Abstract
ObjectiveTo evaluate the microbial loading in aerosols produced after air-puff by non-contact tonometer (NCT) as well as the effect of alcohol disinfection on the inhibition of microbes and thus to provide suggestions for the prevention and control of COVID-19 in ophthalmic departments of hospitals or clinics during the great pandemics.MethodsA cross-sectional study was carried out in this study. A NIDEK NCT was used for intraocular pressure (IOP) measurement for patients who visited Department of Ophthalmology in Qilu Hospital of Shandong University during March 18–25 2020. After ultra-violate (UV) light disinfection, the room air was sampled for 5 minutes. Before and after alcohol disinfection, the air samples and nozzle surface samples were respectively collected by plate exposure method and sterile moist cotton swab technique after predetermined times of NCT air-puff. Microbial colony counts were calculated after incubation for 48 hours. Finally, mass spectrometry was performed for the accurate identification of microbial species.ResultsIncreased microbial colonies were detected from air samples close to NCT nozzle after air-puff compared with air samples at a distance of 1 meter from the nozzle (p = 0.001). Interestingly, none microbes were detected on the surface of NCT nozzle. Importantly, after 75% alcohol disinfection less microbes were detected in the air beside the nozzle (p = 0.003). Microbial species identification showed more than ten strains of microbes, all of which were non-pathogenic.ConclusionAerosols containing microbes were produced by NCT air-puff in the ophthalmic consultation room, which may be a possible virus transmission route in the department of ophthalmology during the COVID-19 pandemic. Alcohol disinfection for the nozzle and the surrounding air was efficient at decreasing the microbes contained in the aerosols and theoretically this prevention measure could also inhibit the virus. This will give guidance for the prevention of virus transmission and protection of hospital staff and patients.
Highlights
At the time of this publication, the coronavirus disease of 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global public health emergency [1, 2]
Increased microbial colonies were detected from air samples close to non-contact tonometer (NCT) nozzle after airpuff compared with air samples at a distance of 1 meter from the nozzle (p = 0.001)
Aerosols containing microbes were produced by NCT air-puff in the ophthalmic consultation room, which may be a possible virus transmission route in the department of ophthalmology during the COVID-19 pandemic
Summary
At the time of this publication, the coronavirus disease of 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global public health emergency [1, 2]. SARS-CoV-2 is spread through respiratory droplets and direct contact. Droplet transmission of virus is via larger respiratory particles, generally above 5μm in diameter, which tends to travel no more than one meter. Contact transmission occurs when the virus remains on the surface and becomes a potential source of infection. Attention has been directed toward the possibility of transmission of SARS-CoV-2 virus through aerosols [5]. In the latest diagnosis and treatment plan issued by the National Health Commission (NHC) of China, "aerosol transmission" was added to the "droplet respiratory particles and close contacts" as one of the major transmission routes of SARS-CoV-2 [6]
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