The critical care response to a hospital outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection: an observational study.
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Auteurs : Hasan M. Al-Dorzi [Arabie saoudite] ; Abdulaziz S. Aldawood [Arabie saoudite] ; Raymond Khan [Arabie saoudite] ; Salim Baharoon [Arabie saoudite] ; John D. Alchin [Arabie saoudite] ; Amal A. Matroud [Arabie saoudite] ; Sameera M. Al Johany [Arabie saoudite] ; Hanan H. Balkhy [Arabie saoudite] ; Yaseen M. Arabi [Arabie saoudite]Source :
- Annals of intensive care [ 2110-5820 ] ; 2016.
Abstract
Middle East respiratory syndrome coronavirus (MERS-CoV) has caused several hospital outbreaks, including a major outbreak at King Abdulaziz Medical City, a 940-bed tertiary-care hospital in Riyadh, Saudi Arabia (August-September 2015). To learn from our experience, we described the critical care response to the outbreak.
DOI: 10.1186/s13613-016-0203-z
PubMed: 27778310
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Arabi@ngha.med.sa.</nlm:affiliation><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Intensive Care Department, Respiratory Services, College of Medicine, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, ICU 1425, PO Box 22490, Riyadh, 11426</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:27778310</idno><idno type="pmid">27778310</idno><idno type="doi">10.1186/s13613-016-0203-z</idno><idno type="wicri:Area/PubMed/Corpus">000F29</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000F29</idno><idno type="wicri:Area/PubMed/Curation">000F29</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000F29</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">The critical care response to a hospital outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection: an observational study.</title><author><name sortKey="Al Dorzi, Hasan M" sort="Al Dorzi, Hasan M" uniqKey="Al Dorzi H" first="Hasan M" last="Al-Dorzi">Hasan M. Al-Dorzi</name><affiliation wicri:level="1"><nlm:affiliation>ICU2 and TICU, Intensive Care Department, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.</nlm:affiliation><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>ICU2 and TICU, Intensive Care Department, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Aldawood, Abdulaziz S" sort="Aldawood, Abdulaziz S" uniqKey="Aldawood A" first="Abdulaziz S" last="Aldawood">Abdulaziz S. Aldawood</name><affiliation wicri:level="1"><nlm:affiliation>Intensive Care Department, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.</nlm:affiliation><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Intensive Care Department, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Khan, Raymond" sort="Khan, Raymond" uniqKey="Khan R" first="Raymond" last="Khan">Raymond Khan</name><affiliation wicri:level="1"><nlm:affiliation>Neuro-ICU, Intensive Care Department, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.</nlm:affiliation><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Neuro-ICU, Intensive Care Department, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Baharoon, Salim" sort="Baharoon, Salim" uniqKey="Baharoon S" first="Salim" last="Baharoon">Salim Baharoon</name><affiliation wicri:level="1"><nlm:affiliation>IMCU, Intensive Care Department, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.</nlm:affiliation><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>IMCU, Intensive Care Department, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Alchin, John D" sort="Alchin, John D" uniqKey="Alchin J" first="John D" last="Alchin">John D. Alchin</name><affiliation wicri:level="1"><nlm:affiliation>ICU2, King Abdulaziz Medical City, Riyadh, Saudi Arabia.</nlm:affiliation><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>ICU2, King Abdulaziz Medical City, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Matroud, Amal A" sort="Matroud, Amal A" uniqKey="Matroud A" first="Amal A" last="Matroud">Amal A. Matroud</name><affiliation wicri:level="1"><nlm:affiliation>TICU, King Abdulaziz Medical City, Riyadh, Saudi Arabia.</nlm:affiliation><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>TICU, King Abdulaziz Medical City, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Al Johany, Sameera M" sort="Al Johany, Sameera M" uniqKey="Al Johany S" first="Sameera M" last="Al Johany">Sameera M. Al Johany</name><affiliation wicri:level="1"><nlm:affiliation>Microbiology Laboratory, King Abdulaziz Medical City, Riyadh, Saudi Arabia.</nlm:affiliation><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Microbiology Laboratory, King Abdulaziz Medical City, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Balkhy, Hanan H" sort="Balkhy, Hanan H" uniqKey="Balkhy H" first="Hanan H" last="Balkhy">Hanan H. Balkhy</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infection Prevention and Control, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.</nlm:affiliation><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Infection Prevention and Control, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Arabi, Yaseen M" sort="Arabi, Yaseen M" uniqKey="Arabi Y" first="Yaseen M" last="Arabi">Yaseen M. Arabi</name><affiliation wicri:level="1"><nlm:affiliation>Intensive Care Department, Respiratory Services, College of Medicine, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, ICU 1425, PO Box 22490, Riyadh, 11426, Saudi Arabia. Arabi@ngha.med.sa.</nlm:affiliation><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Intensive Care Department, Respiratory Services, College of Medicine, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, ICU 1425, PO Box 22490, Riyadh, 11426</wicri:regionArea></affiliation></author></analytic><series><title level="j">Annals of intensive care</title><idno type="ISSN">2110-5820</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Middle East respiratory syndrome coronavirus (MERS-CoV) has caused several hospital outbreaks, including a major outbreak at King Abdulaziz Medical City, a 940-bed tertiary-care hospital in Riyadh, Saudi Arabia (August-September 2015). To learn from our experience, we described the critical care response to the outbreak.