Jan;68(1):1-7. doi: 10.4187/respcare.10323. Epub 2022 Nov 15.
Environmental contamination by SARS-CoV-2 from patients with COVID-19 undergoing noninvasive ventilation (NIV) in the ICU is still under investigation. This study set out to investigate the presence of SARS-CoV-2 on surfaces near subjects receiving NIV in the ICU under controlled conditions (ie, use of dual-limb circuits, filters, adequate room ventilation).
This was a single-center, prospective, observational study in the ICU of a tertiary teaching hospital. Four surface sampling areas, at increasing distance from subject's face, were identified; and each one was sampled at fixed intervals: 6, 12, and 24 h. The presence of SARS-CoV-2 was detected with real-time reverse transcriptase-polymerase-chain-reaction (RT-PCR) test on environmental swabs; the RT-PCR assay targeted the SARS-CoV-2 virus nucleocapsid N1 and N2 genes and the human RNase P gene as internal control.
In a total of 256 collected samples, none were positive for SARS-CoV-2 genetic material, whereas 21 samples (8.2%) tested positive for RNase P, thus demonstrating the presence of genetic material unrelated to SARS-CoV-2.
Our data show that application of NIV in an appropriate environment and with correct precautions leads to no sign of surface environmental contamination. Accordingly, our data support the idea that use of NIV in the ICU is safe both for health care workers and for other patients.
新冠病毒（SARS-CoV-2）在接受 ICU 无创通气（NIV）的 COVID-19 患者中的环境污染仍在调查中。本研究旨在调查在受控条件下（即使用双肢回路、过滤器、充足的房间通风），接受 NIV 的 ICU 患者附近表面上 SARS-CoV-2 的存在情况。
这是一项在三级教学医院 ICU 中进行的单中心、前瞻性、观察性研究。确定了四个距离患者面部逐渐增加的表面采样区域；并在固定间隔时间（6、12 和 24 小时）对每个区域进行采样。使用实时逆转录酶聚合酶链反应（RT-PCR）试验在环境拭子上检测 SARS-CoV-2 的存在情况；RT-PCR 检测针对 SARS-CoV-2 病毒核衣壳 N1 和 N2 基因以及人类 RNase P 基因作为内对照。
在总共采集的 256 个样本中，没有一个样本的 SARS-CoV-2 遗传物质呈阳性，而 21 个样本（8.2%）的 RNase P 呈阳性，这表明存在与 SARS-CoV-2 无关的遗传物质。
我们的数据表明，在适当的环境中和采取正确的预防措施应用 NIV 不会导致表面环境污染的迹象。因此，我们的数据支持在 ICU 中使用 NIV 对医护人员和其他患者都是安全的观点。
