Journal of Peking University (Health Sciences) ›› 2020, Vol. 52 ›› Issue (3): 414-419. doi: 10.19723/j.issn.1671-167X.2020.03.003

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Infection prevention and control of bedside blood purification treatment in patients with COVID-19

Mei-lian CHEN1,Yan GAO1,2,(),Wei GUO3,Li ZUO4,Tian-bing WANG3   

  1. 1. Department of Infection Control
    2. Department of Infectious Disease
    3. Trauma center
    4. Department of Nephrology, Peking University People’s Hospital, Beijing 100044, China
  • Online:2020-06-18 Published:2020-06-30
  • Contact: Yan GAO E-mail:gaoyan6384@163.com

Abstract:

Objective: To explore the infection prevention and control strategy of bedside blood purification treatment in corona virus disease 2019 (COVID-19) isolation ward, and to evaluate the effect of infection prevention and control management measures. Methods: We summarized and analyzed the clinical features, infection status, outcome and infection prevention and control measures of bedside blood purification treatment patients in COVID-19 isolation ward from February 8, 2020 to March 31, 2020, analyzed the COVID-19 cross-infection between the patients and medical staffs, and the blood-borne pathogens cross-infection situation between the patients, and analyzed the effect of bundle prevention and control measures in controlling the occurrence and spread of cross-infection. Results: A total of 101 COVID-19 patients were hospitalized in this COVID-19 isolation ward, of whom 10 patients (9.90%) received bedside blood purification treatment and the blood purification treatment method was continuous hemodialysis filtration (CVVHDF), and the 10 patients received 79 times of blood purification treatment in total. The prevention and control management measures adopted included divisional isolation, patient behavior isolation and patient placement, operator personal protection and hand hygiene, dialysis waste fluid disposal, isolation room air purification, object surfaces, medical devices and medical fabrics dis-infection management. There were no occurrence and spread of COVID-19 in the medical healthcare workers and blood-borne pathogens cross-infection in the patients. And all the twice throat swabs (two sampling interval > 1 day) of the medical staffs in COVID-19 virus nucleic acid test were negative. The 2 suspected COVID-19 patients’ throat swab virus nucleic acid test and the COVID-19 IgG, IgM were always both negative, the chest CT showed no viral pneumonia. Conclusion: Bedside blood purification treatment in the COVID-19 isolation ward, the occurrence and spread of healthcare associated infection can be effectively controlled through effective infection prevention and control management, including divisional isolation, patient behavior isolation and patient placement, operator personal protection and hand hygiene, dialysis waste fluid disposal, isolation room’s air purification, object surfaces, medical devices and medical fabrics disinfection, which can provide experience for diagnosis, treatment and prevention and control of patients in the respiratory infectious disease ward.

Key words: COVID-19, Isolation ward, Bedside blood purification treatment, Infection prevention and control

CLC Number: 

  • R563.1

Figure 1

Study drawing"

Table 1

Basic information and clinical features of bedside blood purification treatment patients"

Number Age/years Gender Underlying disease COVID-19 Clinical classification Dialysis modalities Dialysis times
1 58 Female Hypertension, chronic renal failure Confirmed Severe CVVHDF 7
2 79 Male Hypertension, chronic renal failure Confirmed Severe CVVHDF 5
3 47 Male Hypertension, chronic renal failure, coronary heart disease Confirmed Severe CVVHDF 9
4 67 Male Hypertension, chronic renal failure, coronary heart disease Confirmed Severe CVVHDF 5
5 81 Male Hypertension, chronic renal failure, coronary heart disease, diabetes Confirmed Severe CVVHDF 12
6 68 Male Hypertension, chronic renal failure, coronary heart disease, diabetes Confirmed Severe CVVHDF 10
7 79 Female Hypertension, chronic renal failure, coronary heart disease, COPD Confirmed Severe CVVHDF 11
8 64 Male Hypertension, chronic renal failure Confirmed Severe CVVHDF 6
9 66 Female Hypertension, chronic renal failure Suspected Severe CVVHDF 9
10 40 Female Hypertension, chronic renal failure, coronary heart disease, diabetes, COPD suspected Severe CVVHDF 5

Table 2

Infection status and outcome of bedside blood purification treatment patients at admission and discharge"

Number Lengh
of stay/d
COVID-19 RNA Chest CT Blood-borne pathogens Outcome
Admission Discharge Admission Discharge Admission Discharge
1 16 Positive Negative Viral pneumonia Normal Chronic
hepatitis B
Chronic
hepatitis B
Cured, transferred to the blood purification center for routine treatment
2 12 Positive Negative Viral pneumonia Normal Without Without Cured, transferred to the blood purification center for routine treatment
3 19 Positive Negative Viral pneumonia Normal Without Without Cured, transferred to the blood purification center for routine treatment
4 12 Positive Negative Viral pneumonia Normal Without Without Cured, transferred to the blood purification center for routine treatment
5 26 Positive Negative Viral pneumonia Normal Without Without Cured, transferred to the blood purification center for routine treatment
6 21 Positive Negative Viral pneumonia Normal Without Without Cured, transferred to the blood purification center for routine treatment
7 23 Positive Negative Viral pneumonia Normal Without Without Cured, transferred to the blood purification center for routine treatment
8 14 Positive Negative Viral pneumonia Normal Without Without Cured, transferred to the blood purification center for routine treatment
9 20 Negative Negative Pleural effusion Normal Without Without Exclude, transfer to blood purification center for routine treatment
10 12 Negative Negative Pleural effusion Normal Without Without Exclude, transfer to blood purification center for routine treatment
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