SARS-CoV-2 analysis on environmental surfaces collected in an intensive care unit. Keeping Ernest Shackleton´s spirit.

Abstract Background Intensive care unit workers are at high risk of acquiring COVID-19 infection, specially when performing invasive techniques and certain procedures that generate aerosols (<5 µm). Therefore, one of the objectives of the health systems should be to implement safety practices to minimize the risk of contagion among these health professionals. Monitoring environmental contamination of SARS-CoV-2 may help to determine the potential of the environment as a transmission medium in an area highly exposed to SARS-CoV-2, such as an intensive care unit. The objective of the study was to analyze the environmental contamination by SARS-CoV-2 on surfaces collected in an intensive care unit, which is dedicated exclusively to the care of patients with COVID-19 and equipped with negative pressure of -10 pascals and an air change rate of 20 cycles per hour. Results A total of 102 samples (72 collected with pre-moistened swabs used for collection of nasopharyngeal exudates and 30 with moistened wipes used in the environmental microbiological control of the food industry) were obtained from ventilators, monitors, perfusion pumps, bed rails, lab benches, containers of personal protective equipment, computer keyboards and mice, telephones, workers' shoes, floor and other areas of close contact with COVID-19 patients and healthcare professionals who cared for them. The analysis by quantitative RT-PCR showed no detection of SARS-CoV-2 genome in environmental samples collected by any of the two methods described.Conclusions Presence of SARS-CoV-2 on the ICU surfaces could not be determined supporting that personal protection, decontamination procedures and negative pressure settings are effective in preventing environmental contamination and protecting the staff and patients inside intensive care units.

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SARS-CoV-2 analysis on environmental surfaces collected in an intensive care unit: keeping Ernest Shackleton’s spirit

Intensive Care Medicine Experimental ◽

10.1186/s40635-020-00349-5 ◽

2020 ◽

Vol 8 (1) ◽

Author(s):

Dolores Escudero ◽

José Antonio Boga ◽

Javier Fernández ◽

Lorena Forcelledo ◽

Salvador Balboa ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Environmental Contamination ◽

Negative Pressure ◽

Close Contact ◽

Rt Pcr ◽

Protection Measures ◽

Change Rate ◽

Air Change Rate ◽

Microbiological Control

Summary Background Intensive care unit workers are at high risk of acquiring COVID-19 infection, especially when performing invasive techniques and certain procedures that generate aerosols (< 5 μm). Therefore, one of the objectives of the health systems should implement safety practices to minimize the risk of contagion among these health professionals. Monitoring environmental contamination of SARS-CoV-2 may help to determine the potential of the environment as a transmission medium in an area highly exposed to SARS-CoV-2, such as an intensive care unit. The objective of the study was to analyze the environmental contamination by SARS-CoV-2 on surfaces collected in an intensive care unit, which is dedicated exclusively to the care of patients with COVID-19 and equipped with negative pressure of – 10 Pa and an air change rate of 20 cycles per hour. Furthermore, all ICU workers were tested for COVID-19 by quantitative RT-PCR and ELISA methods. Results A total of 102 samples (72 collected with pre-moistened swabs used for collection of nasopharyngeal exudates and 30 with moistened wipes used in the environmental microbiological control of the food industry) were obtained from ventilators, monitors, perfusion pumps, bed rails, lab benches, containers of personal protective equipment, computer keyboards and mice, telephones, workers’ shoes, floor, and other areas of close contact with COVID-19 patients and healthcare professionals who cared for them. The analysis by quantitative RT-PCR showed no detection of SARS-CoV-2 genome in environmental samples collected by any of the two methods described. Furthermore, none of the 237 ICU workers was infected by the virus. Conclusions Presence of SARS-CoV-2 on the ICU surfaces could not be determined supporting that a strict cleaning protocol with sodium hypochlorite, a high air change rate, and a negative pressure in the ICU are effective in preventing environmental contamination. These facts together with the protection measures used could also explain the absence of contagion among staff inside ICUs.

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SARS-CoV-2 analysis on environmental surfaces collected in an intensive care unit. Keeping Ernest Shackleton´s spirit.

10.21203/rs.3.rs-52899/v2 ◽

2020 ◽

Author(s):

Dolores Escudero ◽

Jose Antonio Boga ◽

Javier Fernández ◽

Lorena Forcelledo ◽

Salvador Balboa ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Environmental Contamination ◽