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">27778310</PMID><DateRevised><Year>2019</Year><Month>11</Month><Day>20</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">2110-5820</ISSN><JournalIssue CitedMedium="Print"><Volume>6</Volume><Issue>1</Issue><PubDate><Year>2016</Year><Month>Dec</Month></PubDate></JournalIssue><Title>Annals of intensive care</Title><ISOAbbreviation>Ann Intensive Care</ISOAbbreviation></Journal><ArticleTitle>The critical care response to a hospital outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection: an observational study.</ArticleTitle><Pagination><MedlinePgn>101</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s13613-016-0203-z</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Middle East respiratory syndrome coronavirus (MERS-CoV) has caused several hospital outbreaks, including a major outbreak at King Abdulaziz Medical City, a 940-bed tertiary-care hospital in Riyadh, Saudi Arabia (August-September 2015). To learn from our experience, we described the critical care response to the outbreak.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">This observational study was conducted at the Intensive Care Department which covered 5 ICUs with 60 single-bedded rooms. We described qualitatively and, as applicable, quantitatively the response of intensive care services to the outbreak. The clinical course and outcomes of healthcare workers (HCWs) who had MERS were noted.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Sixty-three MERS patients were admitted to 3 MERS-designated ICUs during the outbreak (peak census = 27 patients on August 25, 2015, and the last new case on September 13, 2015). Most patients had multiorgan failure. Eight HCWs had MERS requiring ICU admission (median stay = 28 days): Seven developed acute respiratory distress syndrome, four were treated with prone positioning, four needed continuous renal replacement therapy and one had extracorporeal membrane oxygenation. The hospital mortality of ICU MERS patients was 63.4 % (0 % for the HCWs). In response to the outbreak, the number of negative-pressure rooms was increased from 14 to 38 rooms in 3 MERS-designated ICUs. Patients were managed with a nurse-to-patient ratio of 1:0.8. Infection prevention practices were intensified. As a surrogate, surface disinfectant and hand hygiene gel consumption increased by ~30 % and 17 N95 masks were used per patient/day on average. Family visits were restricted to 2 h/day. Although most ICU staff expressed concerns about acquiring MERS, all reported to work normally. During the outbreak, 27.0 % of nurses and 18.4 % of physicians working in the MERS-designated ICUs reported upper respiratory symptoms, and were tested for MERS-CoV. Only 2/196 (1.0 %) ICU nurses and 1/80 (1.3 %) physician tested positive, had mild disease and recovered fully. The total sick leave duration was 138 days for nurses and 30 days for physicians.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Our hospital outbreak of MERS resulted in 63 patients requiring organ support and prolonged ICU stay with a high mortality rate. The ICU response required careful facility and staff management and proper infection control and prevention practices.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Al-Dorzi</LastName><ForeName>Hasan M</ForeName><Initials>HM</Initials><AffiliationInfo><Affiliation>ICU2 and TICU, Intensive Care Department, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Aldawood</LastName><ForeName>Abdulaziz S</ForeName><Initials>AS</Initials><AffiliationInfo><Affiliation>Intensive Care Department, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Khan</LastName><ForeName>Raymond</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Neuro-ICU, Intensive Care Department, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Baharoon</LastName><ForeName>Salim</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>IMCU, Intensive Care Department, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Alchin</LastName><ForeName>John D</ForeName><Initials>JD</Initials><AffiliationInfo><Affiliation>ICU2, King Abdulaziz Medical City, Riyadh, Saudi Arabia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Matroud</LastName><ForeName>Amal A</ForeName><Initials>AA</Initials><AffiliationInfo><Affiliation>TICU, King Abdulaziz Medical City, Riyadh, Saudi Arabia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Al Johany</LastName><ForeName>Sameera M</ForeName><Initials>SM</Initials><AffiliationInfo><Affiliation>Microbiology Laboratory, King Abdulaziz Medical City, Riyadh, Saudi Arabia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Balkhy</LastName><ForeName>Hanan H</ForeName><Initials>HH</Initials><AffiliationInfo><Affiliation>Department of Infection Prevention and Control, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Arabi</LastName><ForeName>Yaseen M</ForeName><Initials>YM</Initials><AffiliationInfo><Affiliation>Intensive Care Department, Respiratory Services, College of Medicine, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, ICU 1425, PO Box 22490, Riyadh, 11426, Saudi Arabia. Arabi@ngha.med.sa.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>10</Month><Day>24</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Ann Intensive Care</MedlineTA><NlmUniqueID>101562873</NlmUniqueID><ISSNLinking>2110-5820</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Critical care</Keyword><Keyword MajorTopicYN="N">Disaster planning</Keyword><Keyword MajorTopicYN="N">Disease outbreak</Keyword><Keyword MajorTopicYN="N">Middle East respiratory syndrome</Keyword><Keyword MajorTopicYN="N">Saudi Arabia</Keyword><Keyword MajorTopicYN="N">Severe acute respiratory infection</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate 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