在多床位病房现场隔离疑似 COVID-19 患者后的二次发病率。

IF 4.8 2区 医学 Q1 INFECTIOUS DISEASES
Silvio Ragozzino, Richard Kuehl, Karoline Leuzinger, Pascal Schläpfer, Pascal Urwyler, Ana Durovic, Sandra Zingg, Matthias von Rotz, Manuel Battegay, Andreas F Widmer, Hans H Hirsch, Stefano Bassetti, Sarah Tschudin-Sutter
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引用次数: 0

摘要

对疑似感染 2019 年冠状病毒病(COVID-19)并等待检测结果的患者实施隔离预防措施需要大量资源。由于我院单人病房有限,我们将疑似感染 COVID-19 的患者与未感染 COVID-19 的患者一起隔离在多人间,直到 SARS-CoV-2 检测结果出来。我们评估了 SARS-CoV-2 向与现场隔离患者同住一室的人传播的可能性。这项观察性研究于 20 年 3 月至 20 年 11 月在瑞士巴塞尔大学医院进行。比较了在多床位病房住院并接触到接受现场隔离预防措施的患者(现场隔离组)和接触到最初未被发现感染 COVID-19、在疑似诊断前未采取隔离预防措施的患者(对照组)的二次发病率。传播事件通过全基因组测序得到确认。在 1218 名疑似 COVID-19 患者中,有 67 人(5.5%)的 SARS-CoV-2 检测呈阳性。其中,21 人是在现场被分离出来的,有 27 名共用一个房间的患者可能因此受到感染。接触时间中位数为 12 小时(四分位数间距为 7-18 小时)。现场隔离组没有发现 SARS-CoV-2 传播,而对照组有 10/63 例(15.9%)(P = 0.03)。在多床位病房对疑似 COVID-19 患者进行现场隔离,避免了许多未确诊感染 SARS-CoV-2 的患者住进单人病房,也避免了随后的院内转移。由于样本量较小,现场隔离组中暴露的病人之间没有二次传播,因此可以对这一策略的风险/效益比进行评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Secondary attack rate following on-site isolation of patients with suspected COVID-19 in multiple-bed rooms.

The implementation of isolation precautions for patients with suspected Coronavirus Disease 2019 (COVID-19) and pending test results is resource intensive. Due to the limited availability of single-bed rooms at our institution, we isolated patients with suspected COVID-19 together with patients without suspected COVID-19 on-site in multiple-bed rooms until SARS-CoV-2-test results were available. We evaluated the likelihood of SARS-CoV-2 transmission to individuals sharing the room with patients isolated on-site. This observational study was performed at the University Hospital Basel, Switzerland, from 03/20 - 11/20. Secondary attack rates were compared between patients hospitalized in multiple-bed rooms and exposed to individuals subjected to on-site isolation precautions (on-site isolation group), and patients exposed to individuals initially not identified as having COVID-19, and not placed under isolation precautions until the diagnosis was suspected (control group). Transmission events were confirmed by whole-genome sequencing. Among 1,218 patients with suspected COVID-19, 67 (5.5%) tested positive for SARS-CoV-2. Of these, 21 were isolated on-site potentially exposing 27 patients sharing the same room. Median contact time was 12 h (interquartile range 7-18 h). SARS-CoV-2 transmission was identified in none of the patients in the on-site isolation group vs. 10/63 (15.9%) in the control group (p = 0.03). Isolation on-site of suspected COVID-19-patients in multiple-bed rooms avoided single-room occupancy and subsequent in-hospital relocation for many patients without confirmed SARS-CoV-2-infection. The absence of secondary transmission among the exposed patients in the on-site isolation group allows for assessment of the risk/benefit ratio of this strategy given the limitation of a small sample size.

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来源期刊
Antimicrobial Resistance and Infection Control
Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
9.70
自引率
3.60%
发文量
140
审稿时长
13 weeks
期刊介绍: Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.
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