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Article Dans Une Revue Journal of Infection and Public Health Année : 2024

Routes of SARS-Cov2 transmission in the Intensive Care Unit: A multicentric prospective study

Résumé

The risk of SARS-CoV-2 transmission to health care workers in intensive care units (ICU) and the contribution of airborne and fomites to SARS-CoV-2 transmission remain unclear. To assess the rate of air and surface contamination and identify risk factors associated with this contamination in patients admitted to the ICU for acute respiratory failure due to SARS-CoV-2 pneumonia. Methods: Prospective multicentric non-interventional study conducted from June 2020 to November 2020 in 3 French ICUs. For each enrolled patient, 3 predefined surfaces were swabbed, 2 air samples at 1m and 3m from the patient’s mouth and face masks of 3 health care workers (HCW) were collected within the first 48 hours of SARS-CoV-2 positive PCR in a respiratory sample. Droplet digital PCR and quantitative PCR were performed on different samples, respectively. Results: Among 150 included patients, 5 (3.6%, 95%CI: 1.2% to 8.2%) had positive ddPCR on air samples at 1 meter or 3 meters. Seventy-one patients (53.3%, CI95%: 44.5% to 62.0%) had at least one surface positive. Face masks worn by HCW were positive in 6 patients (4.4%, CI: 1.6% to 9.4%). The threshold of RT-qPCR of the respiratory sample performed at inclusion (odds ratio, OR= 0.88, 95%CI: 0.83 to 0.93, p<0.0001) and the presence of diarrhea (OR= 3.28, 95%CI: 1.09 to 9.88, p=0.037) were significantly associated with the number of contaminated surfaces. Conclusion: In this study, including patients admitted to the ICU for acute respiratory failure « contact route » of transmission, i.e. through fomites, seems dominant. While presence of SARS-CoV-2 in the air is rare in this specific population, the presence of diarrhea is associated with surface contamination around Covid.
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hal-04598232 , version 1 (03-06-2024)

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Yacine Tandjaoui Lambiotte, Alexandre Elabbadi, Boubaya Marouane, Sebastien Besset, Damien Roux, et al.. Routes of SARS-Cov2 transmission in the Intensive Care Unit: A multicentric prospective study. Journal of Infection and Public Health, inPress, ⟨10.1016/j.jiph.2024.05.042⟩. ⟨hal-04598232⟩
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