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Detection of SARS-CoV-2 within the healthcare environment: a multi-centre study conducted during the first wave of the COVID-19 outbreak in England.
J Hosp Infect. 2021 Feb; 108:189-196.JH

Abstract

BACKGROUND

Understanding how severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is spread within the hospital setting is essential in order to protect staff, implement effective infection control measures, and prevent nosocomial transmission.

METHODS

The presence of SARS-CoV-2 in the air and on environmental surfaces around hospitalized patients, with and without respiratory symptoms, was investigated. Environmental sampling was undertaken within eight hospitals in England during the first wave of the coronavirus disease 2019 outbreak. Samples were analysed using reverse transcription polymerase chain reaction (PCR) and virus isolation assays.

FINDINGS

SARS-CoV-2 RNA was detected on 30 (8.9%) of 336 environmental surfaces. Cycle threshold values ranged from 28.8 to 39.1, equating to 2.2 x 105 to 59 genomic copies/swab. Concomitant bacterial counts were low, suggesting that the cleaning performed by nursing and domestic staff across all eight hospitals was effective. SARS-CoV-2 RNA was detected in four of 55 air samples taken <1 m from four different patients. In all cases, the concentration of viral RNA was low and ranged from <10 to 460 genomic copies/m3 air. Infectious virus was not recovered from any of the PCR-positive samples analysed.

CONCLUSIONS

Effective cleaning can reduce the risk of fomite (contact) transmission, but some surface types may facilitate the survival, persistence and/or dispersal of SARS-CoV-2. The presence of low or undetectable concentrations of viral RNA in the air supports current guidance on the use of specific personal protective equipment for aerosol-generating and non-aerosol-generating procedures.

Authors+Show Affiliations

National Infection Service, Public Health England, Porton Down, Salisbury, UK. Electronic address: ginny.moore@phe.gov.uk.National Infection Service, Public Health England, Porton Down, Salisbury, UK.National Infection Service, Public Health England, Porton Down, Salisbury, UK.National Infection Service, Public Health England, Porton Down, Salisbury, UK.National Infection Service, Public Health England, Porton Down, Salisbury, UK.National Infection Service, Public Health England, Porton Down, Salisbury, UK.National Infection Service, Public Health England, Porton Down, Salisbury, UK.National Infection Service, Public Health England, Porton Down, Salisbury, UK.National Infection Service, Public Health England, Porton Down, Salisbury, UK.National Infection Service, Public Health England, Porton Down, Salisbury, UK.National Infection Service, Public Health England, Porton Down, Salisbury, UK.National Infection Service, Public Health England, Porton Down, Salisbury, UK.National Infection Service, Public Health England, Porton Down, Salisbury, UK.National Infection Service, Public Health England, Porton Down, Salisbury, UK.National Infection Service, Public Health England, Porton Down, Salisbury, UK.National Infection Service, Public Health England, Porton Down, Salisbury, UK.National Infection Service, Public Health England, Porton Down, Salisbury, UK.Emerging Infections and Zoonoses Unit, National Infection Service, Public Health England, Colindale, London, UK; NIHR Health Protection Research Unit in Emerging Infections and Zoonoses, Liverpool, UK.National Infection Service, Public Health England, Porton Down, Salisbury, UK.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

33259882

Citation

Moore, G, et al. "Detection of SARS-CoV-2 Within the Healthcare Environment: a Multi-centre Study Conducted During the First Wave of the COVID-19 Outbreak in England." The Journal of Hospital Infection, vol. 108, 2021, pp. 189-196.
Moore G, Rickard H, Stevenson D, et al. Detection of SARS-CoV-2 within the healthcare environment: a multi-centre study conducted during the first wave of the COVID-19 outbreak in England. J Hosp Infect. 2021;108:189-196.
Moore, G., Rickard, H., Stevenson, D., Aranega-Bou, P., Pitman, J., Crook, A., Davies, K., Spencer, A., Burton, C., Easterbrook, L., Love, H. E., Summers, S., Welch, S. R., Wand, N., Thompson, K. A., Pottage, T., Richards, K. S., Dunning, J., & Bennett, A. (2021). Detection of SARS-CoV-2 within the healthcare environment: a multi-centre study conducted during the first wave of the COVID-19 outbreak in England. The Journal of Hospital Infection, 108, 189-196. https://doi.org/10.1016/j.jhin.2020.11.024
Moore G, et al. Detection of SARS-CoV-2 Within the Healthcare Environment: a Multi-centre Study Conducted During the First Wave of the COVID-19 Outbreak in England. J Hosp Infect. 2021;108:189-196. PubMed PMID: 33259882.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Detection of SARS-CoV-2 within the healthcare environment: a multi-centre study conducted during the first wave of the COVID-19 outbreak in England. AU - Moore,G, AU - Rickard,H, AU - Stevenson,D, AU - Aranega-Bou,P, AU - Pitman,J, AU - Crook,A, AU - Davies,K, AU - Spencer,A, AU - Burton,C, AU - Easterbrook,L, AU - Love,H E, AU - Summers,S, AU - Welch,S R, AU - Wand,N, AU - Thompson,K-A, AU - Pottage,T, AU - Richards,K S, AU - Dunning,J, AU - Bennett,A, Y1 - 2020/11/28/ PY - 2020/10/01/received PY - 2020/11/25/revised PY - 2020/11/25/accepted PY - 2020/12/2/pubmed PY - 2021/2/7/medline PY - 2020/12/1/entrez KW - Air KW - Environmental contamination KW - Environmental surfaces KW - Hospital KW - Infection control KW - SARS-CoV-2 SP - 189 EP - 196 JF - The Journal of hospital infection JO - J Hosp Infect VL - 108 N2 - BACKGROUND: Understanding how severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is spread within the hospital setting is essential in order to protect staff, implement effective infection control measures, and prevent nosocomial transmission. METHODS: The presence of SARS-CoV-2 in the air and on environmental surfaces around hospitalized patients, with and without respiratory symptoms, was investigated. Environmental sampling was undertaken within eight hospitals in England during the first wave of the coronavirus disease 2019 outbreak. Samples were analysed using reverse transcription polymerase chain reaction (PCR) and virus isolation assays. FINDINGS: SARS-CoV-2 RNA was detected on 30 (8.9%) of 336 environmental surfaces. Cycle threshold values ranged from 28.8 to 39.1, equating to 2.2 x 105 to 59 genomic copies/swab. Concomitant bacterial counts were low, suggesting that the cleaning performed by nursing and domestic staff across all eight hospitals was effective. SARS-CoV-2 RNA was detected in four of 55 air samples taken <1 m from four different patients. In all cases, the concentration of viral RNA was low and ranged from <10 to 460 genomic copies/m3 air. Infectious virus was not recovered from any of the PCR-positive samples analysed. CONCLUSIONS: Effective cleaning can reduce the risk of fomite (contact) transmission, but some surface types may facilitate the survival, persistence and/or dispersal of SARS-CoV-2. The presence of low or undetectable concentrations of viral RNA in the air supports current guidance on the use of specific personal protective equipment for aerosol-generating and non-aerosol-generating procedures. SN - 1532-2939 UR - https://www.unboundmedicine.com/medline/citation/33259882/Detection_of_SARS_CoV_2_within_the_healthcare_environment:_a_multi_centre_study_conducted_during_the_first_wave_of_the_COVID_19_outbreak_in_England_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0195-6701(20)30548-X DB - PRIME DP - Unbound Medicine ER -