Department of Infectious Diseases, Singapore General Hospital, Singapore.
Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
Am J Infect Control. 2023 Apr;51(4):413-419. doi: 10.1016/j.ajic.2022.09.004. Epub 2022 Oct 28.
Temporary isolation wards have been introduced to meet demands for airborne-infection-isolation-rooms (AIIRs) during the COVID-19 pandemic. Environmental sampling and outbreak investigation was conducted in temporary isolation wards converted from general wards and/or prefabricated containers, in order to evaluate the ability of such temporary isolation wards to safely manage COVID-19 cases over a period of sustained use.
Environmental sampling for SARS-CoV-2 RNA was conducted in temporary isolation ward rooms constructed from pre-fabricated containers (N = 20) or converted from normal-pressure general wards (N = 47). Whole genome sequencing (WGS) was utilized to ascertain health care-associated transmission when clusters were reported amongst HCWs working in isolation areas from July 2020 to December 2021.
A total of 355 environmental swabs were collected; 22.4% (15/67) of patients had at least one positive environmental sample. Patients housed in temporary isolation ward rooms constructed from pre-fabricated containers (adjusted-odds-ratio, aOR = 10.46, 95% CI = 3.89-58.91, P = .008) had greater odds of detectable environmental contamination, with positive environmental samples obtained from the toilet area (60.0%, 12/20) and patient equipment, including electronic devices used for patient communication (8/20, 40.0%). A single HCW cluster was reported amongst staff working in the temporary isolation ward constructed from pre-fabricated containers; however, health care-associated transmission was deemed unlikely based on WGS and/or epidemiological investigations.
Environmental contamination with SARS-CoV-2 RNA was observed in temporary isolation wards, particularly from the toilet area and smartphones used for patient communication. However, despite intensive surveillance, no healthcare-associated transmission was detected in temporary isolation wards over 18 months of prolonged usage, demonstrating their capacity for sustained use during succeeding pandemic waves.
在 COVID-19 大流行期间，为满足空气传播感染隔离病房（AIIR）的需求，引入了临时隔离病房。对从普通病房和/或预制容器改建的临时隔离病房进行了环境采样和暴发调查，以评估这些临时隔离病房在持续使用一段时间内安全管理 COVID-19 病例的能力。
对从预制容器（N=20）或从普通病房改建的临时隔离病房（N=47）采集的环境样本进行了 SARS-CoV-2 RNA 环境采样。当 2020 年 7 月至 2021 年 12 月期间报告隔离区医护人员中出现聚集性病例时，利用全基因组测序（WGS）来确定是否存在与医疗保健相关的传播。
共采集了 355 个环境拭子；有 22.4%（15/67）的患者至少有一个环境样本呈阳性。从预制容器中改建的临时隔离病房（调整后的优势比，aOR=10.46，95%CI=3.89-58.91，P=0.008）的患者环境污染检测呈阳性的可能性更大，从厕所区（60.0%，12/20）和患者设备，包括用于与患者沟通的电子设备（8/20，40.0%）中获得了阳性环境样本。报告了一个单一的医护人员聚集性病例，该聚集性病例发生在从预制容器中改建的临时隔离病房工作的工作人员中；然而，基于 WGS 和/或流行病学调查，认为不存在与医疗保健相关的传播。
在临时隔离病房中观察到 SARS-CoV-2 RNA 的环境污染，特别是从厕所区和用于与患者沟通的智能手机中。然而，尽管进行了密集监测，但在临时隔离病房持续使用 18 个月期间未检测到与医疗保健相关的传播，证明了它们在随后的大流行浪潮中持续使用的能力。
