Bronchoscopy safety precautions for diagnosing COVID-19 associated pulmonary aspergillosis-A simulation study.
Coronavirus
SARS-CoV-2
contamination
health-care workers
nosocomial infection
Journal
Mycoses
ISSN: 1439-0507
Titre abrégé: Mycoses
Pays: Germany
ID NLM: 8805008
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
01
09
2020
revised:
06
09
2020
accepted:
07
09
2020
pubmed:
13
9
2020
medline:
17
12
2020
entrez:
12
9
2020
Statut:
ppublish
Résumé
With the outbreak of coronavirus disease 2019 (COVID-19), clinicians have used personal protective equipment to avoid transmission of severe acute respiratory syndrome coronavirus 2. However, they still face occupational risk of infection, when treating COVID-19 patients. This may be highest during invasive diagnostic procedures releasing aerosols and droplets. Thereby, the use of diagnostic procedures for Covid-19 associated aspergillosis may be delayed or impeded, as use of bronchoscopy has been discouraged. This leads to avoidance of a crucial procedure for diagnosing invasive aspergillosis. We intent to visualise aerosol and droplet spread and surface contamination during bronchoscopy and address which measures can avoid exposure of health-care workers. We created a simulation model to visualise aerosol and droplet generation as well as surface contamination by nebulising fluorescent solution detected by using ultraviolet light- and slow-motion capture. We repurposed covers for ultrasound transducers or endoscopic cameras to prevent surface and ambient air contamination. In our bronchoscopy simulation model, we noticed extensive aerosol generation, droplet spread and surface contamination. Exposure of health-care workers and contamination of surfaces can be efficiently reduced by repurposing covers for ultrasound transducers or endoscopic cameras to seal the tube opening during bronchoscopy in mechanically ventilated patients. Adequate personal protective equipment and safety strategies allow to minimise contamination during bronchoscopy in mechanically ventilated COVID-19 patients.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
55-59Subventions
Organisme : Open access funding enabled and organized by ProjektDEAL
Informations de copyright
© 2020 The Authors. Mycoses published by Wiley-VCH GmbH.
Références
Houlihan CF, Vora N, Byrne T, et al. Pandemic peak SARS-CoV-2 infection and seroconversion rates in London frontline health-care workers. The Lancet. 2020;396(10246):e6-e7.
Torrego A, Pajares V, Fernández-Arias C, Vera P, Mancebo J. Bronchoscopy in patients with COVID-19 with invasive mechanical ventilation: a single-center experience. Am J Respir Crit Care Med. 2020;202(2):284-287.
Earnest M. On becoming a plague doctor. N Engl J Med. 2020;383(10):e64. https://doi.org/10.1056/NEJMp2011418
Koehler P, Cornely OA, Bottiger BW, et al. COVID-19 associated pulmonary aspergillosis. Mycoses. 2020;63(6):528-534.
Verweij PE, Gangneux JP, Bassetti M, et al. Diagnosing COVID-19-associated pulmonary aspergillosis. The Lancet Microbe. 2020;1(2):e53-e55.
Koehler P, Bassetti M, Chakrabarti A, et al. Defining and managing COVID-19 associated pulmonary aspergillosis. The 2020 ECMM/ISHAM Consensus Criteria for Research and Clinical Guidance. Manuscript in preparation. 2020.
Koehler P, Bassetti M, Kochanek M, Shimabukuro-Vornhagen A, Cornely OA. Intensive care management of influenza-associated pulmonary aspergillosis. Clin Microbiol Infect. 2019;25(12):1501-1509.
Ott M, Milazzo A, Liebau S, et al. Exploration of strategies to reduce aerosol-spread during chest compressions: A simulation and cadaver model. Resuscitation. 2020. https://doi.org/10.1016/j.resuscitation.2020.05.012
https://www.cdc.gov/coronavirus/2019-nCoV/hcp/index.html - last accessed 21. September 2020
https://www.idsociety.org/COVID19guidelines/ip - last accessed 21. September 2020
Ortega R, Gonzalez M, Nozari A, Canelli R. Personal protective equipment and Covid-19. N Engl J Med. 2020;382(26):e105.
https://www.who.int/patientsafety/safesurgery/tools_resources/SSSL_Checklist_finalJun08.pdf - last accessed 17. July 2020
Black JRM, Bailey C, Przewrocka J, Dijkstra KK, Swanton C. COVID-19: the case for health-care worker screening to prevent hospital transmission. Lancet. 2020;395(10234):1418-1420.
van Doremalen N, Bushmaker T, Morris DH, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med. 2020;382(16):1564-1567.
Liu Y, Ning Z, Chen Y, et al. Aerodynamic analysis of SARS-CoV-2 in two Wuhan hospitals. Nature. 2020;582(7813):557-560.
Engel TGP, Erren E, Vanden Driessche KSJ, et al. Aerosol transmission of aspergillus fumigatus in cystic fibrosis patients in the Netherlands. Emerg Infect Dis. 2019;25(4):797-799.
Lemaire B, Normand A-C, Forel J-M, Cassir N, Piarroux R, Ranque S. Hospitalized patient as source of Aspergillus fumigatus, 2015. Emerg Infect Dis. 2018;24(8):1524-1527.
Robin C, Alanio A, Gits-Muselli M, et al. Molecular demonstration of a pneumocystis outbreak in stem cell transplant patients: evidence for transmission in the daycare center. Front Microbiol. 2017;8:700.