2023 年夏季在一个老年急症病房爆发的 SARS-CoV-2 疫情:疫情后时期的感染控制现状。

IF 1.7 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH GMS Hygiene and Infection Control Pub Date : 2024-01-30 eCollection Date: 2024-01-01 DOI:10.3205/dgkh000457
Bettina Lange, Gracinda Mesquita, Heinrich Burkhardt, Marlis Gerigk, Alexandra Heininger
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引用次数: 0

摘要

目的:在老年病人中爆发 SARS-CoV-2 时的管理,同时考虑到向大流行后时期的过渡:方法:在疫情爆发期间进行 PCR 检测,以确定感染规模;在 PCR 检测结果出来之前,病房不再接收新病人。根据检测结果和个人风险评估,按照 RKI 的建议组建了三个队列并进行治疗。终止入院后,新入院的患者接受 PCR 筛查。接触患者在第 3 天和第 5 天接受复检。员工进行自我监测,如果出现症状,则进行抗原检测:11 名 PCR 阳性患者中有 9 人(6 男 5 女)接受了免疫接种,中位年龄为 85 岁。八名患者出现症状,十名接受了抗病毒治疗,两名需要重症监护。三名有症状的员工抗原检测呈阳性。与最初检测呈阴性的阳性病例无直接接触的患者以及 PCR 检测呈阴性的 16 名新入院患者没有感染 COVID-19。疫情管理在 15 天后结束,没有人死于 COVID-19:在疫情爆发期间,PCR 筛查、在获得 PCR 结果之前暂时停止接收新病人、对病人进行风险适应性分组并对新接收的病人进行持续的 PCR 检测,这些措施为成功控制疫情奠定了基础。尽管极易感染,但仍有可能进行治疗。密切监测症状并迅速采取措施可降低风险。对直接接触患者在第 3 天进行的重复 PCR 检测表明,尽管他们没有症状,但仍有必要进行先期抗病毒治疗;在第 5 天进行检测可缩短预防性隔离措施的时间。员工使用防护口罩和进行自我监测是防止进一步感染的基础。
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Outbreak of SARS-CoV-2 in a geriatric acute-care ward during summer 2023: current aspects of infection control in the postpandemic period.

Aim: Management of a SARS-CoV-2 outbreak in geriatric patients, taking into account the transition to the post-pandemic period.

Methods: PCR tests were conducted to identify the scale of infection during the outbreak; no new patients were admitted to the ward until the availability of the PCR results. Based on the results and individual risk assessment, three cohorts were formed and treated as recommended by the RKI. After terminating the admissions stop, new admissions received PCR screening. Contact patients were retested on days 3 and 5. Employees carried out self-monitoring, and if symptoms developed, an antigen test was performed.

Results: Nine of the 11 PCR-positive patients (6m, 5f), median age 85 years, were immunized. Eight patients were symptomatic, ten received antiviral therapy and two required intensive care. Three symptomatic employees had a positive antigen test. Patients without direct contact to the positive cases who initially tested negative and the 16 new admissions with a negative PCR test did not contract COVID-19. Outbreak management ended after 15 days without deaths from COVID-19.

Conclusion: During the outbreak, PCR screening, the temporary stop in new admission until the availability of PCR results, and the risk-adapted cohorting of patients supplemented by consistent PCR tests of new admissions formed the basis for successful outbreak management. Treatment can be made possible despite high vulnerability. Close symptom monitoring and rapid implementation of measures reduce the risk. Repeated PCRs of direct-contact patients on day 3 can warrant pre-emptive antiviral therapy despite being asymptomatic; testing on day 5 makes it possible to shorten preventive isolation measures. The use of protective masks and self-monitoring by employees are fundamental to preventing further infections.

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来源期刊
GMS Hygiene and Infection Control
GMS Hygiene and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
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