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

Authors
 J Y Ahn  ;  S An  ;  Y Sohn  ;  Y Cho  ;  J H Hyun  ;  Y J Baek  ;  M H Kim  ;  S J Jeong  ;  J H Kim  ;  N S Ku  ;  J-S Yeom  ;  D M Smith  ;  H Lee  ;  D Yong  ;  Y-J Lee  ;  J W Kim  ;  H R Kim  ;  J Hwang  ;  J Y Choi 
Citation
 JOURNAL OF HOSPITAL INFECTION, Vol.106(3) : 570-576, 2020-11 
Journal Title
 JOURNAL OF HOSPITAL INFECTION 
ISSN
 0195-6701 
Issue Date
2020-11
Keywords
COVID-19 ; Environmental contamination ; SARS-CoV-2 ; Severe pneumonia
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: Environmental swab samples and air samples were collected from the isolation rooms of three COVID-19 patients with severe pneumonia. Patients 1 and 2 received mechanical ventilation with a closed suction system, while patient 3 received high-flow oxygen therapy and non-invasive 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 patients 1 and 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 may 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.
Files in This Item:
T202004891.pdf Download
DOI
10.1016/j.jhin.2020.08.014
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Ku, Nam Su(구남수) ORCID logo https://orcid.org/0000-0002-9717-4327
Kim, Moo Hyun(김무현)
Kim, Jung Ho(김정호) ORCID logo https://orcid.org/0000-0002-5033-3482
Baek, Yae Jee(백예지)
Sohn, Yujin(손유진)
Ahn, Jin Young(안진영) ORCID logo https://orcid.org/0000-0002-3740-2826
Yeom, Joon Sup(염준섭) ORCID logo https://orcid.org/0000-0001-8940-7170
Yong, Dong Eun(용동은) ORCID logo https://orcid.org/0000-0002-1225-8477
Lee, Hyuk Min(이혁민) ORCID logo https://orcid.org/0000-0002-8523-4126
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Cho, Yunsuk(조윤숙)
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
Hyun, Jong Hoon(현종훈)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180542
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