Negative Pressure ◽

Close Contact ◽

Rt Pcr ◽

Protection Measures ◽

Change Rate ◽

Air Change Rate ◽

Microbiological Control

Abstract Background: Intensive care unit workers are at high risk of acquiring COVID-19 infection, especially when performing invasive techniques and certain procedures that generate aerosols (<5 µm). Therefore, one of the objectives of the health systems should implement safety practices to minimize the risk of contagion among these health professionals. Monitoring environmental contamination of SARS-CoV-2 may help to determine the potential of the environment as a transmission medium in an area highly exposed to SARS-CoV-2, such as an intensive care unit. The objective of the study was to analyze the environmental contamination by SARS-CoV-2 on surfaces collected in an intensive care unit, which is dedicated exclusively to the care of patients with COVID-19 and equipped with negative pressure of -10 pascals and an air change rate of 20 cycles per hour. Furthermore, all ICU workers were tested for COVID-19 by quantitative RT-PCR and ELISA methods.Results: A total of 102 samples (72 collected with pre-moistened swabs used for collection of nasopharyngeal exudates and 30 with moistened wipes used in the environmental microbiological control of the food industry) were obtained from ventilators, monitors, perfusion pumps, bed rails, lab benches, containers of personal protective equipment, computer keyboards and mice, telephones, workers' shoes, floor and other areas of close contact with COVID-19 patients and healthcare professionals who cared for them. The analysis by quantitative RT-PCR showed no detection of SARS-CoV-2 genome in environmental samples collected by any of the two methods described. Furthermore, none of the ICU workers was infected by the virus.Conclusions: Presence of SARS-CoV-2 on the ICU surfaces could not be determined supporting that a strict cleaning protocol with sodium hypochlorite, a high air change rate and a negative pressure in the ICU are effective in preventing environmental contamination. These facts together with the protection measures used could also explain the absence of contagion among staff inside ICUs.

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Environmental contamination in a coronavirus disease 2019 (COVID-19) intensive care unit—What is the risk?

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1278 ◽

2020 ◽

pp. 1-9

Author(s):

Sean Wei Xiang Ong ◽

Pei Hua Lee ◽

Yian Kim Tan ◽

Li Min Ling ◽

Benjamin Choon Heng Ho ◽

...

Keyword(s):

Intensive Care Unit ◽

Cell Culture ◽

Intensive Care ◽

Infection Control ◽

Environmental Contamination ◽

Transmission Risk ◽

Common Area ◽

The Common ◽

General Wards ◽

The Impact

Abstract Background: The risk of environmental contamination by severe acute respiratory coronavirus virus 2 (SARS-CoV-2) in the intensive care unit (ICU) is unclear. We evaluated the extent of environmental contamination in the ICU and correlated this with patient and disease factors, including the impact of different ventilatory modalities. Methods: In this observational study, surface environmental samples collected from ICU patient rooms and common areas were tested for SARS-CoV-2 by polymerase chain reaction (PCR). Select samples from the common area were tested by cell culture. Clinical data were collected and correlated to the presence of environmental contamination. Results were compared to historical data from a previous study in general wards. Results: In total, 200 samples from 20 patient rooms and 75 samples from common areas and the staff pantry were tested. The results showed that 14 rooms had at least 1 site contaminated, with an overall contamination rate of 14% (28 of 200 samples). Environmental contamination was not associated with day of illness, ventilatory mode, aerosol-generating procedures, or viral load. The frequency of environmental contamination was lower in the ICU than in general ward rooms. Eight samples from the common area were positive, though all were negative on cell culture. Conclusion: Environmental contamination in the ICU was lower than in the general wards. The use of mechanical ventilation or high-flow nasal oxygen was not associated with greater surface contamination, supporting their use and safety from an infection control perspective. Transmission risk via environmental surfaces in the ICUs is likely to be low. Nonetheless, infection control practices should be strictly reinforced, and transmission risk via droplet or airborne spread remains.

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Airflow as a Possible Transmission Route of Middle East Respiratory Syndrome at an Initial Outbreak Hospital in Korea

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15122757 ◽

2018 ◽

Vol 15 (12) ◽

pp. 2757 ◽

Cited By ~ 5

Author(s):

Minki Sung ◽

Seongmin Jo ◽

Sang-Eun Lee ◽

Moran Ki ◽

Bo Choi ◽

...

Keyword(s):

Middle East ◽

Infected Patient ◽

Close Contact ◽

Middle East Respiratory Syndrome ◽

High Concentration ◽

Tracer Gas ◽

Long Distance ◽

Indoor Airflow ◽

Change Rate ◽

Air Change Rate

In this study, the results of an airflow investigation conducted on 7 June 2015 as part of a series of epidemiologic investigations at Pyeongtaek St. Mary’s Hospital, South Korea, were investigated. The study involved 38 individuals who were infected directly and indirectly with Middle East Respiratory Syndrome (MERS), by a super-spreader patient. Tracer gas experiments conducted on the eighth floor, where the initial patient was hospitalized, confirmed that the tracer gas spread to adjacent patient rooms and rooms across corridors. In particular, the experiment with an external wind direction and speed similar to those during the hospitalization of the initial patient revealed that the air change rate was 17–20 air changes per hour (ACH), with air introduced through the window in the room of the infected patient (room 8104). The tracer gas concentration of room 8110, which was the farthest room, was 7.56% of room 8104, indicating that a high concentration of gas has spread from room 8104 to rooms across the corridor. In contrast, the tracer gas was barely detected in a maternity ward to the south of room 8104, where there was no secondary infected patient. Moreover, MERS is known to spread mainly by droplets through close contact, but long-distance dispersion is probable in certain environments, such as that of a super-spreader patient hospitalized in a room without ventilation, hospitals with a central corridor type, and indoor airflow dispersion due to external wind.

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