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SARS-CoV-2 environmental contamination in COVID-19 patient rooms in a VA medical center
- Kristen Gibson, Jennifer Ridenour, Kyle Carver, Julia Mantey, Jane Deng, Lona Mody
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- Journal:
- Antimicrobial Stewardship & Healthcare Epidemiology / Volume 2 / Issue S1 / July 2022
- Published online by Cambridge University Press:
- 16 May 2022, pp. s76-s77
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- Article
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Background: SARS-CoV-2, the virus causing COVID-19 infection, can significantly contaminate environmental surfaces and can remain viable on surfaces for up to 9 days. Although respiratory route remains the most significant mode of transmission, fomites and environmental sources of infection remain a concern for healthcare personnel who are working in dedicated COVID-19 units. We investigated the extent of detectable SARS-CoV-2 contamination in the environment of COVID-19 patients at a single VA hospital, with the intent of identifying potential high-touch surfaces at risk for viral contamination, which could be used to inform the development of simple COVID-19 prevention strategies. Methods: We conducted a cohort study at 1 VA hospital in a unit housing adult veterans admitted with COVID-19 between October and December 2020. In total, 11 swab specimens were collected for PCR analysis (SARS-CoV-2 env gene) from environmental surfaces inside and just outside the rooms of COVID-19 patients one time. Retrospective chart reviews were conducted to provide the SARS-CoV-2 epidemiologic context for environmental detection. Results: In total, 297 swabs were collected from the unit and environmental areas surrounding 27 hospitalized patients: average age, 72.5 years (range, 34–94); 100% male; 92% non-Hispanic white; average comorbidities, 1.8 (SD, 1.1). Of 297 swabs, 80 (27%) were positive for SARS-CoV-2 and 19 (70%) of 27 patients had at least 1 positive site. The most contaminated site was the floor just outside the patient room (78% positive samples), followed by the patient’s bedrail (37%) and chair handle (37%) (Fig. 1). Traditionally high-touch surfaces, such as the door handle (outside patient room) and the light switch, did not have high positivity rates (<15%). Interestingly, both the personal protective equipment (PPE) cart outside patient’s room (33%) and the double doors leading out of the unit (19%) were positive, which are surfaces often touched with bare hands after handwashing. Analyses of clinical data are underway to examine whether specific care needs, based on activities of daily living disability, comorbidities, and clinical presentation of COVID-19, predict SARS-CoV-2 environmental contamination. Conclusions: The presence of environmental contamination by SARS-CoV-2 highlights the importance of transmission via direct or indirect contact. Studies targeting high-risk populations are needed to better understand the transmission of SARS-CoV-2 between infected patients and their environment. Our findings also suggest that handwashing and attention to using disinfecting wipes may mitigate the risk of transmission of virus from surfaces that one might consider safe to touch.
Funding: None
Disclosures: None
19 - Conditionally essential nutrients: choline, inositol, taurine, arginine, glutamine and nucleotides
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- By Jane Carver, Department of Pediatrics, University of South Florida College of Medicine, Tampa, FL
- Patti J. Thureen, University of Colorado at Denver and Health Sciences Center
- Edited by William W. Hay, University of Colorado at Denver and Health Sciences Center
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- Book:
- Neonatal Nutrition and Metabolism
- Published online:
- 10 December 2009
- Print publication:
- 04 May 2006, pp 299-311
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- Chapter
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Summary
Introduction
The term “conditionally essential” has been used to describe the role of choline, inositol, taurine, arginine, glutamine, and nucleotides in human nutrition. The biochemical pathways to synthesize these nutrients are present, and their absence from the diet does not lead to a classical clinical deficiency syndrome. However, under certain conditions, the biosynthetic capacity may be below functional metabolic demands. The conditions under which these nutrients may become essential include prematurity, certain disease states, periods of limited nutrient intake or rapid growth, and the presence of regulatory or developmental factors that interfere with full expression of the endogenous synthetic capacity. Under these conditions, dietary intake of the nutrient may optimize tissue function.
Several of the conditionally essential nutrients are present in significantly higher quantities in human milk versus infant formulas, and several are added to term and/or preterm formulas. On-going research will help to clarify their roles in neonatal nutrition and metabolism.
Choline
Choline was classified in 1998 as an essential nutrient for humans by the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences. The Board recognized that fetal development and infancy constitute periods of increased demand for choline. The classification of choline as an essential nutrient will likely stimulate renewed interest and research in its role in the developing infant.
Choline has a variety of biological functions. It is a precursor for the neurotransmitter acetylcholine, and for two signaling lipids, platelet-activating factor and sphingosylphosphorylcholine.