Environmental contamination in the isolation rooms of COVID-19 patients with severe pneumonia requiring mechanical ventilation or high-flow oxygen therapy

Source avec lien : Journal of Hospital Infection, (Prépublication), 8/21/2020. 10.1016/j.jhin.2020.08.014

Contexte L’identification de l’étendue de la contamination environnementale du coronavirus 2 du syndrome respiratoire aigu sévère (SRAS-CoV-2) est essentielle pour le contrôle et la prévention des infections. L’étendue de la contamination environnementale n’a pas été entièrement étudiée dans le contexte des patients atteints d’une maladie coronavirale grave (COVID-19). Objectif Étudier la contamination environnementale par le SRAS-CoV-2 dans les chambres d’isolement des patients atteints de COVID-19 sévère nécessitant une ventilation mécanique ou une oxygénothérapie à haut débit.

Background Identifying the extent of environmental contamination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is essential for infection control and prevention. The extent of environmental contamination has not been fully investigated in the context of severe coronavirus disease (COVID-19) patients. Aim To investigate environmental SARS-CoV-2 contamination in the isolation rooms of severe COVID-19 patients requiring mechanical ventilation or high-flow oxygen therapy. Methods We collected environmental swab samples and air samples from the isolation rooms of three COVID-19 patients with severe pneumonia. Patient 1 and Patient 2 received mechanical ventilation with a closed suction system, while Patient 3 received high-flow oxygen therapy and noninvasive ventilation. Real-time reverse transcription polymerase chain reaction (rRT-PCR) was used to detect SARS-CoV-2; viral cultures were performed for samples not negative on rRT-PCR. Findings Of the 48 swab samples collected in the rooms of Patient 1 and Patient 2, only samples from the outside surfaces of the endotracheal tubes tested positive for SARS-CoV-2 by rRT-PCR. However, in Patient 3’s room, 13 of the 28 environmental samples (fomites, fixed structures, and ventilation exit on the ceiling) showed positive results. Air samples were negative for SARS-CoV-2. Viable viruses were identified on the surface of the endotracheal tube of Patient 1 and seven sites in Patient 3’s room. Conclusion Environmental contamination of SARS-CoV-2 can be a route of viral transmission. However, it might be minimized when patients receive mechanical ventilation with a closed suction system. These findings can provide evidence for guidelines for the safe use of personal protective equipment.

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