Risk of nosocomial transmission of coronavirus disease 2019: an experience in a general ward setting in Hong Kong
Risk of nosocomial transmission of coronavirus disease 2019: an experience in a general ward setting in Hong Kong
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DOI：
10.1016/j.jhin.2020.03.036
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发表时间：
2020-06-01
影响因子：
6.9
通讯作者：
Lung, D. C.
中科院分区：
文献类型：
--
作者：
Wong, S. C. Y.;Kwong, R. T-S;Lung, D. C.
背景：冠状病毒病2019(新冠肺炎)于2019年12月在武汉首次报告，并在中国内外的不同城市迅速传播。香港于2019年12月31日开始为新冠肺炎做准备，公立医院的感染控制措施被收紧，以限制医疗设施内的医院传播。然而，关于医院环境下新冠肺炎所需的基于传播的预防措施的建议各不相同，从飞沫和接触预防，到将患者安置在空气传播感染隔离室的接触和空气传播预防措施。目的：描述一例新冠肺炎患者在确诊前在普通病房的开放式隔间接受护理的暴发调查。方法：确定接触者并将其风险归类为“密切”或“随意”，以决定隔离和/或医学监测。在监测期间，从出现发烧和/或呼吸道症状的接触者身上收集呼吸道样本，并进行SARS-CoV-2检测。结果：通过接触者追踪，共发现71名工作人员和49名患者，其中7名工作人员和10名患者符合“密切接触”标准。在28天的监测结束时，对52名接触者进行了76次检测，均为阴性，包括所有患者密切接触者和7名工作人员密切接触者中的6人。结论：SARS-CoV-2不是通过空气传播，院内感染可通过戴口罩、手部和环境卫生等基本控制措施预防。(C)2020年医疗感染学会。爱思唯尔有限公司出版。保留所有权利。
Background: Coronavirus disease 2019 (COVID-19) was first reported in Wuhan in December 2019 and has rapidly spread across different cities within and outside China. Hong Kong started to prepare for COVID-19 on 31st December 2019 and infection control measures in public hospitals were tightened to limit nosocomial transmission within healthcare facilities. However, the recommendations on the transmission-based precautions required for COVID-19 in hospital settings vary from droplet and contact precautions, to contact and airborne precautions with placement of patients in airborne infection isolation rooms.Aim: To describe an outbreak investigation of a patient with COVID-19 who was nursed in an open cubicle of a general ward before the diagnosis was made.Method: Contacts were identified and risk categorized as 'close' or 'casual' for decisions on quarantine and/or medical surveillance. Respiratory specimens were collected from contacts who developed fever, and/or respiratory symptoms during the surveillance period and were tested for SARS-CoV-2.Findings: A total of 71 staff and 49 patients were identified from contact tracing, seven staff and 10 patients fulfilled the criteria of 'close contact'. At the end of 28-day surveillance, 76 tests were performed on 52 contacts and all were negative, including all patient close contacts and six of the seven staff close contacts. The remaining contacts were asymptomatic throughout the surveillance period.Conclusion: Our findings suggest that SARS-CoV-2 is not spread by an airborne route, and nosocomial transmissions can be prevented through vigilant basic infection control measures, including wearing of surgical masks, hand and environmental hygiene. (C) 2020 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.