隔离病房新型冠状病毒污染情况及防控措施探讨

Contamination of SARS-CoV-2 in isolation wards and discussion on prevention and control measures

目的了解隔离病房新型冠状病毒污染情况,为精准医院感染监控提供依据。方法随机采集湖南省长沙市第一医院新型冠状病毒隔离病房清洁区、潜在污染区、污染区清洁消毒前的物体表面标本,参考咽拭子标本检测方法,对采集的标本进行新型冠状病毒核酸检测,并对检测结果进行统计学分析。结果共采集隔离病房各类物体表面标本191份,9份标本新型冠状病毒核酸检测阳性,阳性率为4.71%。阳性标本均来自于隔离病房污染区,呼吸机面板、B超机探头及外表面、医疗废物桶脚踏板、患者被套、床头灯开关、医务人员手、床头桌、厕所门把手、患者手机各检出阳性标本1份;潜在污染区及清洁区采集的所有物体表面标本均未检出新型冠状病毒。污染区有咳嗽症状患者周围环境新型冠状病毒核酸检测阳性率高于无咳嗽症状患者周围环境(10.81%VS 1.43%,P<0.05);患者个人物品、患者生活用品、医疗设施设备及医患手冠状病毒核酸检出阳性率比较,差异无统计学意义(P>0.05)。结论隔离病房污染区新型冠状病毒污染严重,尤其是有咳嗽症状患者的周围环境。按相关要求采取严格的消毒、隔离措施,才能切实降低新冠肺炎医院感染风险。

Objective To understand contamination of SARS-CoV-2 in isolation wards,and provide evidence for precise monitoring on healthcare-associated infection(HAI).Methods Object surface specimens were taken from clean area,potentially contaminated area and contaminated area in the SARS-CoV-2 isolation wards in The First Hospital of Changsha before disinfection,referring to pharyngeal swab test method,specimens were performed SARS-CoV-2 nucleic acid test,test results were analyzed statistically.Results A total of 191 specimens of various object surface in isolation wards were collected,9 of which were positive for SARS-CoV-2 test,positive rate was 4.71%.Positive specimens were all from contaminated areas of SARS-CoV-2 isolation wards,ventilator panel,probe and outer surface of B-ultrasound machine,foot pedal of medical waste bin,patient’s quilt cover,bedside lamp switch,hands of health care workers(HCWs),bedside table,toilet door handle,patient’s mobile phone were detected one positive specimen respectively.Specimens of object surface of potentially contaminated area and clean area was not found SARS-CoV-2.In contaminated areas,positive rate of SARS-CoV-2 nucleic acid test of surroun-ding of patients with cough was higher than that of patients without cough(10.81%vs 1.43%,P<0.05);there was no statistical difference among positive rates of patients’personal belongings,patients’daily necessities,medical facilities and equipment,as well as hands of HCWs and patients(P>0.05).Conclusion Contaminated area in isolation wards is contaminated seriously by SARS-CoV-2,especially surrounding of patients with cough.Strict disinfection and isolation measures should be taken to effectively reduce the HAI risk of COVID-19.