tetano
Editor, Senior Moderator
J Hosp Infect
. 2020 Aug 20;S0195-6701(20)30401-1.
doi: 10.1016/j.jhin.2020.08.014. Online ahead of print.
Environmental contamination in the isolation rooms of COVID-19 patients with severe pneumonia requiring mechanical ventilation or high-flow oxygen therapy
Jin Young Ahn[SUP] 1 [/SUP], Sanggwon An[SUP] 2 [/SUP], Yujin Sohn[SUP] 1 [/SUP], Yunsuk Cho[SUP] 1 [/SUP], Jong Hoon Hyun[SUP] 1 [/SUP], Yae Jee Baek[SUP] 1 [/SUP], Moo Hyun Kim[SUP] 1 [/SUP], Su Jin Jeong[SUP] 1 [/SUP], Jung Ho Kim[SUP] 1 [/SUP], Nam Su Ku[SUP] 1 [/SUP], Joon-Sup Yeom[SUP] 1 [/SUP], Davey M Smith[SUP] 3 [/SUP], Hyukmin Lee[SUP] 4 [/SUP], Dongeun Yong[SUP] 4 [/SUP], Youn-Jung Lee[SUP] 1 [/SUP], Ji Won Kim[SUP] 1 [/SUP], Hyeong Rae Kim[SUP] 2 [/SUP], Jung Ho Hwang[SUP] 2 [/SUP], Jun Yong Choi[SUP] 5 [/SUP]
Affiliations
Abstract
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.
Keywords: COVID-19; SARS-CoV-2; environmental contamination; severe pneumonia.
. 2020 Aug 20;S0195-6701(20)30401-1.
doi: 10.1016/j.jhin.2020.08.014. Online ahead of print.
Environmental contamination in the isolation rooms of COVID-19 patients with severe pneumonia requiring mechanical ventilation or high-flow oxygen therapy
Jin Young Ahn[SUP] 1 [/SUP], Sanggwon An[SUP] 2 [/SUP], Yujin Sohn[SUP] 1 [/SUP], Yunsuk Cho[SUP] 1 [/SUP], Jong Hoon Hyun[SUP] 1 [/SUP], Yae Jee Baek[SUP] 1 [/SUP], Moo Hyun Kim[SUP] 1 [/SUP], Su Jin Jeong[SUP] 1 [/SUP], Jung Ho Kim[SUP] 1 [/SUP], Nam Su Ku[SUP] 1 [/SUP], Joon-Sup Yeom[SUP] 1 [/SUP], Davey M Smith[SUP] 3 [/SUP], Hyukmin Lee[SUP] 4 [/SUP], Dongeun Yong[SUP] 4 [/SUP], Youn-Jung Lee[SUP] 1 [/SUP], Ji Won Kim[SUP] 1 [/SUP], Hyeong Rae Kim[SUP] 2 [/SUP], Jung Ho Hwang[SUP] 2 [/SUP], Jun Yong Choi[SUP] 5 [/SUP]
Affiliations
- PMID: 32828864
- DOI: 10.1016/j.jhin.2020.08.014
Abstract
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.
Keywords: COVID-19; SARS-CoV-2; environmental contamination; severe pneumonia.