Laura M Orsel, Juliëtte A Severin, Marjolein Knoester, Mariëtte Lokate, Andreas Voss, Cynthia P Haanappel, Jeroen J A van Kampen, Bart L Haagmans, Marion P G Koopmans, Karin Ellen Veldkamp, Rosa van Mansfeld, Herbert J de Jager, Anne F Voor In 't Holt, Edmée C Bowles
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引用次数: 0
Abstract
Introduction: During the COVID-19 pandemic, long-sleeved gowns were advocated as personal protective equipment for healthcare workers (HCW). The purpose of gowns is preventing transmission of infectious agents via the uniform or arms during contact with patients and their surroundings. Gowns, however, entail a substantial burden; in costs, workload for HCW, and generated waste. Our objective is to evaluate the current knowledge regarding the use of gowns during care of patients with COVID-19 and other respiratory viruses to prevent nosocomial transmission.
Methods: We used the PRISMA guidelines and searched five databases (Medline, Embase, Web of Science, Cochrane, Google Scholar) until April 11th, 2023.
Results: The search identified 2667 potentially relevant studies, of which 30 were selected and divided into four categories. In 12 studies, contamination rates of gowns ranged from 0% to 77.5% (median = 1.43%). Three out of seven studies showed that virus remained infectious the longest on Tyvek coveralls and plastic gowns, and the shortest on cotton and polyester. Two out of seven studies found a protective effect between HCW protective clothing and infection of HCW. Finally, three out of four studies concluded that short-sleeves, cotton gowns or no gowns provided the same level of protection as standard gowns.
Conclusion: The results show viral RNA can be found on clothing, but it is unclear if viruses are transmitted to HCW and/or patients. Evidence for the protective effect of long-sleeved gowns over alternatives is still insufficient. Therefore, well-controlled and adequately powered laboratory transmission experiments that simulate real-life conditions are necessary.
导言：在2019冠状病毒病大流行期间，长袖服被倡导作为医护人员的个人防护装备。防护服的目的是在与患者及其周围环境接触时，防止传染性病原体通过制服或手臂传播。然而，长袍带来了巨大的负担；成本，HCW工作量和产生的废物。我们的目标是评估目前关于在护理COVID-19和其他呼吸道病毒患者期间使用隔离衣以防止院内传播的知识。方法：采用PRISMA指南，检索Medline、Embase、Web of Science、Cochrane、b谷歌Scholar 5个数据库，检索时间截止至2023年4月11日。结果：检索确定了2667项可能相关的研究，其中30项被选中并分为四类。在12项研究中，隔离衣的污染率从0%到77.5%不等（中位数= 1.43%）。七项研究中有三项表明，穿特卫强工作服和塑料长袍的病毒保持传染性的时间最长，穿棉质和涤纶长袍的病毒保持传染性的时间最短。七项研究中有两项发现，HCW防护服与HCW感染之间存在保护作用。最后，四分之三的研究得出结论，短袖、棉质长袍或不穿长袍提供与标准长袍相同的保护水平。结论：研究结果显示衣服上可以发现病毒RNA，但尚不清楚病毒是否会传播给HCW和/或患者。证明长袖长袍比其他替代品具有保护作用的证据仍然不足。因此，有必要进行控制良好、动力充足的实验室传输实验，模拟现实生活条件。
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
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