Environmental contamination and evaluation of healthcare-associated SARS-CoV-2 transmission risk in temporary isolation wards during the COVID-19 pandemic.

Autor: Wee LE; Department of Infectious Diseases, Singapore General Hospital, Singapore. Electronic address: ian.wee.l.e@singhealth.com.sg., Arora S; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore., Ko KK; Department of Molecular Pathology, Singapore General Hospital, Singapore; Department of Microbiology, Singapore General Hospital, Singapore; Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore., Conceicao EP; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore., Coleman KK; School of Public Health, University of Maryland, USA., Tan KY; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore., Tohid HB; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore., Liu Q; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore., Tung GLT; Department of Medicine, National University Hospital, Singapore., See SWJ; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore., Suphavilai C; Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore., Ling ML; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore., Venkatachalam I; Department of Infectious Diseases, Singapore General Hospital, Singapore; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
Jazyk: angličtina
Zdroj: American journal of infection control [Am J Infect Control] 2023 Apr; Vol. 51 (4), pp. 413-419. Date of Electronic Publication: 2022 Oct 28.
DOI: 10.1016/j.ajic.2022.09.004
Abstrakt: Background: Temporary isolation wards have been introduced to meet demands for airborne-infection-isolation-rooms (AIIRs) during the COVID-19 pandemic. Environmental sampling and outbreak investigation was conducted in temporary isolation wards converted from general wards and/or prefabricated containers, in order to evaluate the ability of such temporary isolation wards to safely manage COVID-19 cases over a period of sustained use.
Methods: Environmental sampling for SARS-CoV-2 RNA was conducted in temporary isolation ward rooms constructed from pre-fabricated containers (N = 20) or converted from normal-pressure general wards (N = 47). Whole genome sequencing (WGS) was utilized to ascertain health care-associated transmission when clusters were reported amongst HCWs working in isolation areas from July 2020 to December 2021.
Results: A total of 355 environmental swabs were collected; 22.4% (15/67) of patients had at least one positive environmental sample. Patients housed in temporary isolation ward rooms constructed from pre-fabricated containers (adjusted-odds-ratio, aOR = 10.46, 95% CI = 3.89-58.91, P = .008) had greater odds of detectable environmental contamination, with positive environmental samples obtained from the toilet area (60.0%, 12/20) and patient equipment, including electronic devices used for patient communication (8/20, 40.0%). A single HCW cluster was reported amongst staff working in the temporary isolation ward constructed from pre-fabricated containers; however, health care-associated transmission was deemed unlikely based on WGS and/or epidemiological investigations.
Conclusion: Environmental contamination with SARS-CoV-2 RNA was observed in temporary isolation wards, particularly from the toilet area and smartphones used for patient communication. However, despite intensive surveillance, no healthcare-associated transmission was detected in temporary isolation wards over 18 months of prolonged usage, demonstrating their capacity for sustained use during succeeding pandemic waves.
(Copyright © 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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