新型コロナウイルス感染症院内クラスターの対応経験とそこから見えたクラスター対応アルゴリズム

　The novel coronavirus disease (COVID-19) pandemic that began in 2019 is yet to end, as of the summer of 2022. During the pandemic, community-acquired infections spread easily to healthcare-associated facilities, resulting in COVID-19 clusters among high-risk individuals that have been difficult to contain. Our regional base hospital also experienced a nosocomial cluster of COVID-19 in October 2020 that took 30 days to contain and affected 9 hospital staff and 14 patients. Six patients died due to COVID-19, and six died due to COVID-19-related complications. Two patients were discharged alive. Patient characteristics included ① advanced age (79.0±8.1 years), ② dementia (64.3%), ③ low Prognostic Nutrition Index (31.1 ±7.9), ④ zinc deficiency (50.2±13.1μg/dL), ⑤ vitamin C deficiency (1.6±1.9μg/mL), ⑥ elevated urea nitrogen-to-creatinine ratio (27.4±23.5), ⑦ anticancer and immunosuppressive drug use (78.6%), and ⑧ malignancy (75.6%). This cluster had a very high mortality rate, but the viral spread was contained in a short period. Algorithmizing the cluster response was crucial to controlling this cluster. We report on our actual cluster response algorithm, as well as our strategy and response procedure during the pandemic.

原著(Original)