Infectious Diseases Society of America Guidelines on Infection Prevention for Healthcare Personnel Caring for Patients With Suspected or Known COVID-19 (July 2020)
Infectious Diseases Society of America Guidelines on Infection Prevention for Healthcare Personnel Caring for Patients With Suspected or Known COVID-19 (July 2020)
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DOI：
10.1093/cid/ciaa1063
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发表时间：
2020-10-08
影响因子：
11.8
通讯作者：
Sultan, Shahnaz
中科院分区：
文献类型：
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作者：
Lynch, John B.;Davitkov, Perica;Sultan, Shahnaz
背景 严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 是一种高度传播的病毒，可以感染医疗机构中的医护人员 (HCP) 和患者。特定护理活动，特别是产生气溶胶的程序，可能具有较高的传播风险。 SARS-CoV-2 的迅速出现和全球传播给医疗机构带来了重大挑战，特别是用于保护 HCP 的个人防护装备 (PPE) 严重短缺。需要针对在常规、应急和危机护理标准中使用哪些个人防护装备提出基于证据的建议。在缺乏证据的情况下，制定具体的研究问题可以帮助指导资助者和研究人员。 目的 我们的目标是制定基于证据的快速指南，旨在支持 HCP 在护理疑似或已知的 2019 冠状病毒病 (COVID-19) 患者时做出有关感染预防的决定。 方法 美国传染病学会 (IDSA) 组建了一个多学科指南小组，其中包括一线临床医生、传染病专家、感染控制专家以及由来自该协会的代表组成的指南方法学家。预防保健、公共卫生、医学微生物学、儿科、重症监护医学和胃肠病学等学科。该过程遵循快速推荐清单。小组对问题和结果进行了优先排序。然后，对同行评审和灰色文献进行了系统回顾。建议分级评估、制定和评估方法用于评估证据的确定性并提出建议。结果 IDSA 指南小组就 8 项建议达成一致，并提供了正在评估的其他干预措施的叙述性总结。结论 结合直接和间接证据，小组能够针对为疑似或已知 COVID-19 患者提供护理的 HCP 使用 PPE 的 8 个具体问题提供建议。在缺乏证据的情况下，我们尝试提供潜在的调查途径。对 SARS-CoV-2 传播动力学的理解仍然存在重大差距，个人防护装备建议可能需要根据新证据进行修改。
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible virus that can infect healthcare personnel (HCP) and patients in healthcare settings. Specific care activities, in particular, aerosol-generating procedures, may have a higher risk of transmission. The rapid emergence and global spread of SARS-CoV-2 has created significant challenges in healthcare facilities, particularly with severe shortages of personal protective equipment (PPE) used to protect HCP. Evidence-based recommendations for what PPE to use in conventional, contingency, and crisis standards of care are needed. Where evidence is lacking, the development of specific research questions can help direct funders and investigators.Objective Our objective was to develop evidence-based rapid guidelines intended to support HCP in their decisions about infection prevention when caring for patients with suspected or known coronavirus disease 2019 (COVID-19).Methods The Infectious Diseases Society of America (IDSA) formed a multidisciplinary guideline panel that included front-line clinicians, infectious diseases specialists, experts in infection control, and guideline methodologists with representation from the disciplines of preventive care, public health, medical microbiology, pediatrics, critical care medicine, and gastroenterology. The process followed a rapid recommendation checklist. The panel prioritized questions and outcomes. Then, a systematic review of the peer-reviewed and gray literature was conducted. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the certainty of evidence and make recommendations.Results The IDSA guideline panel agreed on 8 recommendations and provided narrative summaries of other interventions undergoing evaluations.Conclusions Using a combination of direct and indirect evidence, the panel was able to provide recommendations for 8 specific questions on the use of PPE for HCP who provide care for patients with suspected or known COVID-19. Where evidence was lacking, attempts were made to provide potential avenues for investigation. Significant gaps in the understanding of the transmission dynamics of SARS-CoV-2 remain, and PPE recommendations may need to be modified in response to new evidence.