Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University Basel, Basel, Switzerland.
Clinical Virology, Laboratory Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
Antimicrob Resist Infect Control. 2024 Jul 6;13(1):73. doi: 10.1186/s13756-024-01430-4.
The implementation of isolation precautions for patients with suspected Coronavirus Disease 2019 (COVID-19) and pending test results is resource intensive. Due to the limited availability of single-bed rooms at our institution, we isolated patients with suspected COVID-19 together with patients without suspected COVID-19 on-site in multiple-bed rooms until SARS-CoV-2-test results were available. We evaluated the likelihood of SARS-CoV-2 transmission to individuals sharing the room with patients isolated on-site. This observational study was performed at the University Hospital Basel, Switzerland, from 03/20 - 11/20. Secondary attack rates were compared between patients hospitalized in multiple-bed rooms and exposed to individuals subjected to on-site isolation precautions (on-site isolation group), and patients exposed to individuals initially not identified as having COVID-19, and not placed under isolation precautions until the diagnosis was suspected (control group). Transmission events were confirmed by whole-genome sequencing. Among 1,218 patients with suspected COVID-19, 67 (5.5%) tested positive for SARS-CoV-2. Of these, 21 were isolated on-site potentially exposing 27 patients sharing the same room. Median contact time was 12 h (interquartile range 7-18 h). SARS-CoV-2 transmission was identified in none of the patients in the on-site isolation group vs. 10/63 (15.9%) in the control group (p = 0.03). Isolation on-site of suspected COVID-19-patients in multiple-bed rooms avoided single-room occupancy and subsequent in-hospital relocation for many patients without confirmed SARS-CoV-2-infection. The absence of secondary transmission among the exposed patients in the on-site isolation group allows for assessment of the risk/benefit ratio of this strategy given the limitation of a small sample size.
实施针对疑似 2019 年冠状病毒病（COVID-19）患者和待检测结果的隔离预防措施需要耗费大量资源。由于我们机构的单人间床位有限，因此我们将疑似 COVID-19 患者与未疑似 COVID-19 的患者一起安置在多人间病房中，直到获得 SARS-CoV-2 检测结果。我们评估了与现场隔离患者同住一室的个体感染 SARS-CoV-2 的可能性。这项观察性研究在瑞士巴塞尔大学医院进行，时间为 2020 年 3 月至 11 月。我们比较了在多人间病房住院且暴露于现场隔离预防措施的个体（现场隔离组）的患者和暴露于最初未被确定为 COVID-19 患者且未被隔离的个体（对照组）的二级攻击率。通过全基因组测序确认传播事件。在 1218 名疑似 COVID-19 的患者中，有 67 人（5.5%）对 SARS-CoV-2 检测呈阳性。其中 21 人在现场隔离，可能会使 27 名同住一室的患者暴露于其中。中位接触时间为 12 小时（四分位间距为 7-18 小时）。现场隔离组中未发现 SARS-CoV-2 传播，而对照组中有 10/63（15.9%）例（p=0.03）。在多人间病房中对疑似 COVID-19 患者进行现场隔离避免了许多未确诊 SARS-CoV-2 感染的患者入住单人病房和随后的院内转移。现场隔离组中暴露的患者未发生二次传播，这使得我们能够在样本量较小的限制下评估这种策略的风险/获益比。
