Meltzer Lilac, Amit Sharon, Gilboa Mayan, Tal Ilana, Mechnik Bella, Irony Avi, Engelrad Hindi, Epstein Avi, Frenkel-Nir Yael, Levy Yuval, Kreiss Yitshak, Regev-Yochay Gili
Infection Control & Prevention Unit, Sheba Medical Center, Ramat Gan 52621, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
Microorganisms. 2023 Jan 21;11(2):284. doi: 10.3390/microorganisms11020284.
The emergency department (ED) is the initial point of contact between hospital staff and patients potentially infected with SARS-CoV-2, thus, prevention of inadvertent exposure to other patients is a top priority. We aimed to assess whether the introduction of antigen-detecting rapid diagnostic tests (Ag-RDTs) to the ED affected the likelihood of unwanted SARS-CoV-2 exposures. In this retrospective single-center study, we compared the rate of unwarranted exposure of uninfected adult ED patients to SARS-CoV-2 during two separate research periods; one before Ag-RDTs were introduced, and one with Ag-RDT used as a decision-support tool. The introduction of Ag-RDTs to the ED significantly decreased the relative risk of SARS-CoV-2-negative patients being incorrectly assigned to the COVID-19 designated site ("red ED"), by 97%. There was no increase in the risk of SARS-CoV-2-positive patients incorrectly assigned to the COVID-19-free site ("green ED"). In addition, duration of ED admission was reduced in both the red and the green ED. Therefore, implementing the Ag-RDT-based triage protocol proved beneficial in preventing potential COVID-19 nosocomial transmission.
急诊科（ED）是医院工作人员与可能感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的患者的最初接触点，因此，防止意外接触其他患者是首要任务。我们旨在评估在急诊科引入抗原检测快速诊断测试（Ag-RDT）是否会影响意外感染SARS-CoV-2的可能性。在这项回顾性单中心研究中，我们比较了在两个不同研究期间未感染的成年急诊科患者无必要接触SARS-CoV-2的发生率；一个是在引入Ag-RDT之前，另一个是将Ag-RDT用作决策支持工具的时期。在急诊科引入Ag-RDT显著降低了SARS-CoV-2阴性患者被错误分配到新冠肺炎指定区域（“红色急诊科”）的相对风险，降低了97%。将SARS-CoV-2阳性患者错误分配到无新冠肺炎区域（“绿色急诊科”）的风险没有增加。此外，红色和绿色急诊科的急诊住院时间均有所缩短。因此，实施基于Ag-RDT的分诊方案被证明有助于预防潜在的新冠肺炎医院内传播。
