重新设计隔离实践:对包括循环值 (Ct) 值动态在内的呼吸道病毒控制综合协议的评估
Stefanie Lemmens1, Kevin Janssen1, Tine Nelis2
1Department of Molecular Microbiology, Ziekenhuis Oost-Limburg, 3600 Genk, Belgium.
Viruses
|January 28, 2026
概括
新证据表明,目前的呼吸道病毒隔离指南需要修订. 低于28的CT值表明潜在的活跃传播,许多患者在7天以上的时间内释放病毒,与流感患者不同.
科学领域:
- 传染性疾病 传染性疾病
- 病毒学 病毒学
- 公共卫生 公共卫生
背景情况:
- 现有的呼吸道病毒隔离指南是基于过时的传播模型.
- 最近的文献质疑滴滴传播假设,强调空气传播和接触路线.
- 需要基于证据的修订来优化患者隔离协议.
研究的目的:
- 评估一种新的呼吸道病毒隔离协议,包括个人防护设备和空气净化.
- 用后续采样中的Ct值来评估隔离缓解标准.
- 为了确定病毒分泌的持续时间和各种呼吸道病毒的传染性.
主要方法:
- 实施和评估了一种新的隔离协议.
- 使用Ct值作为病毒复制和传播能力的代理值 (Ct < 28).
- 在对RSV,HRV,hMPV,SARS-CoV-2,流感和PIV阳性患者进行了随访采样.
主要成果:
- 25%-50%的RSV,HRV,hMPV或SARS-CoV-2患者在第7天具有较高的病毒载荷 (Ct <28).
- 流感和PIV的病毒清除速度更快,在第7天Ct<28的比例分别只有7%和14%.
- 在没有后续检测的情况下停止隔离,对大多数研究的病毒构成持续病毒传播的风险.
结论:
- 对于流感阳性患者,没有后续检测的标准7天隔离期可能足够.
- 对于其他呼吸道病毒,如RSV,HRV,hMPV和SARS-CoV-2,持续感染超过7天是常见的.
- 修订的隔离指南,包括基于Ct值的标准,是防止医院传播的必要条件.
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