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.

项目概要/摘要 来自呼吸道感染（例如 COVID-19 和流感）患者的病毒的雾化是一个主要的 医疗保健领域的关注，因为这些病毒可能使医护人员 (HCP) 和患者面临感染的风险 感染。这项研究的基本原理是，虽然流行病学研究已经确定了一些医疗保健 被认为对 HCP 构成高风险的活动，并且这些活动被认为会产生气溶胶， 有关气溶胶中传染性病毒的浓度和大小分布的信息有限。结果，它 仍然很难识别产生气溶胶的医疗活动并区分那些造成高浓度气溶胶的医疗活动 对 HCP 和患者的风险。这项研究的长期目标是预防病毒性疾病的传播 通过呼吸气溶胶。提出了三个目标。目标 1 是开发和评估尺寸选择性 评估气溶胶中活病毒的方法。市售尺寸选择性进样口符合健康要求 将评估采样惯例是否与创新仪器“活病毒气溶胶采样器”一起使用 （VIVAS，Aerosol Devices, Inc.），参考气溶胶和噬菌体 MS2。目标 2 是表征 医疗保健活动产生的活病毒气溶胶的浓度和尺寸分布。一个或多个 Aim 1 的入口将与传统气溶胶采样设备一起部署，以测量选定的尺寸 活病毒、选定大小的病毒遗传物质以及房间内的气溶胶数量和大小分布 流感或 COVID-19 患者。将研究六项医疗保健活动，每项都有 6-9 个针对新冠肺炎的观察结果 19 名患者和 6-9 名流感患者观察。这些活动将根据初步情况进行选择 15 种活动的气溶胶特征。目标 2 的主要假设是呼吸的方差 医疗保健活动中的气溶胶比医疗保健活动中的气溶胶更大，并且在不同医疗保健活动之间没有变化 病毒，这意味着某些活动会比其他活动产生更多或不同的气溶胶。二级 目标 2 的假设是，呼吸道气溶胶中病毒基因拷贝与活病毒的比率不 医疗活动内部或之间存在差异，如果属实，则意味着活病毒浓度可以是 从 PCR 结果可靠地推断出。目标 3 是将气溶胶特性与患者、手术和环境联系起来 特征。目标 3 的主要假设是呼吸气溶胶特征的方差 环境、患者和医疗保健活动特征所解释的相对于内部变化而言很小 以及医疗保健活动，这反映了环境和患者的有限变化 由于这项研究在医疗机构和人群中的表现，预计会出现一些特征 住院病人。通过这项研究产生的知识将极大地增强我们的理解 呼吸道气溶胶中的病毒带来的风险。感染预防专家将能够利用这些知识 对 HCP 进行教育，并选择允许 HCP 安全有效地执行其工作的控制策略。这 这项研究的成果将是针对气溶胶产生活动的基于证据的感染预防实践。