Containment of a healthcare-associated COVID-19 outbreak in a university hospital in Seoul, Korea: A single-center experience
Containment of a healthcare-associated COVID-19 outbreak in a university hospital in Seoul, Korea: A single-center experience
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DOI：
10.1371/journal.pone.0237692
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发表时间：
2020-08-14
期刊：
影响因子：
3.7
通讯作者：
Lee, Jehoon
中科院分区：
文献类型：
--
作者：
Kim, Sei Won;Jo, Sung Jin;Lee, Jehoon
背景：在韩国确诊首例新冠肺炎病例时，首尔发生了首尔首例与医疗保健相关的新冠肺炎疫情。首例确诊的新冠肺炎患者是一名医院内负责转运患者的工作人员。为了控制病毒的传播，我们关闭了我们的医院，并对所有住院患者、医务人员和员工进行了检测。方法根据接触史、职业、有无呼吸道症状对SARS-CoV-2 RT-PCR检测结果进行回顾性分析。在流行病学家在场的情况下对闭路电视进行了审查，以确定与确诊的新冠肺炎患者有过接触的个人。结果共采集2924人的3091份呼吸道样本。在2924名患者中，两名住院患者和一名照顾者检测呈阳性(阳性率为0.1%)。尽管所有确诊病例都与为肺科患者指定的普通病房有关，但没有医务人员、医疗支持人员或在同一病房工作的员工受到感染。住院患者和医疗支持人员与新冠肺炎确诊病例接触频繁。最常见的接触区是肺科患者的普通病房和医疗支持区，包括临床和影像检查室。最后，医院相关感染总数为14例，其中4例在医院确诊，10例在医院外确诊。结论新冠肺炎疫情的有力控制进一步减少了SARS-CoV-2在医院和当地社区的传播。然而，关于医院关闭和对所有医院工作人员和患者进行测试的适当时间也存在争议。未来的研究需要根据流行病学和临床环境来完善和建立医院内隔离和非隔离指南。
Background Our hospital experienced the first healthcare-associated COVID-19 outbreak in Seoul at the time the first COVID-19 cases were confirmed in Korea. The first confirmed COVID-19 patient was a hospital personnel who was in charge of transferring patients inside our hospital. To contain the virus spread, we shutdown our hospital, and tested all inpatients, medical staff members, and employees. Methods We retrospectively analyzed the results of SARS-CoV-2 RT-PCR testing according to the contact history, occupation, and presence of respiratory symptoms. Closed-circuit television (CCTV) was reviewed in the presence of an epidemiologist to identify individuals who came into contact with confirmed COVID-19 patients. Results A total of 3,091 respiratory samples from 2,924 individuals were obtained. Among 2,924 individuals, two inpatients, and one caregiver tested positive (positivity rate, 0.1%). Although all confirmed cases were linked to a general ward designated for pulmonology patients, no medical staff members, medical support personnel, or employees working at the same ward were infected. Contact with confirmed COVID-19 cases was frequent among inpatients and medical support personnel. The most common contact area was the general ward for pulmonology patients and medical support areas, including clinical and imaging examination rooms. Finally, the total number of hospital-associated infections was 14, consisting of four diagnosed at our hospital and ten diagnosed outside the hospital. Conclusions The robust control of the COVID-19 outbreak further minimized the transmission of SARS-CoV-2 in the hospital and local communities. However, there was also a debate over the appropriate period of hospital shutdown and testing of all hospital staff and patients. Future studies are required to refine and establish the in-hospital quarantine and de-isolation guidelines based on the epidemiological and clinical settings.