Linking SARS-CoV-2 Aerosol Viability and Environmental Factors in Healthcare Settings

将 SARS-CoV-2 气溶胶活力与医疗机构中的环境因素联系起来

• 批准号: 10588041
• 负责人: Rachael Mary Jones
• 金额: $ 70.41万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-17 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10588041
• 关键词: 2019-nCoV; Achievement; Aerosols; COVID-19; COVID-19 patient; Characteristics; Collection; Consensus; Deposition; Detection; Development; Devices; Enterobacteria phage MS2; Environmental Risk Factor; Environmental Wind; Equipment; Evaluation; Genes; Genetic Materials; Goals; Growth; Health; Health Personnel; Health care facility; Healthcare; Healthcare Activity; Hospitalization; Infection; Infection Control; Infection prevention; Influenza; Influenza A virus; Influenza B Virus; Inhalation; Knowledge; Link; Liquid substance; Measurement; Measures; Methods; Microbiology; Occupational Health; Occupations; Outcomes Research; Patient Care; Patients; Pattern; Performance; Physical condensation; Prevent viral transmission; Procedures; Process; Property; Research; Research Personnel; Respiratory Disease; Respiratory System; Respiratory Tract Infections; Risk; Risk Assessment; Route; Sampling; Science; Speed; Standardization; Tube; Variant; Virus; Virus Diseases; Work; acute care; aerosolized; coarse particles; design; detection limit; disease transmission; epidemiology study; evidence base; experience; fine particles; health care settings; high risk; hospital analysis; improved; infection risk; innovation; instrument; meetings; microbial; prevent; prevention practice; respiratory aerosol; respiratory virus; seasonal influenza; symposium; transmission process; virology; virus genetics

PROJECT SUMMARY/ABSTRACT Aerosolization of viruses from patients with respiratory infections, such as COVID-19 and influenza, is a major concern in healthcare because these viruses can put healthcare personnel (HCP) and patients at risk of infection. The rationale for this study is that while epidemiology studies have identified some healthcare activities as posing a high risk to HCP and these activities are thought to generate aerosols, there exists very limited information about the concentration and size distribution of infectious virus in the aerosol. As a result, it remains difficult to identify aerosol-generating healthcare activities and to distinguish those that pose a high risk to HCP and patients. The long-term goal of this research is to prevent the transmission of viral diseases through respiratory aerosol. Three aims are proposed. Aim 1 is to develop and evaluate a size-selective method to assess viable virus in aerosol. Commercially available size-selective inlets meeting health-based sampling conventions will be evaluated for use with an innovative instrument, the Viable Virus Aerosol Sampler (VIVAS, Aerosol Devices, Inc.), with reference aerosols and bacteriophage MS2. Aim 2 is to characterize the concentration and size distribution of viable virus aerosol generated from healthcare activities.One or more inlet from Aim 1 will be deployed alongside conventional aerosol sampling equipment to measuresize-selected viable virus, size-selected virus genetic material, and aerosol number and size distribution in rooms with influenza or COVID-19 patients. Six healthcare activities will be studied, each with 6-9 observationsfor COVID- 19 patients and 6-9 observations for influenza patients. These activities will be selected based on preliminary aerosol characterization of 15 activities. The primary hypothesis of Aim 2 is that the variance in respiratory aerosol is greater among healthcare activities than within healthcare activities, and does not vary between viruses, which implies that some activities generate more or different aerosol than others. The secondary hypothesis of Aim 2 is that therethe ratio of virus gene copies to viable virus in respiratory aerosol does not vary within or among healthcare activities, which, if true, means that the viable virus concentration can be reliably inferred from PCR results. Aim 3 is to link aerosol properties to patient, procedure, and environmental characteristics. The primary hypothesis of Aim 3 is that the variance in respiratory aerosol characteristics explained by environmental, patient, and healthcare activity characteristics is small relative to variation within and among healthcare activities, which reflects that limited variation in environmental and patient characteristics are expected owing to the performance of this research in a healthcare facility and among hospitalized patients. The knowledge generated through this research will greatly enhance our understanding ofthe risks posed by viruses in respiratory aerosol. Infection preventionists will be able to use this knowledge to educate HCP, and to select control strategies that permit HCP to perform their jobs safely and efficiently. The outcome of this research will be evidence-based infection prevention practices for aerosol-generating activities.

项目摘要/摘要 来自呼吸道感染患者（例如Covid-19和流感）的病毒的气化是主要的 在医疗保健方面的关注，因为这些病毒可以使医疗保健人员（HCP）和患者面临 感染。这项研究的理由是，尽管流行病学研究已经确定了一些医疗保健 人们认为对HCP构成高风险的活动被认为会产生气溶胶，存在非常 关于气溶胶中传染病的浓度和尺寸分布的有限信息。结果，它 仍然很难识别出气溶胶生成的医疗保健活动，并区分那些造成高的医疗活动 HCP和患者的风险。这项研究的长期目标是防止病毒疾病的传播 通过呼吸道气溶胶。提出了三个目标。目标1是开发和评估尺寸选择性 评估气溶胶中可行病毒的方法。商业可用的尺寸选择性入口符合健康 采样约定将用于与创新仪器一起使用，即生存的病毒气溶胶采样器 （Vivas，气溶胶设备，Inc。），带有参考气溶胶和噬菌体MS2。目标2是表征 由医疗保健活动产生的可行病毒气溶胶的浓度和大小分布。 AIM 1的入口将与常规的气溶胶采样设备一起部署，以测量固定的 可行的病毒，大小选择的病毒遗传物质以及带有气雾剂的数量和大小分布 流感或共同-19患者。将研究六项医疗保健活动，每次都有6-9个观察结果 流感患者的19例患者和6-9例观察。这些活动将根据初步选择 15个活动的气雾剂表征。目标2的主要假设是呼吸道的差异 在医疗保健活动中，气雾剂比医疗保健活动更大，并且在 病毒，这意味着某些活动比其他活动会产生更多或不同的气雾剂。次要 AIM 2的假设是，病毒基因副本与呼吸道气溶胶中的病毒的比率不在 在医疗保健活动中或之间有所不同，如果是真的，这意味着可行的病毒浓度可以是 可靠地从PCR结果推断出来。 AIM 3是将气溶胶特性与患者，程序和环境联系起来 特征。目标3的主要假设是呼吸道气溶胶特征的差异 通过环境，患者和医疗保健活动特征解释，相对于内部的变化而言很小 在医疗保健活动中，这反映了环境和患者的差异有限 由于这项研究在医疗机构和中间的表现，预计的特征是 住院的患者。通过这项研究产生的知识将大大增强我们的理解 病毒在呼吸道气溶胶中带来的风险。感染预防主义者将能够利用这些知识 教育HCP，并选择允许HCP安全有效地执行其工作的控制策略。这 这项研究的结果将是基于证据的感染预防烟雾生成活动。