Usiak Shauna, Aslam Anoshe, Yan Judy, Madhavappallil Jerin, Bokhari Marissa, Romero Tiffany, Bubb Tania N, Kodama Rich, Babady Esther, Kamboj Mini
Infection Control, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Infect Control Hosp Epidemiol. 2024 Dec 3:1-3. doi: 10.1017/ice.2024.174.
SARS-CoV-2 asymptomatic surveillance testing (AST) is a common strategy to minimize the risk of nosocomial infection in patients and healthcare personnel. In contrast to admission screening, post-admission AST was less widely adopted.
This study describes the diagnostic yield of post-admission serial SARS-COV-2 testing in hospitalized patients at a large cancer center with mostly double-occupancy rooms.
Retrospective cohort study design. Post-admission SARS-CoV-2 tests were examined over a 18 month study period. Positive results were reviewed to determine true hospital-onset infections using a combination criteria of screening all sample cycle threshold (Ct) values >30, results of non-concordant repeat testing, and clinical symptoms.
Post-admission serial testing of 15,048 hospitalized patients during an 18-month study period at a tertiary care cancer center detected hospital-onset infection in 1.6% (n = 245 patients). Among all hospital-onset positive SARS-CoV-2 RNA tests, 13% were clinically false positive. Most true infections were mild to moderate in severity.
In summary, post-admission serial testing in a high-risk setting is a low-yield strategy with several unfavorable effects and should no longer be routinely applied.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）无症状监测检测（AST）是一种将患者和医护人员医院感染风险降至最低的常用策略。与入院筛查不同，入院后AST的应用不太广泛。
本研究描述了在一家大多为双人间的大型癌症中心，对住院患者进行入院后系列SARS-CoV-2检测的诊断率。
回顾性队列研究设计。在18个月的研究期间检查入院后SARS-CoV-2检测情况。对阳性结果进行审查，以使用所有样本循环阈值（Ct）值>30的筛查、不一致重复检测结果和临床症状的综合标准来确定真正的医院感染。
在一家三级护理癌症中心18个月的研究期间，对15048名住院患者进行入院后系列检测，发现1.6%（n = 245例患者）发生医院感染。在所有医院感染阳性的SARS-CoV-2 RNA检测中，13%为临床假阳性。大多数真正的感染为轻度至中度。
总之，在高风险环境中进行入院后系列检测是一种低收益策略，有多种不利影响，不应再常规应用。
