投稿分類 感控監測

主委發表種類: 壁報

投稿標題(中): 結合抗原快篩及環境採檢快速協助感染COVID-19洗腎病人執行透析治療

投稿標題(英): Prompt COVID-19 rapid antigen test and clinical environmental investigation to maintain the treatment of patients scheduled hemodialysis

投稿摘要: Background
The COVID-19 (novel Coronavirus 2019) was first detected in December 2019. The hemodialysis patients diagnosed with COVID-19 may affect scheduled hemodialysis to increase the risk of complications. We would share our experiences and strategies about prompt response to prevent the potential outbreak in the hemodialysis center of regional hospital in 2022.
Methods
At first, we used SARS-CoV-2 Ag rapid test kit to identify COVID-19-infected asymptomatic hemodialysis patients before received treatment. Moreover, the clinical environmental investigation and active screening surveillance were triggered following the occurrence of confirmed case in the hemodialysis center. Finally, the suspected specimens were performed on the Roche cobas® 6800 System.
Results
At first, a total of 822 patients (631 patients with hemodialysis and 191 companions) were screened by SARS-CoV-2 Ag rapid test kit at outdoor screening station in May 2022. The test results were reported by licensed medical technologists within 30 minutes after sampling. A total of three asymptomatic patients with covid-19 antigen positive were confirmed by PCR among 631 patients. The hemodialysis of 3 new patients with covid-19 antigen screening positive were performed at restricted area with other confirmed cases. The disinfection and environmental investigation by will be triggered to guarantee the cleanliness of hemodialysis center after the hemodialysis of confirmed cases were finished. However, the 41 environmental investigation samples revealed that two COVID-19 were isolated and detected from the ward beds and dialysis machine that had been disinfected with diluted bleach following discharge of patients. Finally, the reinforced training of disinfection technique and terminal disinfection were conducted to avoid further potential outbreaks.
Conclusion
In summary, the patients with kidney diseases should be prioritized for COVID-19 vaccination to decrease the risk of infection. The contaminated environment can facilitate cross-transmission. Our infection control team play a critical role in the treatment of patients regularly scheduled hemodialysis. Rapid identification of patient with COVID-19 by Ag rapid test and active screening realtime PCR could significantly avoid potential outbreaks to improve patient safety.

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