目的 通过处置1例新型冠状病毒IgM抗体检测单阳患者的应急措施复盘研究,进一步清晰应急处置工作的任务与流程,加强院内感染防控措施。方法 某医院在新冠肺炎疫情常态化防控中,妇产科对1例住院术后发热患者进行新冠病毒抗体主动筛查,发现该患者全血新冠病毒抗体IgM阳性。医院及时启动突发传染病疫情应急响应机制,固化工作场景,控制可疑病例,采用流行病学调查确定已有密切接触人员,并对相关医护人员及工勤人员立即进行咽拭子采样以及新型冠状病毒核酸检测;同步采集病区高频接触点位环境样本,用以评价医院环境清洁消毒效果等。结果 经过流行病学调查确定密切接触陪护人员4名、病区医护人员及工勤人员59名,以上人员新型冠状病毒核酸检测均为阴性;病区环境高频接触点位新型冠状病毒核酸均未检出,病区清洁消毒及终末消毒有效可靠。结论 经过及时对可疑患者及密切接触人员开展流行病学调查及核酸检测,排除患者受新型冠状病毒感染,解除可能发生的院内感染及社区传播警讯;同时也检验了医院防控体系能力,暴露了短板,为进一步强化常态化医院防控措施,迅速恢复正常医疗秩序提供了有益借鉴。

Objective To strengthen prevention and control of nosocomial infections by retrospectively analyzing procedures of emergency responses to a patient with single IgM antibody positivity.Methods A feverish patient at the Department of Obstetrics and Gynecology in a tertiary hospital was found positive for the coronavirus IgM antibody during the active screening. A series of emergency responses were initiated immediately. The source of infection was blocked and the possible transmission routes were cut off. Epidemiological investigations were conducted to identify close contacts, throat swab samples were taken and the medical staff had their nucleic acid detected. Environmental samples at high-frequency contact points in the ward were collected to evaluate the disinfection effects of the hospital.Results After epidemiological investigations, 4 carers of patients and 59 medical staffs in the wards were determined as close contacts, all of whom tested negative for coronavirus. No positive cases for coronavirus were detected at the high-frequency contact points in the ward environment. Environmental cleaning and disinfection were effective and reliable. The warnings about potential nosocomial and community infections warnings were lifted. The prevention and control system was tested and flaws were also disclosed.Conclusions This case has provided useful reference for normalized hospital prevention and control and for quick restoration of normal medical order.