Environmental Contamination and Viral Shedding in MERS Patients During MERS-CoV Outbreak in South Korea
Environmental Contamination and Viral Shedding in MERS Patients During MERS-CoV Outbreak in South Korea
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DOI：
10.1093/cid/civ1020
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发表时间：
2016-03-15
影响因子：
11.8
通讯作者：
Choi, Young Ki
中科院分区：
文献类型：
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作者：
Bin, Seo Yu;Heo, Jung Yeon;Choi, Young Ki
背景虽然中东呼吸综合征冠状病毒（MERS-CoV）的特点是医院传播的风险，详细的传播模式和病毒从感染患者脱落的时间知之甚少。本研究的目的是调查MERS冠状病毒在医疗环境中的环境污染的潜在作用，并确定MERS患者的活病毒脱落期。我们调查了2家医院MERS CoV部门的4名患者的环境污染。采用逆转录聚合酶链反应（PCR）检测MERS CoV，并通过培养分离活病毒。MERS病房的许多环境表面，包括患者或医护人员经常接触的地方，都被MERS-CoV污染。在患者呼吸道标本的最后一次阳性PCR后，从环境表面检测到病毒RNA长达5天。MERS-CoV RNA在前房、医疗器械和通风设备的样本中检测到。此外，MERS-CoV与环境物体分离，如床单，床栏杆，IV流体衣架和X射线设备。在MERS晚期临床阶段，4例患者中有3例在症状发作后第18 ~ 25天分离到活病毒。MERS病房的大部分可触摸表面都被病人和医护人员污染，活病毒可以通过临床完全康复的病人的呼吸道分泌物传播。这些结果强调需要严格的环境表面卫生习惯，并根据实验室结果而不仅仅是临床症状进行足够的隔离期。
Background. Although Middle East Respiratory Syndrome coronavirus (MERS-CoV) is characterized by a risk of nosocomial transmission, the detailed mode of transmission and period of virus shedding from infected patients are poorly understood. The aims of this study were to investigate the potential role of environmental contamination by MERS-CoV in healthcare settings and to define the period of viable virus shedding from MERS patients.Methods. We investigated environmental contamination from 4 patients in MERS-CoV units of 2 hospitals. MERS-CoV was detected by reverse transcription polymerase chain reaction (PCR) and viable virus was isolated by cultures.Results. Many environmental surfaces of MERS patient rooms, including points frequently touched by patients or healthcare workers, were contaminated by MERS-CoV. Viral RNA was detected up to five days from environmental surfaces following the last positive PCR from patients' respiratory specimens. MERS-CoV RNA was detected in samples from anterooms, medical devices, and air-ventilating equipment. In addition, MERS-CoV was isolated from environmental objects such as bed sheets, bedrails, IV fluid hangers, and X-ray devices. During the late clinical phase of MERS, viable virus could be isolated in 3 of the 4 enrolled patients on day 18 to day 25 after symptom onset.Conclusions. Most of touchable surfaces in MERS units were contaminated by patients and health care workers and the viable virus could shed through respiratory secretion from clinically fully recovered patients. These results emphasize the need for strict environmental surface hygiene practices, and sufficient isolation period based on laboratory results rather than solely on clinical symptoms.