Division of Infection Control and Biosafety, Taiwan Centers for Disease Control, Taipei, Taiwan.
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Infect Control Hosp Epidemiol. 2024 Jan;45(1):68-74. doi: 10.1017/ice.2023.144. Epub 2023 Jul 18.
Universal admission screening and follow-up symptom-based testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may play critical roles in controlling nosocomial transmission. We describe the performance of test strategies for inpatients and their companions during various disease incidences in Taiwan.
Retrospective population-based cohort study.
The study was conducted across 476 hospitals in Taiwan.
The data for both testing strategies by reverse transcription-polymerase chain reaction for SARS-CoV-2 in newly admitted patients and their companions during May 2021-June 2022 were extracted and analyzed.
The positivity rate of universal admission screening was 0.76% (14,640 of 1,928,676) for patients and 0.37% (5,372 of 1,438,944) for companions. The weekly community incidences of period 1 (May 2021-June 2021), period 2 (July 2021-March 2022), and period 3 (April 2022-June 2022) were 6.57, 0.27, and 1,261, respectively, per 100,000 population. The positivity rates of universal admission screening for patients and companions (4.39% and 2.18%) in period 3 were higher than those in periods 1 (0.29% and 0.04%) and 2 (0.03% and 0.003%) (all < .01). Among the 22,201 confirmed cases, 9.86% were identified by symptom-based testing. The costs and potential savings of universal admission screening for patients and companions achieved a breakeven point when the test strategy was implemented in a period with weekly community incidences of 27 and 358 per 100,000 population, respectively.
Universal admission screening and follow-up symptom-based testing is important for reducing nosocomial transmission. Implementing universal admission screening at an appropriate time would balance the benefits with costs and potential unintended harms.
对严重急性呼吸综合征冠状病毒 2 （SARS-CoV-2）进行普遍入院筛查和基于症状的后续检测，可能在控制医院内传播方面发挥关键作用。我们描述了在台湾不同疾病发病期间对住院患者及其陪护人员进行检测策略的性能。
回顾性基于人群的队列研究。
研究在台湾的 476 家医院进行。
提取并分析了 2021 年 5 月至 2022 年 6 月期间新入院患者及其陪护人员采用逆转录聚合酶链反应（RT-PCR）进行的两种检测策略的检测结果。
普遍入院筛查的阳性率为患者 0.76%（1928676 人中有 14640 人），陪护人员 0.37%（1438944 人中有 5372 人）。第 1 期（2021 年 5 月至 2021 年 6 月）、第 2 期（2021 年 7 月至 2022 年 3 月）和第 3 期（2022 年 4 月至 2022 年 6 月）的每周社区发病率分别为每 10 万人 6.57、0.27 和 1261。第 3 期患者和陪护人员的普遍入院筛查阳性率（4.39%和 2.18%）高于第 1 期（0.29%和 0.04%）和第 2 期（0.03%和 0.003%）（均<.01）。在 22201 例确诊病例中，有 9.86%是通过症状检测发现的。当每周每 10 万人社区发病率分别达到 27 和 358 时，对患者和陪护人员进行普遍入院筛查的成本和潜在节省就达到了盈亏平衡点。
普遍入院筛查和基于症状的后续检测对减少医院内传播很重要。在适当的时候实施普遍入院筛查，将使效益与成本和潜在的意外危害达到平衡。
