SARS-CoV-2黏膜暴露后杀菌剂应用研究进展  

Research progress on the application of antiseptics after mucosal exposure of SARS-CoV-2

作　　者：倪晓平[1] 刘运喜[2] 金慧[1] 王慧敏 索继江[2,3] NI Xiao-ping;LIU Yun-xi;JIN Hui;WANG Hui-min;SUO Ji-jiang(Hangzhou Center for Disease Control and Prevention,Hangzhou,Zhejiang 310021,China;不详)

机构地区：[1]杭州市疾病预防控制中心,浙江杭州310021 [2]解放军总医院第一医学中心疾病预防控制科,北京100853 [3]解放军总医院海南医院疾病预防控制科,海南三亚572013

出　　处：《中华医院感染学杂志》2022年第12期1900-1905,共6页Chinese Journal of Nosocomiology

基　　金：“十三五”国家科技重大专项子课题(2018ZX10733-402-005)。

摘　　要：严重急性呼吸系统综合征-冠状病毒-2(SARS-CoV-2)感染途径包括飞沫、空气和接触传播,但是无论何种传播途径,病毒最终须经口、鼻、眼黏膜的暴露才能入侵人体。保障新型冠状病毒肺炎(COVID-19)防控一线医务人员的呼吸道防护是医院感染管理的首要任务之一。《医疗机构内新型冠状病毒感染预防与控制技术指南(第三版)》指出,发生呼吸道职业暴露可采用过氧化氢、碘伏等消毒口腔/鼻腔。但是,目前在医院感染管理领域中,相对于手卫生而言,“黏膜卫生”少有提及,尤其是呼吸道黏膜暴露于急性传染性呼吸道病原体后的处理,国内研究尚处于空白。本文经快速文献复习,发现一些杀菌剂在临床上已经普遍应用,诸如COVID-19疫情下口腔科患者诊疗程序前采用杀菌溶液漱口,择期手术患者鼻腔去定植预防手术部位感染,以及杀菌剂滴眼预防新生儿结膜炎。鉴于目前缺乏有效治疗SARS-CoV-2的抗病毒药物,不断出现的变异株可突破人体的免疫屏障,为此,本文推荐医务人员在发生SARS-CoV-2口、鼻、眼黏膜意外暴露后,采用杀菌剂进行应急黏膜消毒作为呼吸道防护的辅助措施。The transmission routes of SARS-CoV-2 include droplet, air and contact transmission, but regardless of the transmission route, the virus must eventually be exposed through the oral, nasal and ocular mucous membranes to invade the human body. Guaranteeing the respiratory protection of front-line medical staff in the prevention and control of COVID-19 is one of the primary tasks of nosocomial infection management. According to《Technical Guidelines for Prevention and Control of COVID-19 in Healthcare Settings(3 rd Edition)》,oral/nasal cavity can be disinfected with hydrogen peroxide, iodophor, in the event of occupational respiratory exposure. But, at the moment, In the field of nosocomial management, compared with hand hygiene, "mucosal hygiene" is rarely mentioned, especially the treatment of respiratory mucosa after exposure to acute infectious respiratory pathogens, which is still blank in the domestic research. After a rapid literature review, it is found that some antiseptics have been widely used in clinical practices, such as gargling with bactericidal solution before the diagnosis and treatment procedure for dental patients under covid-19 epidemic, nasal decolonization for patients undergoing elective surgery to prevent surgical site infection, and use of eye drops of antiseptics to prevent neonatal conjunctivitis. In view of the current lack of effective antiviral drugs for treatment of SARS-CoV-2, and the constantly emerging mutant strains can break through the immune barrier of human body, this paper recommends that medical personnel use antiseptics for emergency mucosal disinfection as an supporting measure for respiratory tract protection after accidental exposure to SARS-CoV-2 of oral, nasal and ocular mucosa.

关 键 词：严重急性呼吸系统综合征-冠状病毒-2 杀菌剂 黏膜暴露 黏膜消毒 消毒 

分 类 号：R187[医药卫生—流行病学]