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首页> 美国卫生研究院文献>Morbidity and Mortality Weekly Report >Serial Testing for SARS-CoV-2 and Virus Whole Genome Sequencing Inform Infection Risk at Two Skilled Nursing Facilities with COVID-19 Outbreaks — Minnesota April–June 2020
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Serial Testing for SARS-CoV-2 and Virus Whole Genome Sequencing Inform Infection Risk at Two Skilled Nursing Facilities with COVID-19 Outbreaks — Minnesota April–June 2020

机译：SARS-COV-2的连续测试和病毒全基因组测序为Covid-19爆发的两个熟练的护理设施提供信息风险 - Minnesota4月20日至6月20日

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摘要

SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), can spread rapidly in high-risk congregate settings such as skilled nursing facilities (SNFs) (1). In Minnesota, SNF-associated cases accounted for 3,950 (8%) of 48,711 COVID-19 cases reported through July 21, 2020; 35% of SNF-associated cases involved health care personnel (HCP*), including six deaths. Facility-wide, serial testing in SNFs has been used to identify residents with asymptomatic and presymptomatic SARS-CoV-2 infection to inform mitigation efforts, including cohorting of residents with positive test results and exclusion of infected HCP from the workplace (2,3). During April–June 2020, the Minnesota Department of Health (MDH), with CDC assistance, conducted weekly serial testing at two SNFs experiencing COVID-19 outbreaks. Among 259 tested residents, and 341 tested HCP, 64% and 33%, respectively, had positive reverse transcription–polymerase chain reaction (RT-PCR) SARS-CoV-2 test results. Continued SARS-CoV-2 transmission was potentially facilitated by lapses in infection prevention and control (IPC) practices, up to 12-day delays in receiving HCP test results (53%) at one facility, and incomplete HCP participation (71%). Genetic sequencing demonstrated that SARS-CoV-2 viral genomes from HCP and resident specimens were clustered by facility, suggesting facility-based transmission. Residents and HCP working in SNFs are at risk for infection with SARS-CoV-2. As part of comprehensive COVID-19 preparation and response, including early identification of cases, SNFs should conduct serial testing of residents and HCP, maximize HCP testing participation, ensure availability of personal protective equipment (PPE), and enhance IPC practices† (4–5).
机译：SARS-COV-2，导致冠状病毒疾病2019（Covid-19）的病毒，可以在高风险的聚集设置中迅速传播，如熟练的护理设施（SNF）（1）。在明尼苏达州，SNF相关案件占48,711份Covid-19案件的3,950（8％），于2020年7月21日报告; 35％的SNF相关案件涉及医疗保健人员（HCP *），包括六人死亡。在SNF中的串行检测已被用于识别具有无症状和假设SARS-COV-2感染的居民，以便于减缓努力，包括居民的居民与阳性测试结果和从工作场所排除感染的HCP（2,3） 。在4月20日至6月期间，明尼苏达州的卫生部（MDH），并在COVID-19爆发的两个SNF下进行了每周连续测试。在259个测试的居民中，341个测试的HCP，64％和33％分别具有阳性逆转录聚合酶链反应（RT-PCR）SARS-COV-2测试结果。持续的SARS-COV-2传输可能促进了感染预防和控制（IPC）实践中的失误，最多可在一个设施接受HCP测试结果（53％）的12日延迟，并不完整的HCP参与（71％）。遗传测序证明，来自HCP和驻留标本的SARS-COV-2病毒基因组被设施聚集，建议基于设施的传输。在SNF中使用的居民和HCP有风险，有SARS-COV-2感染。作为综合Covid-19的一部分，包括早期识别案件，SNF应该进行居民和HCP的串行测试，最大限度地提高HCP测试参与，确保个人防护设备（PPE）的可用性，并加强IPC实践†（4- 5）。

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